Lineamientos de bioseguridad utilizados en las clínicas dentales periféricas de la Universidad de Monterrey durante la pandemia de COVID-19 / Biosafety guidelines used in the peripheral dental clinics of the University of Monterrey during the COVID-19 pandemic

El presente artículo tiene como propósito informar sobre los lineamientos que las clínicas dentales periféricas de la Escuela de Odontología de la Universidad de Monterrey (UDEM) han tomado frente a la pandemia actual COVID-19, emergente en la ciudad de Wuhan, China el pasado diciembre 2019. Dichas medidas surgen con el objetivo de cumplir con estándares de bioseguridad que eviten el contagio y/o la contaminación cruzada entre pacientes, profesionales y personal de las clínicas dentales de la UDEM; Clínica de Prevención Dental (CPD) y Clínica de Atención Dental Avanzada (CADA), las cuales permanecerán activas frente a situaciones que requieran atención de urgencia y postergando los tratamientos dentales de rutina. Los protocolos para brindar una atención de urgencia conllevan determinados pasos a seguir desde que el paciente ingresa a la clínica; iniciando con la revisión del expediente electrónico médico por medio de la plataforma Atlas.xp, seguido del llenado de un cuestionario enfocado al riesgo de la enfermedad y culminando con la toma de temperatura con termómetro infrarrojo. Los pacientes que no presenten síntomas y muestren una temperatura inferior a los 37.3 oC podrán ser atendidos bajo la aplicación de todas las medidas de bioseguridad establecidas (medidas de protección personal, de equipo y paciente, mantenimiento de dos metros de distancia en sala de espera, cumplimiento de tiempos de trabajo parciales, uso de lámparas purificadoras de aire distribuidas en las salas operatorias de las clínicas, trabajo asistido o a cuatro manos con la implementación de aislamiento absoluto en el paciente y con la utilización mínima de la pieza de alta velocidad). Asimismo, se menciona que posterior a cada tratamiento y en la culminación de la jornada laboral, todas las áreas y superficies deberán ser sanitizadas con sustancias desinfectantes específicas. Por su parte, el personal deberá portar ropa convencional al salir de las instalaciones y haber realizado un adecuado lavado de manos para evitar al máximo posible la transmisión del virus (AU)

The purpose of this article is to inform about the guidelines that the peripheral dental clinics of the School of Dentistry of the University of Monterrey (UDEM) have taken in the face of the current pandemic COVID-19, emerging in the city of Wuhan, China in the past December 2019. These measures arise with the aim of fulfilling biosafety standards that avoid contagion and/or cross contamination between patients, professionals and staff of UDEM dental clinics; Clínica de Prevención Dental (CPD) and Clínica de Atención Dental Avanzada (CADA), which will remain active in situations that require urgent care and postponing routine dental treatments. The protocols to provide urgent care include certain steps to follow from the moment the patient enters the clinic; starting with the review of the electronic medical record through the Atlas.xp platform, followed by the completion of a questionnaire focused on the risk of the disease and culminating with temperature measurement with an infrared thermometer. Patients who do not present symptoms and show a temperature below 37.3 oC may be treated under the application of all established biosecurity measures (personal, equipment and patient protection measures, maintenance of two meters in the waiting room, compliance with partial work times, use of air purifying lamps distributed in the operating rooms of the clinics, assisted or four-hand work with the implementation of absolute isolation in the patient and with the minimum use of the high-speed handpiece). It is also mentioned that after each treatment and at the end of the working day, all areas and surfaces must be sanitized with specific disinfecting substances. For their part, the personnel must wear conventional clothing when leaving the facilities and have carried out adequate hand washing to avoid transmission of the virus as much as possible (AU)

Impact of teleconsultations on the conduct of oral health teams in the Telehealth Brazil Networks Programme.

