Oral health in home care: Perspectives and experiences of dentists in a Brazilian region.

INTRODUCTION: Home care provided by dentists is crucial for ensuring adequate oral care. However, oral health professionals face challenges in delivering treatment at patients' residences due to a lack of resources. Our objective was to explore dentists' perspectives and experiences of dental home care and potential challenges for its implementation. METHODS: The study took a qualitative approach. Guided by a semi-structured interview schedule, data were gathered using recorded interviews with 22 dental professionals. After transcription, data were analysed thematically using the Discourse of the Collective Subject (DCS) method, using Qualiquantisoft. RESULTS: The majority of participants were female (n = 20), aged between 30 and 40 years old, and predominantly specialising in primary care (n = 6) or endodontics (n = 6). All participants provided home care, performing general dental procedures, normally responding to requests from the work team (n = 13) or family (n = 7). Six main categories on to the topic emerged: importance and access to home care, procedures performed during home visits, discussions about post-home care, professional competence and patient-centred care, positive aspects of home care, and negative aspects and challenges faced in this type of care. CONCLUSION: This study highlights the fundamental, yet complex, role of home care in dentistry. Continuity of treatment through adaptability and a patient-centred approach are important.

Systematic review: Impact of parental decision on paediatric COVID-19 vaccination.

OBJECTIVE: The objective was to carry out a systematic review on the acceptance of parents to vaccinate their children against COVID-19 and the factors that contribute for vaccination hesitancy. METHODS: The Preferred Reporting Items for Systematic Re- views and Meta-Analyses (PRISMA) guidelines and the Patient, Intervention, Comparison and Outcome (PICO) strategy were followed. A search was carried out in the VHL Regional Portal, PubMed, Scielo, Web of Science, Embase and Scopus databases. We included articles that assessed the rate of acceptance and/or hesitation of parents and the factors that affect the decision about vaccination against COVID-19 for their children in cross-sectional studies. Laboratory studies, animal models, tests and case reports that elected other aspects related to COVID-19 were excluded. The methodological quality of the studies was based on the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data, developed by the Joanna Briggs Institute. RESULTS: From the 708 articles found, 237 studies remained after removal of duplicates. Titles and abstracts of these publications were evaluated and, applying the exclusion criteria, 56 articles were selected. Inclusion criteria were employed and 28 studies were eligible. Overall average vaccination acceptance rate was 55.81%, and the main reasons for vaccine hesitancy were uncertainty of vaccine efficacy and safety, concerns about side effects, and lack of access to relevant information. CONCLUSION: The research results can be useful for the development of health education and parental awareness strategies in order to promote greater adherence to vaccination against COVID-19.

COVID-19 and changes in dental practices in the Brazilian Public Health System: perception of the oral health team.

The aim of this study was to verify the perception of the oral health team regarding work safety and aspects related to changes in dental practices during the COVID-19 pandemic. A descriptive, exploratory, quantitative, and qualitative cross-sectional study was conducted using an electronic questionnaire sent via email to health professionals (n = 197) affiliated with the Brazilian Public Health System (SUS), from December 2020 to September 2021, in a municipality located in the northeast of the state of São Paulo, Brazil. The variables of interest were sociodemographic characteristics and those related to the professionals' perception of oral health care during the pandemic and its impact on these workers' occupational safety. Descriptive statistics were performed, and the absolute and relative frequencies of quantitative variables were calculated, whereas lexical analysis was performed for textual content using the descending hierarchical classification (CHD). Out of the total sample, elective and urgent/emergency care was provided by 58.95% (n = 56); physical barriers were absent between the teams in 54.74% (n = 52); minimally invasive techniques were applied in 71.58% (n = 68); personal protective equipment (PPE) was replaced in 81.05% (n = 77) between appointments; and occupational safety was reported by 49.47% (n = 47). Textual analysis showed a decrease in appointments and consultations, with a longer interval between appointments. The professionals noticed changes in dental practices during the pandemic, mainly regarding the use of PPE, the type of treatment performed, the number of treated patients, and the greater time interval between consultations. The physical infrastructure of health units and the availability of PPE to patients needed some adjustments. A significant number of workers felt safe in providing dental care during the pandemic.

Analysis of the Dental Caries Epidemiological Profile in Children of Benguela city, Angola.

PURPOSE: To analyse the epidemiological profile of dental caries in children aged 5 and 12 years in the city of Benguela, Angola. MATERIALS AND METHODS: This was an observational, analytical, cross-sectional study conducted in 2019 with 190 12-year-old schoolchildren and 240 5-year-old schoolchildren from the public education system in Benguela, Angola. The relationship between dental caries and dental characteristics, sociodemographic factors, access to dental services, oral hygiene practices, and eating habits was analysed. Dental condition was evaluated using the dmft and decayed, missing, and filled teeth (DMFT) indices. RESULTS: It was found that 62.63% (n = 119) of 12-year-old students and 42.08% (n = 101) of 5-year-old students were free from dental caries. The average DMFT was 0.76 + 1.35 and dmft was 2.19 + 2.95. The majority of children (56.51%) had never been to the dentist, had no dental elements restored, and none of the students used dental floss. The proportion of students who consumed sweets every day was higher at 5 years of age (46.25%) than at 12 years of age (22.63%). There was a statistically significant association (P = 0.01) between the higher incidence of dental caries and peri-urban location among 5-year-old schoolchildren. CONCLUSION: This study showed that the prevalence of dental caries in the permanent dentition of schoolchildren in Benguela is very low; however, the situation is critical in the primary dentition, especially in the peri-urban area. The limited access to dental surgeons and lack of treatment for affected teeth highlight the need to implement and develop public policies to promote oral health.