Telehealth has been applied in the Unified Health System (SUS) as a tool for qualifying professionals and improving the healthcare provided to the population served by the system. The aim of the present study was to evaluate the impact of teleconsultations on the qualifications of the clinical approach of the oral health teams involved in primary health care (PHC) in the state of Rio Grande do Sul under the Telehealth Brazil Networks Programme. The sample population of the study was composed of 285 dentists and 132 oral health assistants belonging to the Family Health Teams. A chi-square test was used to investigate possible associations between the absolute number of teleconsultations performed and several independent variables, namely, gender, age, dental specialty, time since graduation, time working in the Family Health Strategy (FHS), employment status, type of training institution, familiarity with information technology, and work satisfaction at the health facility. The level of significance was p < 0.05. Use of the oral health teleconsultation service led to a reduction of more than 45% in the number of referrals to other levels of care. However, no significant association was found between the number of teleconsultations and the independent variables analysed. The use of teleconsultations proved to be a powerful tool for professional training, for increasing the effectiveness of PHC, and for improving the oral healthcare provided.

Impact of teleconsultations on the conduct of oral health teams in the Telehealth Brazil Networks Programme

Abstract Telehealth has been applied in the Unified Health System (SUS) as a tool for qualifying professionals and improving the healthcare provided to the population served by the system. The aim of the present study was to evaluate the impact of teleconsultations on the qualifications of the clinical approach of the oral health teams involved in primary health care (PHC) in the state of Rio Grande do Sul under the Telehealth Brazil Networks Programme. The sample population of the study was composed of 285 dentists and 132 oral health assistants belonging to the Family Health Teams. A chi-square test was used to investigate possible associations between the absolute number of teleconsultations performed and several independent variables, namely, gender, age, dental specialty, time since graduation, time working in the Family Health Strategy (FHS), employment status, type of training institution, familiarity with information technology, and work satisfaction at the health facility. The level of significance was p < 0.05. Use of the oral health teleconsultation service led to a reduction of more than 45% in the number of referrals to other levels of care. However, no significant association was found between the number of teleconsultations and the independent variables analysed. The use of teleconsultations proved to be a powerful tool for professional training, for increasing the effectiveness of PHC, and for improving the oral healthcare provided.

Inserção no mercado de trabalho de egressos de um curso de Odontologia do Piauí / Insertion of graduates of a Dentistry course in Piauí in the job market

As transformações e dificuldades que permeiam o mercado de trabalho odontológico despertam questões sobre a inserçãodos cirurgiões-dentistas e sua formação diante do exercício profissional. O objetivo deste trabalho foi avaliar a inserção de egressos do curso de Odontologia da Universidade Federal do Piauí no mercado de trabalho. Neste estudo transversal de caráter quantitativo, um questionário online autoaplicável foi enviado a 76 cirurgiões-dentistas formados entre 2017 e 2018, abordandodados sociodemográficos,investimento em pós-graduação e ingresso no mercado de trabalho.Foi realizada análise descritiva dos dados.A taxa de resposta foi de 92,1%. A maioria dos egressos(88,6%)possuíaou cursavaalgum tipo de pós-graduação, principalmente nas áreas de Cirurgia, Endodontia e Ortodontia. Quanto ao ingresso no mercado, apenas 4,3% nunca exerceram a profissãoe 75,7% se inseriram em até 3meses de formados. Os cirurgiões-dentistas estão divididos de forma equiparável entre os setores público e privado, possuem em sua maioria jornadas de até 40 horas (75,4%) e renda mensal de até 5 salários mínimos (91,3%). Apenas 11,4% nãoestão satisfeitos com a profissão escolhida e 40% julgam o mercado como regular. Entre as dificuldades relatadas no início da profissão, as mais citadas foram baixa remuneração (82,1%) e insegurança na prática clínica (70,1%). Como sugestão para o curso de graduação, indicaram a abordagem de Administração, Marketing e Empreendedorismo. Observou-se que o mercado proporcionou oportunidades para uma inserção rápida, no entanto, com redução do exercício estritamente autônomo. Os egressos valorizam a pós-graduação e apesar das dificuldades, estão satisfeitos com a profissão (AU).

Existent transformations and complexities within dental labor market raise doubts about dentists' inclusion in professional practice, and their training. This research, therefore, aimed to evaluate the entry of Federal University of Piauí dentistry course graduates into the labor-market. This cross-sectional, quantitative study, conducted by sending an online auto-questionnaire to 76 dentists, graduated between 2017 and 2018, addressing sociodemographic data, postgraduate studies and entry into the labor market, receiving response-rate of 92.1%. Descriptive data analysis performed showed the majority of graduates (88.6%) had or were taking a postgraduate course, mainly in Surgery, Endodontics and Orthodontics. Relative to market entry, 4.3% had never practiced the profession, and 75.7% entered within 3 months after graduation. Dentists were equally divided between public and private sectors, primarily working 40 hours/week (75.4%), earning monthly income of up to 5 minimum salaries (91.3%). Only 11.4% were not satisfied with the chosen profession, and 40% judged the level of market difficulty was intermediate. Among the difficulties reported at the beginning of the profession, the majority of dentists cited the low salaries (82.1%) and insecurity in clinical practice (70.1%). As a suggestion for the undergraduate course, they indicated that they could focus on Administration, Marketing and Entrepreneurship. The market was observed to provide opportunities for rapid inclusion, however with a reduction in exercising the profession in a strictly independent manner. Graduates placed value on postgraduate studies, and despite difficulties, they were satisfied with the profession (AU).

Oral health management considerations for patients with sickle cell disease.

Sickle cell disease (SCD) can affect many systems in the body including the oral cavity. This necessitates modifications in oral health care management of these patients. The purpose of this paper is to make recommendations for management of SCD patients according to their oral health care needs based on the known findings.

Dental Therapists as New Oral Health Practitioners: Increasing Access for Underserved Populations.

The development of dental therapy in the U.S. grew from a desire to find a workforce solution for increasing access to oral health care. Worldwide, the research that supports the value of dental therapy is considerable. Introduction of educational programs in the U.S. drew on the experiences of programs in New Zealand, Australia, Canada, and the United Kingdom, with Alaska tribal communities introducing dental health aide therapists in 2003 and Minnesota authorizing dental therapy in 2009. Currently, two additional states have authorized dental therapy, and two additional tribal communities are pursuing the use of dental therapists. In all cases, the care provided by dental therapists is focused on communities and populations who experience oral health care disparities and have historically had difficulties in accessing care. This article examines the development and implementation of the dental therapy profession in the U.S. An in-depth look at dental therapy programs in Minnesota and the practice of dental therapy in Minnesota provides insight into the early implementation of this emerging profession. Initial results indicate that the addition of dental therapists to the oral health care team is increasing access to quality oral health care for underserved populations. As evidence of dental therapy's success continues to grow, mid-level dental workforce legislation is likely to be introduced by oral health advocates in other states. This article was written as part of the project "Advancing Dental Education in the 21st Century."

Sustentabilidade ambiental: gerenciamento de resíduos odontológicos no Serviço Público / Sostenibilidad ambiental: gestión de residuos odontológicos en el Servicio Público / Environmental sustainability: dental waste management in the public service

Introdução: os Resíduos de Serviço de Saúde constituem um grande problema para a sociedade e para o meio ambiente, e o conhecimento de seu correto manejo é imprescindível para a formação do profissional da saúde. Objetivo: verificar o conhecimento dos profissionais de Odontologia atuantes nas Unidades Básicas de Saúde de municípios do noroeste do estado de São Paulo, Brasil, sobre o correto manejo dos Resíduos de Serviço de Saúde. Métodos: o instrumento de coleta de dados foi um questionário semiestruturado, preenchido durante as visitas nos estabelecimentos de saúde, a fim de verificar a conformidade do processo de gerenciamento de resíduos Odontológicos. Realizou-se análise descritiva. Além disso, aplicaram-se os testes do qui-quadrado e o Exato de Fisher para verificar associação entre o conhecimento do descarte de resíduos e a informação sobre o tema, ao nível de significância de 1 porcento. As análises foram realizadas no programa BioEstat 5.0. Resultado: do total (n= 74) dos profissionais, a maioria (97,3 porcento) diz saber o que são Resíduos de Serviço de Saúde e todos acreditam que eles podem fazem mal a saúde. No entanto, 41,9 porcento não responderam de forma correta como descartar os sugadores e luvas infectados e 20,3 porcento sobre o descarte de perfurocortantes. Em relação à informação sobre o tema, 40,5 porcento não obtiveram. Conclusão: o conhecimento sobre o correto descarte dos Resíduos de Serviço de Saúde por esses profissionais ainda é falho. Isso reflete a importância de capacitar os profissionais e propor formas de gerenciamento adequadas dos Resíduos de Serviço de Saúde(AU)