Knowledge and attitude of women with high-risk pregnancy about the Zika virus transmission. / Conhecimento e atitude das gestantes de alto risco sobre a transmissibilidade do vírus zika.

Objective was to analyze the knowledge and attitude of high risk pregnant women about zika. This is a cross-sectional study, quantitative, with a sample of 201 high risk women who perform prenatal the Ambulatory Medical Specialties. A self-administered instrument, was applied after consultation with the doctor. Inclusion criteria were the presence of pregnant women on the day of the interview and their consent to participate. Exclusion criteria were those who did not agree to participate and were not performing prenatal care during the study period. For the data analysis we used chi square and fisher exact, in software Epi info 7.1 and Bioestat 5.0. Of the pregnant women, 76% believed that their neighborhood was likely to be infected by the virus and used measures to control mosquito proliferation, such as not leaving standing water (n = 154). In relation to knowledge, there was an association between Zika and microcephaly (p≤ 0.0001) and the need for more information (p = 0.0439). To prevent infection, 76% took no action, there was an association between the need for knowledge about the subject and the actions taken to combat the virus (p = 0.0049). We conclude that pregnant women's knowledge and attitude about zika is failed.

Objetivou analisar o conhecimento e a atitude das gestantes de alto risco sobre a zika. Trata-se de um estudo transversal, quantitativo, com amostra de 201 gestantes de alto risco, que realizam pré-natal no Ambulatório Médico de Especialidades. Aplicou-se um instrumento auto administrado, aplicados após a consulta com o médico. Os critérios de inclusão utilizados foram a presença das gestantes no dia da entrevista e seu consentimento de participação. Os de exclusão as que não aceitaram participar e não estarem realizando o pré natal no período do estudo. Para análise de dados, utilizou-se qui-quadrado e exato de Fisher, nos softwares Epi info 7.1 e Bioestat 5.0. Das gestantes, 76% acreditavam que, em seu bairro, é provável a infecção pelo vírus e utilizam medidas para controlar a proliferação do mosquito, como não deixar água parada (n = 154). Em relação ao conhecimento, houve associação entre a zika e a microcefalia (p ≤ 0,0001) e o apontamento da necessidade de mais informações (p = 0,0439). Para impedir o contágio, 76% não tomaram nenhuma atitude; houve, ainda, associação entre a necessidade de conhecimento sobre o assunto e as ações realizadas no combate ao vírus (p = 0,0049). Conclui-se que o conhecimento e a atitude das gestantes sobre a zika é falho.

[A quantitative and qualitative study of exclusive breastfeeding intention by high-risk pregnant women]. / Estudo quanti-qualitativo sobre amamentação exclusiva por gestantes de alto risco.

The scope of this research was to assess the breastfeeding intention among high-risk pregnant women and related factors. It is a cross-sectional, qualitative and quantitative study, with 1,118 high-risk pregnant women who attended the prenatal care unit at a specialized center of the Unified Health System. The dependent variables were exclusive breastfeeding intention, intended duration and conditions that might interfere with breastfeeding. The Epi Info 7.4.1, Bioestat 5.3 and IRAMUTEQ 0.7.2.0 programs were used for data processing. The results showed that 8.76% of the pregnant women had conditions that could affect lactation. Among the women, 93.83% affirmed having exclusive breastfeeding intention, of which 69.86% intended to breastfeed until the child was six months old, revealing an association with sociodemographic variables (p<0.05). The intended breastfeeding duration was related to the age (p=0.0041), marital status (p=0.0053) and level of education (p=0.0116). The main reasons reported for not providing exclusive breastfeeding were the following: HIV, use of medications, work and lack of information. This research concluded that a small cohort of high-risk pregnant women presented conditions that could interfere with breastfeeding. Most of them intended to breastfeed exclusively for six months.

A cross-sectional study on dental surgeons' immune status against hepatitis B virus in the Public Health System.

Hepatitis B is a severe public health problem. The main world health centers have discussed it due to its pandemic proportion, high pathogenicity and infectivity. This study aimed to determine the immunization profile of dental surgeons - against hepatitis B virus (HBV) in the Public Health System (PHS) through the detection of anti-HBsAg antibodies by immunochromatography and associations with dental surgeons' social and educational profile, factors related to professional knowledge and practices. This is a cross-sectional study on the prevalence of vaccination and immune status to HBV in dentists of Sao Paulo State PHS. Data collection occurred in three stages: questionnaire application, analysis of adhesion to the vaccination protocol and anti-HBsAg tests. Statistical analysis used the Bivariate Analysis and the Binary Logistic Regression. From the total of 219 interviewees, 74.9% reported having received three doses of the vaccine, but 35.6% were not immune to HBV. The dependent variable was associated with years in the public service (years) (OR [Odds Ratio]=1.04; 95% CI 1.00-1.08); knowledge on the subject (OR=6.93; 95% CI 1.39-34.40); incorrect answer concerning the etiological agent of the disease (OR=2.60; 95% CI 1.30-5.22); ignorance on the number of vaccine doses that have been administered (OR=3.43; 95% CI 1.14-10.30); and less than three doses of the vaccine in the immunization schedule (OR=8.76; 95% CI 3.50-21.91). A considerable portion of professionals non-immune to the HBV were found. We concluded that knowledge, years of practice and completion of the vaccination schedule (three doses) affected dental surgeons' immune status to HBV.

Health surveillance: public water supply fluoridation in 40 municipalities of São Paulo, Brazil. / Vigilância em saúde: fluoretação das águas de abastecimento público em 40 municípios do estado de São Paulo, Brasil.

Since fluoridation of water is an established public health measure for the prevention of dental caries and considering that monitoring of the method is crucial to its success, this study aimed to analyze the results of the analysis of the fluorine content of public water supply of 40 municipalities in the state of São Paulo, from November 2004 to December 2016. Samples were analyzed monthly using the potentiometric method. Of the 32,488 samples, 50.94% contained fluoride levels within the recommended range. In 2004, it was verified that 21 cities (52.50%) had mean levels within the recommended parameter, increasing to 32 cities (80.00%) in 2016. It was observed that 15 municipalities that initially had levels of fluoride below 0.55 mgF/L in their water supply adjusted to adequate levels during the project. In the first year of the study, 47.76% of the samples had values in the recommended range, which increased to 58.22% in 2016. Most of the municipalities adjusted the levels of fluoride in their waters over the years, evidencing the performance of heterocontrol programs as important strategies that assist in the monitoring of the method and have significant participation in the control of the water quality supplied to the population.

Sendo a fluoretação das águas uma medida de saúde pública consagrada na prevenção de cárie dentária e considerando que a vigilância do método é fundamental para o seu sucesso, este estudo objetivou analisar os resultados das análises dos teores de flúor das águas de abastecimento público de 40 municípios do estado de São Paulo, de novembro de 2004 a dezembro de 2016. A análise das amostras foi realizada mensalmente por meio do método potenciométrico. De 32.488 amostras, 50,94% continham níveis de flúor dentro do intervalo recomendado. Em 2004, verificou-se que 21 cidades (52,50%) apresentaram teores médios dentro do parâmetro recomendado, passando, em 2016, para 32 cidades (80,00%). Observou-se que 15 municípios que possuíam inicialmente níveis de flúor abaixo de 0,55 mgF/L em suas águas de abastecimento adequaram-se no decorrer do projeto. No primeiro ano do estudo, 47,76% das amostras possuíam valores no intervalo preconizado e, em 2016, houve um aumento para 58,22%. Foi verificado que no decorrer dos anos, a maioria dos municípios adequou os níveis de flúor em suas águas, evidenciando a atuação dos programas de heterocontrole como importantes estratégias que auxiliam na vigilância do método, tendo participação fundamental no controle da qualidade da água ofertada à população.

Quality of life of people with HIV/AIDS - the influence of social determinants and disease-related factors.

INTRODUCTION: This study assessed the quality of life (QoL) of people with HIV/AIDS. METHODS: This cross-sectional epidemiological study was conducted at a specialized HIV/AIDS health facility of the Brazilian Public Health Service. Data were collected using the HIV/AIDS-Targeted Quality of Life (HAT-QoL) instrument. RESULTS: The study included 109 participants. Among the many significant statistical associations found in the study, the variables that had a greater effect on the domains assessed by the instrument were educational level, occupation, financial situation, ethnicity, and symptomatology. CONCLUSIONS: Sociodemographic factors and HIV/AIDS-related aspects were influential in the QoL of people living with HIV/AIDS.

Caries Experience in Preschool Children over a 10-year Period.

PURPOSE: To analyse the caries experience in preschool children at two moments 10 years apart. MATERIALS AND METHODS: Two cross-sectional epidemiological studies, the first in 2006 (n = 275) and the second in 2016 (n = 258), were carried out with samples composed of children from 3 to 6 years of age. All children were enrolled in the municipal schools of basic education of a municipality in northwest São Paulo state, and they attended an annual and continuous oral health education programme. Caries experience was calculated for deciduous and permanent teeth using the dmft and DMFT indices, according to the World Health Organization (WHO). Statistical analysis was performed using Epi info 7.1 and Bioestat 5.0 software. RESULTS: In 2006, the mean dmft index was 1.88, with 7.59% of teeth having caries experience. In 2016, the mean dmft index was 0.99, with 5.15% of teeth showing caries experience. In contrast, in 2006, the mean DMFT index was 0.08 (n = 509), with 4.1% of teeth with caries experience; in 2016, the mean DMFT index was 0.06 (n = 381) and 3.6% of teeth showed caries experience. The proportions of teeth with caries experience differed statistically significantly (p = 0.435). In the last study, 78.2% of the children were caries free, below the WHO target for 2020. The Significant Caries Index (SiC Index) was 0.2. CONCLUSION: A decline of caries experience in the deciduous dentition was found in the study population.

Clinical and Microbiological Analysis of Mechanical and Chemomechanical Methods of Caries Removal in Deciduous Teeth.