Introducción: los residuos de servicios de salud son un grave problema para la sociedad y el medio ambiente, y el conocimiento de su correcta gestión es esencial para la formación de los profesionales de la salud. Objetivo: evaluar el conocimiento de los profesionales de Odontología que trabajan en las Unidades Básicas de Salud de los municipios en el noroeste de São Paulo, Brasil, sobre el manejo adecuado de los residuos de servicios de salud. Métodos: el instrumento de recolección de datos fue un cuestionario semiestructurado, completado durante las visitas a los centros de salud, con el fin de verificar la conformidad del proceso de gestión de residuos dentales. Se realizó un análisis descriptivo. Además, se aplicó la prueba de chi cuadrado y exacta de Fisher para determinar la asociación entre la eliminación de residuos y los conocimientos e información sobre el tema, considerándose un nivel de significación del 1 por ciento. Los análisis se realizaron en BioEstat 5.0. Resultados: del total (n= 74) de los profesionales, la mayoría (97,3 por ciento) afirmó no saber cuáles son los residuos de servicios de salud y todos creyeron que pueden hacer mal a la salud. Sin embargo, el 41,9 por ciento no contestó correctamente sobre la eliminación de dispositivos de succión y guantes infectados, y el 20,3 por ciento sobre la eliminación de objetos punzantes. Con respecto a la información sobre el tema, el 40,5 por ciento no la obtuvo. Conclusiones: el conocimiento sobre la eliminación adecuada de los residuos de servicios de salud por estos profesionales todavía es deficiente. Esto refleja la importancia de la capacitación de los profesionales y proponer formas de gestión adecuadas de los residuos de servicios de salud(AU)

Introduction: medical waste is a serious problem for both society and the environment, and knowledge about its proper management is essential for the training of health care professionals. Objective: evaluate knowledge among dental professionals working in Basic Health Units from municipalities in northeast Sao Paulo, Brazil, about proper management of medical waste. Methods: the data collection tool used was a semi-structured questionnaire completed during visits to the health centers, aimed at verifying the adequacy of dental waste management. A descriptive analysis was performed. Additionally, chi-square and Fisher's exact tests were applied to determine the association between waste disposal, and knowledge and information about the subject, using a significance level of 1 percent. Analyses were conducted on BioEstat 5.0. Results: of the total professionals (n= 74), most (97.3 percent) stated not knowing which are the medical wastes, and all believed that they may be harmful to health. However, 41.9 percent did not provide a correct answer about disposal of infected gloves and suction devices, and 20.3 percent about sharps disposal. With respect to information about the subject, 40.5 percent did not obtain it. Conclusions: knowledge about proper disposal of medical waste is still deficient among these professionals, pointing to the importance of professional training and of proposing forms of proper management of medical waste(AU)

O profissionalismo na formação superior em saúde: uma análise sobre a graduação em odontologia / Professionalism in the education of health: an analysis of the undergraduate dentistry

Esta tese foi desenvolvida com o objetivo de analisar a formação de cirurgiões-dentistas, a partir do conceito de profissionalismo, que contempla a aquisição de expertise, ética e a prestação de serviço. Teve como base uma pesquisa qualitativa, realizada com professores, alunos e responsável pela coordenação da graduação, em um dos cursos públicos de odontologia do estado do Rio de Janeiro. Os dados foram obtidos por meio da realização de entrevistas individuais, grupo focal, observação participante e diário de campo. Os resultados mostraram que os métodos de avaliação empregados contribuem para o estabelecimento de relações abusivas com os pacientes da clínica de ensino, nas quais podem ser equiparados a objetos de consumo usados para fins de aprovação acadêmica. A aquisição de expertise apresenta-se comprometida na Instituição de Ensino Superior pelo curto período de duração do curso, pelas divergências entre o agir em saúde de parte dos docentes e ensinamentos teóricos ministrados, quando os alunos são impedidos de realizar procedimentos que lhes caberia executar. A ética está comprometida quando autonomia e confidencialidade da atenção são violadas, quando ocorre negativa de assistência emergencial por indisponibilidade financeira do paciente, quando se trabalha com a perspectiva de que os usuários da clínica de ensino devem se contentar com serviços de baixa qualidade e inacabados e quando não há compromisso com as responsabilidades profissionais por parte de alunos e/ou professores. O serviço sofre comprometimento quando ocorrem barreiras ao fluxo dos pacientes e descontinuidade da assistência sem que haja resolutividade das necessidades em saúde dos pacientes...