PURPOSE: This study evaluated carious tissue removal by mechanical and chemomechanical methods (Carisolv and Papacárie) through colony-forming unit (CFU) counts of Streptococcus mutans and Lactobacillus sp. Treatment acceptability, presence and level of pain, use of anesthesia, time required for caries removal and pain 24 h after treatment were also compared. MATERIALS AND METHODS: A clinical trial with 32 individuals who had at least two deciduous molars with active occlusal caries lesions were selected and randomly divided into two groups (I and II). One lesion in each individual was excavated with hand excavator only. The remaining lesions were excavated using modified hand excavation and Carisolv in group 1 or modified hand-excavation and Papacárie in group 2. Bacterial samples were taken from each caries lesion before and after treatment. RESULTS: All the methods reduced the amount of cultivable Streptococcus mutans and Lactobacillus sp. after treatment (p < 0.05) and no statistically significant difference was found between the groups (p > 0.05). There was 97% acceptability of treatments, and anesthesia was used in 14% of teeth. Pain was present 24 h after treatment in 6% of teeth. The mean times for caries removal by the mechanical and chemomechanical treatments were not statistically significantly different (p > 0.05). CONCLUSIONS: All treatments were found to effectively reduce bacterial counts (p < 0.05). There were no statistically significant differences (p > 0.05) among treatments or between clinical variables (p > 0.05).

Caries in children with lactose intolerance and cow's milk protein allergy.

Dental caries in 5-to-8-year-old children with cow's milk protein allergy (CMPA) and lactose intolerance (LI), their treatment needs, and the consumption of milk-based products and milk derivatives by these patients were investigated. A cross-sectional study was undertaken with 200 children in southern Brazil in 2017. The clinical examination was based on the World Health Organization criteria and a questionnaire was sent to parents or legal guardians to collect information on the children's food intake, pre-existing systemic diseases, medication use, and CMPA and LI. Standardization was performed to verify concordance among examiners (kappa = 0.96). Caries prevalence was 67.50% in children with CMPA or LI, but 34.37% in those without these conditions. The mean dmft (decayed, missing, and filled teeth) index in children with CMPA or LI was 1.75 ± 1.84, significantly higher than among non-allergic or lactose-tolerant children (0.83 ± 1.60) (p < 0.001). In children with CMPA or LI, the mean for treatment needs was 1.58 ± 1.50. Lactose-free milk was the most frequently consumed food among allergic/intolerant children (65.00%), with a mean dmft of 2.00 ± 2.08, higher than that obtained for those without CMPA/LI (0.82 ± 0.87), showing no significant difference (p = 0.129). Although dental caries and treatment needs in primary dentition were associated with CMPA or LI, children's intake of replacement foods did not pose any risk for the development of carious lesions. Statistically significant differences were obtained for the prevalence and severity of dental caries. This shows the need for treatment of children with CMPA or LI, who had the worst caries prevalence and severity rates.

Influence of oral health on the quality of life of institutionalized and noninstitutionalized elderly people.

BACKGROUND: This study aimed to determine the perception of institutionalized (G1) and noninstitutionalized (G2) elderly people on oral health and quality of life (QOL). MATERIALS AND METHODS: This cross-sectional, exploratory study applied two instruments - the Geriatric Oral Health Assessment Index (GOHAI) and the World Health Organization QOL-Bref (WHOQOL-BREF) - in two cities of the state of Sao Paulo, Brazil. Among the institutionalized elderly, G1 (n = 150), 50% were not mentally able to answer the questions correctly, 12% did not answer all the questions, and 7.34% refused to take part in the research or were too frail or dependent, resulting in 31 institutionalized participants. In the noninstitutionalized group, G2 (n = 80), 52.50% refused to take part in the research, resulting in 38 noninstitutionalized participants. The elderly individuals (i) who did not respond to three or more questions of the GOHAI, (ii) those who did not answer all the questions of the WHOQOL-Bref, and (iii) those who did not consent to participate in the research study were excluded from the study population (P < 0.05 consider significant). RESULTS: The oral health of both groups minimally affected the QOL of the elderly. The WHOQOL-Bref score varied between the two study groups mainly in terms of physical domain and self-perception of QOL. The study groups showed differences in some variables: self-perception of QOL (P = 0.0209), mobility (P = 0.0057), and access to health services (P = 0.0252). G2 presented the best conditions. CONCLUSION: The oral health condition of both groups minimally affected the QOL of the participants; however, differences in the self-perception of QOL were significant, mainly in the physical domain.

COVID-19 and changes in dental practices in the Brazilian Public Health System: perception of the oral health team

Abstract The aim of this study was to verify the perception of the oral health team regarding work safety and aspects related to changes in dental practices during the COVID-19 pandemic. A descriptive, exploratory, quantitative, and qualitative cross-sectional study was conducted using an electronic questionnaire sent via email to health professionals (n = 197) affiliated with the Brazilian Public Health System (SUS), from December 2020 to September 2021, in a municipality located in the northeast of the state of São Paulo, Brazil. The variables of interest were sociodemographic characteristics and those related to the professionals' perception of oral health care during the pandemic and its impact on these workers' occupational safety. Descriptive statistics were performed, and the absolute and relative frequencies of quantitative variables were calculated, whereas lexical analysis was performed for textual content using the descending hierarchical classification (CHD). Out of the total sample, elective and urgent/emergency care was provided by 58.95% (n = 56); physical barriers were absent between the teams in 54.74% (n = 52); minimally invasive techniques were applied in 71.58% (n = 68); personal protective equipment (PPE) was replaced in 81.05% (n = 77) between appointments; and occupational safety was reported by 49.47% (n = 47). Textual analysis showed a decrease in appointments and consultations, with a longer interval between appointments. The professionals noticed changes in dental practices during the pandemic, mainly regarding the use of PPE, the type of treatment performed, the number of treated patients, and the greater time interval between consultations. The physical infrastructure of health units and the availability of PPE to patients needed some adjustments. A significant number of workers felt safe in providing dental care during the pandemic.

Ansiedade dos profissionais da atenção primária à saúde na pandemia de COVID-19 / Anxiety in Primary Health Care professionals during the COVID-19 pandemic

Fundamentos: O desequilíbrio entre o dever profissional e o medo na COVID-19 causaram instabilidade emocional nos trabalhadores da saúde. Objetivos: Avaliar a ansiedade dos profissionais da Atenção Primária à Saúde (APS) e fatores associados e analisar a percepções, positivas e negativas, da pandemia. Metodologia: Estudo transversal descritivo-exploratório, quanti-qualitativo, com profissionais da APS, em município do Estado de São Paulo, Brasil, de dezembro/2020 a março/2021. Realizou-se estatística descritiva e aplicou-se, ao nível de 5%, o teste Qui-quadrado. Para o conteúdo textual, efetuou-se a análise léxica pela Classificação Hierárquica Descendente. Principais resultados: Foi identificado que mais de 50% dos participantes apresentaram ansiedade e ela esteve associada ao fato de ter contraído COVID-19 (p-valor = 0.0327); à interferência nas atividades diárias (P-valor < 0.0001) e com a profissão (p-valor = 0.0483). Os pontos negativos foram a saúde mental; condições de trabalho; atendimentos e comportamento. Os positivos foram biossegurança, autocuidado e uso de equipamentos de proteção individual. Conclusões: A maioria dos profissionais da APS apresentou ansiedade e esteve associada aos fatores sociodemográficos. A pandemia trouxe pontos positivos e negativos na ótica dos profissionais da APS (AU).

Fundaments: The imbalance between professional duty and fear during the in COVID-19 pandemic caused emotional instability in health workers. Objectives: To assess anxiety in Primary Health Care (PHC) professionals and associated factors and analyze the positive and negative perceptions of the pandemic. Methodology: This is a descriptive-exploratory, quantitative and qualitative cross-sectional study, with PHC professionals, in a municipality in the state of São Paulo, Brazil, from December 2020 to March 2021. Descriptive statistics were carried out, and the chi-square test was applied at the 5% level. For textual content, lexical analysis was carried out by Descending Hierarchical Classification. Main results: It was identified that more than 50% of participants had anxiety, and it was associated with having contracted COVID-19 (p-value = 0.0327), interference with daily activities (p-value < 0.0001) and occupation (p-value < 0.0001) -value = 0.0483). Negative points were mental health, working conditions, service and behavior. Positive points were biosafety, self-care and personal protective equipment use. Conclusions: Most PHC professionals presented anxiety, and it was associated with sociodemographic factors. The pandemic brought positive and negative points from PHC professionals' perspective (AU).

The impact of the COVID-19 pandemic on dental practice in Brazil / O impacto da pandemia de COVID-19 na prática odontológica no Brasil

INTRODUCTION: Dentists are at high risk of contamination by COVID-19 due to the proximity to the patients' oral cavity and airways. OBJECTIVE: To elucidate thebehaviors and adversities experienced by dentists because of the COVID-19 pandemic. METHODS: This descriptive study invited 1.811 dentists affiliated with professional associations, dental cooperatives, and health insurance providers from São Paulo State, Brazil, in 2020 of which 473 agreed to participate. The data collection, using Google Forms, included the variables: sociodemographic conditions; characteristics of dental work; level of healthcare and sources of information about the pandemic; changes in the work process, financial impact with personal protective equipment (PPE) andbiosafety measures; and consequences of the pandemic in the professional practice. RESULTS: The 473 dentists (40.36±13.44 years), were mostly women (52.22%), had a specialty (55.60%), and were self-employed professionals (73.36%). It was observed that 78.01% of professionals had a reduction in their monthly income. The average ofpatients treated daily decreased by 35.48%. It was found that 30.44% of professionalshad difficulty with the use of PPE, 3.59% contracted COVID-19, and 53.03% decided to postpone the appointment if the patient with suspected or confirmed COVID-19 sought treatment, even in emergencies. The use of high-speed handpieces was reported by most professionals (n=428; 90.48%). CONCLUSION: Behaviors: dentists used PPE and assigned very high or high levels of precaution about COVID-19. Adversities: dentists reported an increase in operating costs, changes in the work process, a decrease in appointments, and a reduction in the monthly income.