This dissertation has been developed in order to analyze the preparation of graduates in dentistry from the concept of professionalism, which envolves the expertise, ethics and service providing. It was based on a qualitative research conducted among students, teachers and the coordinator of the program in one of the public Schools of Dentistry in Rio de Janeiro. Data collection methods used in this research was in-depth interviews, focus groups, intense observation and field diary. The results showed that the graduate’s assessment method contributes to estabilish an abusive relationship between students and dental care clinic patients, where patients can be seen by the students as consumer objects necessary to their academic approval. Dental students' knowledge acquisition has been compromised by the reduced graduate program period, by the discrepancies between acting in health and taught theoretical lessons on the part of teachers, and when students were unable to perform procedures that would be up them to perform. Ethitcs has been compromised when detal care authonomy and confidentiality were violated, when there was a denial of providing emergency care due to the financial inability of the patient, when is accepted the clinic costumers the must be settle for low quality or unfinished services and when there is no commitment to professional responsibility on the part of students and / or teachers. The service has been compromised when there were barriers to the flow of patients and interruptions of the service before finishing the threatment...

Egressos de Odontologia: o sonho da profissão liberal confrontado com a realidade da saúde bucal / Graduates of Dentistry: the dream of liberal profession faced with the reality of oral health

Modificações no campo do trabalho em Odontologia demostram uma transformação no mercado, na prática e na formação do cirurgião-dentista. Procura-se um novo profissional para atender as necessidades de saúde da sociedade, com foco na atenção em saúde bucal coerente com a realidade epidemiológica. O objetivo deste estudo foi avaliar a inserção dos egressos de Odontologia da Universidade Federal do Rio Grande do Norte no mercado de trabalho e sua relação com o currículo e atividades de educação permanente. A pesquisa foi desenvolvida por meio de questionário autoadministrado, composto por variáveis relativas ao tempo de ingresso no mercado de trabalho, participação em pós-graduação, ações desenvolvidas ao longo da graduação, inserção profissional e satisfação profissional. Os resultados demostraram que o serviço privado é, ainda, um grande empregador, fato que caracteriza o perfil do profissional e corrobora a grande predominância de disciplinas clínicas no currículo. A participação do aluno em atividades complementares configura-se estratégia essencial para a perspectiva da futura inserção profissional, assim como flexibilização curricular. Apesar da transição sinalizada pelas perspectivas de universalização do acesso público à saúde bucal, são necessários esforços ímpares na educação permanente para que a Odontologia alcance seu espaço valorizado perante a sociedade e cumpra efetivamente seu papel de profissão de saúde (AU).

Changes in the labor Dentistry demonstrate a transformation in the market, in practice and in the formation of dentists. A new professional is necessary to meet the health needs of society, with focus on attention to oral health with the epidemiological reality. The aim of this study was to evaluate the insertion of the graduates of Dentistry in Natal-RN in the labor market and its relationship with the curriculum and continuing education activities. The survey was developed through self-administered questionnaire composed of variables related to the time of entry into the labor market, participation in postgraduate actions developed over graduation, employability and job satisfaction. Results demonstrated that the private service is also a major employer, fact that determines the professional profile and supports the great predominance of clinical disciplines in the curriculum. The student's participation in complementary activities sets up essential strategies for future job prospects, as well as curricular flexibility. Despite the transition foreseen in the prospects of universal public access to oral health transition, great efforts are needed in continuing education for dentistry to reach its valued space in society and effectively fulfill their role as health care profession (AU).