INTRODUÇÃO: Os cirurgiões-dentistas apresentam alto risco de contaminação pelo COVID-19 devido à proximidade com a cavidade oral e vias aéreas dos pacientes. OBJETIVO: Elucidar os comportamentos e adversidades vivenciados por cirurgiões-dentistas devido à pandemia de COVID-19. MÉTODOS: A pesquisa descritiva envolveu 1.811 cirurgiões-dentistas de associações profissionais, cooperativas odontológicas e convênios do Estado de São Paulo, Brasil, em 2020, dos quais 473 concordaram em participar. A coleta de dados, por meio do Formulários Google, incluiu as variáveis: condições sociodemográficas; características do trabalho odontológico; nível de atenção e fontes de informação sobre a pandemia; mudanças no processo de trabalho, impacto financeiro com equipamentos de proteção individual (EPI) e medidas de biossegurança; e consequências da pandemia na prática profissional. RESULTADOS: Dos 473 dentistas (40,36±13,44 anos), a maioria era mulher (52,22%), especialista (55,60%) e trabalhava como autônomo (73,36%). Observou-se que 78,01% dos profissionais apresentaram redução na renda mensal. A média de pacientes atendidos diminuiu 35,48%. Constatou-se que 30,44% dos profissionais tiveram dificuldade com o uso de EPI, 3,59% contraíram COVID-19 e 53,03% postergaram o atendimento de paciente com suspeita ou confirmação de COVID-19, mesmo em emergências. O uso de peça de alta rotação foi relatado pela maioria dos profissionais (n=428; 90,48%). CONCLUSÃO: Como comportamentos: os dentistas usaram EPI e atribuíram níveis muito altos ou altos de cuidados sobre o COVID-19. Como adversidades: os dentistas relataram aumento nos custos operacionais, mudanças no processo de trabalho, diminuição no atendimento e redução na renda mensal.

Percepción de los inmigrantes: consentimiento informado y acceso a servicios de salud / Perception of immigrants: free consent and access to health services / Percepção dos imigrantes: consentimento livre e acesso aos serviços de saúde

Resumen En este estudio se propone conocer la percepción de los inmigrantes cubanos sobre el formulario de consentimiento informado y el acceso a tratamientos médicos y odontológicos. Este es un estudio descriptivo transversal, tipo encuesta. La muestra se compuso de inmigrantes de un municipio de mediano porte del estado de São Paulo, Brasil. Los participantes respondieron a un formulario con preguntas relacionadas al conocimiento del formulario de consentimiento informado y la accesibilidad a tratamientos médicos y odontológicos en Brasil y en su país de origen, instrumento que también recogía información sociodemográfica sobre los encuestados. Los participantes tenían accesibilidad a la atención médica y odontológica, pero poco conocimiento sobre ese formulario durante los tratamientos. Los médicos y los odontólogos deben adoptar medidas para una práctica profesional segura, pues un formulario de consentimiento informado bien preparado y de conocimiento del paciente favorece la realización exitosa de los procedimientos.

Abstract This study aims to identify the perception of Cuban immigrants about the free and informed consent form and access to dental and medical care. This is a cross-sectional descriptive survey conducted with a sample of immigrants from a medium-sized municipality in the state of São Paulo. Data were collected by means of a questionnaire addressing the form and the access to dental and medical care both in Brazil and in their country of origin, as well as sociodemographic aspects. The results indicate that immigrants have access to medical and dental care, but little knowledge about the consent form during treatment. Considering that a well-designed consent term and patient knowledge promotes the successful performance of procedures, physicians and dentists need to adopt measures for a safe professional practice.

Resumo Este estudo visa conhecer a percepção dos imigrantes cubanos sobre o termo de consentimento livre e esclarecido e o acesso a tratamentos médicos e odontológicos. Trata-se de um estudo descritivo transversal, tipo inquérito. A amostra foi composta por imigrantes de um município de médio porte do estado de São Paulo. Os participantes responderam a um formulário com questões relacionadas ao conhecimento desse termo e ao acesso a tratamentos médicos e odontológicos no Brasil e no país de origem, instrumento que também coletou dados sociodemográficos. Os participantes tinham acesso à assistência médica e odontológica, mas pouco conhecimento sobre o termo de consentimento durante os tratamentos. Os médicos e odontólogos devem tomar medidas para uma prática profissional segura, pois um termo de consentimento bem elaborado e de conhecimento do paciente promove a realização bem-sucedida dos procedimentos.

Cuidadores domiciliares de idosos: qualidade de vida e práticas no processo de cuidar / Home caregivers of elderly: quality of life and practices in the care process

Objetivou-se avaliar a autopercepção da qualidade de vida dos cuidadores de idosos e conhecer as práticas no processo de cuidar. A amostra foi composta por 194 cuidadores domiciliares de idosos. Os dados foram coletados por meio de entrevistas, utilizando um roteiro semiestruturado e o instrumento EQ-5D-3L/ VAS. Do total, 34,5% não apresentou problemas nas cinco dimensões estudadas e declarou boa saúde (VAS médio 86,5 ±13,4).Em 65,5%, observaram-se problemas moderados e ou extremos nascinco dimensões, sendo que os extremos foram relatados somente nas dimensões dor/mal-estar e ansiedade/depressão. Administravam medicamentos 76,8% dos cuidadores, 60,3% auxiliavam com vestuário, 58,7% com o banho, 58,2% com a locomoção, 31,9% alimentação e 34% com a higiene bucal. Do total, 39,18% relatou ter dificuldades na rotina de cuidados, 12,89% estavam relacionadas à locomoção do idoso; 7,73% ao banho; 3,09% à convivência com o idoso, 0,52% à administração de medicamentos e 14,95% a outras dificuldades descritas e agrupadas em três categorias: "isolamento social" (13,80%), "conflitos de convivência" (48,27%) e "sobrecarga física e emocional" (37,93%). Houve predomínio de cuidadores do sexo feminino, revelando que o dever de cuidar ainda é cultural e socialmente considerado como característica da mulher. A imposição dos familiares, o acúmulo de funções diversas no lar e a falta de suporte familiar e financeiro explicariam a percepção de forma mais negativa do estado de saúde destas cuidadoras. A rotina de cuidados prestados aos idosos é complexa e são necessárias intervenções voltadas ao acompanhamento e capacitação destes cuidadores.(AU)

The objective was to evaluate the self-perception of the quality of life of caregivers of the elderly and to know the practices in the care process. The sample consisted of 194 home caregivers for the elderly. Data were collected through interviews, using a semi-structured script and the EQ-5D-3L /VAS instrument. Of the total, 34.5% had no problems in the five dimensions studied and declared good health (average VAS 86.5 ± 13.4). In 65.5%, moderate and/or extreme problems were observed in the five dimensions, and the extremes were reported only in the pain/malaise and anxiety/depression dimensions. 76.8% of the caregivers administered medication, 60.3% helped with clothing, 58.7% bath, 58.2% walking, 31.9% food, and 34% oral hygiene. Of the total 39.18% reported difficulties in the care routine, 12.89% was related to the elderly's locomotion; 7.73% to the bath; 3.09% to living with the elderly, 0.52% to medication administration, and 14.95% to other difficulties described and grouped into three categories: "social isolation" (13.80%), "conflicts of living" (48.27%) and "physical and emotional overload" (37.93%). There was a predominance of female caregivers revealing that the duty to care is still, culturally and socially considered a characteristic of women. The negative self-perception of caregivers is associated with the imposition of family members, the accumulation of various functions in the home, and the lack of support. The routine of care provided to the elderly is complex and interventions aimed at monitoring and training these caregivers are necessary.(AU)

Experiência do professor na identificação do bullying na escola / Teacher's experience in identifying bullying at school / Experiencia del profesor en la identificación del acoso escolar

Introdução:Atualmente, o bullyingé uma das principais formas de violência nas escolas, podendo provocar severos danos psicológicos e físicos em suas vítimas. A inserção do professor tem sido apontada como o fator crucial no enfrentamentoe na resolução da problemática.Objetivo:Objetivou-se neste estudo, verificar a experiência do professor no reconhecimento do bullying e na sala de aula.Metodologia:Trata-se de um estudo transversal descritivo, composto por 73 professores que atuam com crianças na faixa etária de 10 a 12 anos, de um total de 138 educadores, de 22 escolas da rede pública estadual de um município do interior do estado de São Paulo. Para a coleta de dados, aplicou-se um questionário misto e para a interpretação dos resultados, utilizou-se a frequência e análise de conteúdo. O Plano de Análise foi organizado em três etapas: pré análise; exploraçãoe interpretação do material textual, onde foram estabelecidas seis categorias: presenciar atos de bullying em sala de aula; fatores associados ao fenômeno; estratégias para solução do problema; associação do fenômeno a estrutura familiar; comunicação com os paise/ou responsáveis; sentimento diante ao ato.Resultados:Do total de participantes, 83,5% tinham até 10 anos de trabalho como professor e 72,6% afirmou já ter presenciado episódios de discriminação e/ou violência entre os adolescentes na sala de aula, onde 86,3% salientou sentir tristeza, indignação e revolta diante de tais atos. Em relação à atitude que tomariam diante ao bullying, prevaleceu o diálogo como sendo a medida mais eficaz, ressaltando ainda que o incentivo a participação dos pais na vida dos filhos favoreceria a melhora do comportamento.Conclusões:Conclui-se que os educadores identificam o bullying na sala de aula e se sentem tristes diante da situação, considerando o diálogo e a participação da família na vidadas crianças como fatores essenciais no combate ao problema (AU).

Introduction:Currently, bullying is one of the main forms of violence in schools, and can cause severe psychological and physical damage to its victims. The insertion of the teacher has been identified as the crucial factor in facing and solving the problem. Objective:The aim of this study was to verify the teacher's experience in recognizing bullying in the classroom.Methodology:This is a descriptive cross-sectional study, consisting of 73 teachers who work with children aged 10 to 12 years, from a total of 138 educators, from 22 public schools in a city in the interior of the state of São Paulo. For data collection, a mixed questionnaire was applied and for the interpretation of results, frequency and content analysis were used. The Analysis Plan was organized in three stages: pre-analysis; exploration and interpretation of textual material,, where six categories were established:witnessing acts of bullying in the classroom; factors associated with the phenomenon; strategies to solve the problem; association of the phenomenon with the family structure; communication with parents and/or guardians;feeling towards the act. Results:Of the total participants, 83.5% had up to 10 years of work as a teacher and 72.6% said they had witnessed episodes of discrimination and /or violence among adolescents in the classroom, where 86.3% stressed feeling sad, indignation and revolt at such acts. In relation to the attitude they would take in the face of bullying, dialogue prevailed as being the most effective measure, emphasizingthat encouraging parents' participation in their children's lives would favor the improvement of behavior.Conclusions:It is concluded that educators identify bullying in the classroom and feel sad about the situation, considering the dialogue and the participation of the family in the children's lives as essential factors in combating the problem (AU).