Inserção de egressos de Odontologia do Tocantins no mercado de trabalho / Introduction of newly graduated dental students from the State of Tocantins into the job market

O objetivo do presente trabalho foi investigar a inserção e a perspectiva profissional de egressos de Odontologia no mercado de trabalho. Trata-se de um estudo observacional, transversal e descritivo, realizado por meio de um questionário eletrônico aplicado aos 298 egressos de um curso de Odontologia do Tocantins, distribuídos em 14 turmas (2008 a 2015). A taxa de resposta foi de 61,41% (n=183). Após análise dos dados (Teste de Quiquadrado/Exato de Fisher; nível de significância de 5%) verificou-se que 65,6% dos respondentes eram do sexo feminino, com idade média de 30 (±6,6) anos. O tempo médio de formado foi de 3,7 (±2,2) anos. Dentre os egressos, 37,8% trabalhavam em serviço público, sendo que 17,5% o faziam exclusivamente. A maioria deles trabalhava no estado do Tocantins (65,0%), sendo que 62,8% estava cursando ou cursou pósgraduação, sendo Ortodontia (17,5%), Endodontia (14,8%), Odontopediatria (7,6%); a área de Saúde Coletiva apareceu para 3,8% dos respondentes. A renda mensal da maioria (46,4%) foi de até 5 salários mínimos (R$ 3 640,00) e 49,8% dos respondentes mostraramse satisfeitos com o rendimento mensal. A inserção imediata no mercado de trabalho foi relatada por 72,7% dos egressos, sendo que 6% não exerciam a profissão naquele momento e destes, 2,7% nunca exerceram. Dentre as disciplinas consideradas mais significativas na graduação apareceram Cirurgia Oral (26,8%), Endodontia (21,3%), Dentística (14,2%), Odontopediatria (11,5%), Prótese (9,3%) e Saúde Coletiva (4,9%). Os resultados encontrados permitem concluir que a inserção dos egressos no mercado de trabalho foi rápida e a maioria se encontrava satisfeita com os rendimentos naquele momento (AU).

Introduction of newly graduated dental students from the State of Tocantins into the job market. The aim of this study was to investigate the insertion and professional perspective of dental graduates into the labor market. An observational, cross-sectional and descriptive study was performed, by means of an electronic questionnaire, to a sample of 298 Dentistry graduates from the State of Tocantins, Brazil. The sample showed 14 classroom groups from the years 2008 to 2015. The response rate was 61.41% (n = 183). After data analysis (chi-square test / Fisher's exact, 5% significance level) it was found that 65.6% of respondents were female, mean age 30 (± 6.6) years. The average time since their graduation was 3.7(± 2.2) years. Among the graduates, 37.8% are now working in Public Health, and 17.5% do so, exclusively. Most of them work in the State of Tocantins (65.0%) and 62.8% have attended or are still attending post-graduation courses in Orthodontics (17.5%), Endodontics (14.8%), Pediatric Dentistry (7.6%) and Public Health (3.8%). The monthly income of the majority (46.4%) is up to 5 times the minimum wage (R $ 3,640.00) and 49.8% of the respondents reported a sense of achievement with the monthly income. The immediate insertion in the labor market was reported by 72.7% of the graduates, and 6% do not work as dental professionals, 2.7% of these have never done it. Among the most significant subjects while undergraduate students, Oral Surgery (26.8%), Endodontics (21.3%), Restorative Dentistry (14.2%), Pediatric Dentistry (11.5%), Prosthodontics (9.3%) and Public Health (4.9%) were the most meaningful for them. According to the results found it was concluded that the insertion of Dentistry graduates in the labor market was quick and the majority are happily satisfied with the income (AU).

Medical emergencies in the dental surgery. Part 1: Preparation of the office and basic management.

STATEMENT OF THE PROBLEM: Medical emergencies can and do happen in the dental surgery. In the 20- to 30-year practice lifetime of the typical dentist, he/she will encounter between five and seven emergency situations. Being prepared in advance of the emergency increases the likelihood of a successful outcome. PURPOSE OF THE PAPER: To prepare members of the dental office staff to be able to promptly recognize and efficiently manage those medical emergency situations that can occur in the dental office environment. MATERIALS AND METHODS: Preparation of the dental office to promptly recognize and efficiently manage medical emergencies is predicated on successful implementation of the following four steps: basic life support for ALL members of the dental office staff; creation of a dental office emergency team; activation of emergency medial services (EMS) when indicated; and basic emergency drugs and equipment. The basic emergency algorithm (P->C->A->B->D) is designed for implementation in all emergency situations. RESULTS AND CONCLUSIONS: Prompt implementation of the basic emergency management protocol can significantly increase the likelihood of a successful result when medical emergencies occur in the dental office environment.