Introducción: Actualmente, el bullyingescolares una de las principales formas de violencia en las escuelas,puede causar graves daños psicológicos y físicos a sus víctimas. La inserción del maestro ha sido identificada como el factor crucial para enfrentar y resolver el problema.Objetivo: El objetivo de este estudio fue verificar la experiencia del maestro al reconocer el acoso escolarescolar y en el aula. Metodología: Este es un estudio transversal descriptivo, compuesto por 73 maestros que trabajan con niños de 10 a 12 años, de un total de 138 educadores, de 22 escuelas públicas en una ciudad del interior del estado de São Paulo.Para la recolección de datos se aplicó un cuestionario mixto y se utilizó análisis de frecuencia y contenido para interpretar los resultados.El Plan de Análisis se organizó en tres etapas: pre análisis; exploraciónde material textual,, donde se establecieron seis categorías: presenciar actos de bullying en el aula; factores asociados al fenómeno; estrategias de resolución de problemas; asociación del fenómeno con la estructura familiar; comunicación con los padres;sentimiento hacia el acto. Resultados: Del número total de participantes, el 83.5% tenía hasta 10 años de docenciay el 72.6% dijo haber presenciado episodios de discriminación y / o violencia entre en el aula,donde el 86.3% enfatizó sentirse triste, indignado y asqueado por tales actos. En relación con la actitud que adoptarían ante el acoso escolar, el diálogo prevaleció como la medida más efectiva, enfatizando que alentar la participación de los padres en la vida de sus hijos favorecería la mejora del comportamiento.Conclusiones: Se concluye que los educadores identificanel acoso escolaren el aula y sentirse triste por la situación, considerando el diálogo y la participación de la familia en la vida de los niños como factores esenciales para combatirel problema.Palabras clave: Acoso Escolar;Maestros; Instituciones Académicas (AU).

Condição de saúde bucal e acesso aos serviços odontológicos em idosos atendidos em um hospital municipal da área rural de Benguela, Angola / Oral health condition and access to dental services in older people attended at a municipal hospital in the rural area of Benguela, Angola

Resumo Objetivo Analisar a condição de saúde bucal em idosos do município de Bocoio, província de Benguela, Angola, Africa. Métodos Estudo epidemiológico, transversal e analítico, realizado com 213 idosos, em 2019. Por meio de entrevistas e exames clínicos, analisou-se o perfil sociodemográfico; percepção de saúde bucal; higiene oral; uso de serviços odontológicos; consumo de tabaco, álcool, e açúcar; prejuízos funcionais e sociais devido a problemas bucais; índice de cárie dentária (CPOD); cárie radicular; condição periodontal; uso e necessidade de prótese; e lesões bucais. Resultados A maioria dos idosos era do sexo feminino (69,01%), com 60 a 70 anos (77,46%), não trabalhava (92,96%), não frequentou a escola (82,63%), e classificou sua saúde bucal como moderada (75,59%). Verificou-se que 52,58% realizava higienização bucal duas vezes por dia, utilizando escova dentária e dentifrício fluoretado (92,49%); nenhum participante utilizava fio dental; 47,89% realizou a última consulta odontológica há mais de dois anos; 20,66% fumavam diariamente; o consumo de álcool e alimentos açucarados foi baixo; 89,67% relataram dificuldade para mastigar; e 7,04% eram edêntulos totais. Houve associação (p<0,01) entre maior número de dentes perdidos, faixa etária mais avançada e baixo nível de escolaridade. O CPOD médio foi de 20,8±5,3 e nenhum dente obturado foi encontrado; a média de raízes cariadas foi de 2,43±2,10; a maioria dos dentes apresentava bolsa periodontal (50,32%) e perda de inserção (51,00%); 99,53% dos idosos necessitava de prótese; e 0,94% apresentava lesões bucais. Conclusão A condição de saúde bucal dos idosos de Bocoio é precária e marcada pela falta de acesso aos serviços odontológicos.

Abstract Objective To analyze the oral health status of elderly people in the municipality of Bocoio, Benguela province, Angola, Africa. Methods Epidemiological, cross-sectional and analytical study carried out with 213 elderly people in 2019. Through interviews and clinical examinations, the sociodemographic profile; oral health perception; oral hygiene; use of dental services; consumption of tobacco, alcohol, and sugar; functional and social impairments due to oral problems; dental caries index (DMFT); root caries; periodontal condition; use and need for prosthesis; and presence of oral lesions were analyzed. Results Most of the elderly were female (69.01%), aged 60 to 70 years (77.46%), did not work (92.96%), did not attend school (82.63%), and classified their oral health status as moderate (75.59%). It was found that 52.58% performed oral hygiene twice a day, using toothbrush and fluoridated dentifrice (92.49%); no participant used dental floss; 47.89% had their last dental appointment more than two years ago; 20.66% smoked daily; consumption of alcohol and sugary foods was low; 89.67% reported difficulty chewing; and 7.04% were fully edentulous. There was an association (p<0.01) between the greater number of missing teeth, and older age group and low level of education. The mean DMFT was 20.8±5.3 and no filled teeth were found; the mean of decayed roots was 2.43±2.10; most teeth had periodontal pocket (50.32%) and attachment loss (51.00%); 99.53% of the elderly needed a prosthesis; and 0.94% had oral lesions. Conclusion The oral health condition of the elderly in Bocoio is precarious and marked by the lack of access to dental services.