Legislation in Hospital Dentistry: Gaps, Perspectives and Desires

Abstract Objective: To analyze the existing state legislation, including not only the ordinary laws, but also their infralegal regulation and the state legislation on Hospital Dentistry. Material and Methods: A survey was carried out in the databases of the Legislative Assemblies of the Brazilian States and the Federal District, as well as the Regional and Federal Councils of Dentistry in Brazil. Subsequently, a survey was carried out in the databases of the Ministry of Health, State Dental Councils and Federal Dental Council in Brazil. Results: Only 8 Brazilian states have legislation in force regarding hospital dentistry, which represents 29.63% of the federative units. Among the Brazilian regions, the Midwest presented the highest prevalence of the laws found (37.50%), followed by the North (25%) and the other regions with the same coverage (12.50%). Also, an orientation and an ordinance from the Ministry of Health, six resolutions from the Federal Council of Dentistry, and a technical note from the National Health Surveillance Agency were found. Conclusion: Several States do not have rules on the subject, making it imperative to create a federal rule that not only imposes the presence of the dentist, but also regulates the proportion of the team, workload, and availability.

Use of Reflectometer Optipen to assess the preventive effect of a sugarcane cystatin on initial dental erosion in vivo.

The sugarcane cystatin 5 (CaneCPI-5) showed protection against erosion and erosive tooth wear (ETW) under several protocols. However, evaluating these conditions in vivo is hard due to the lack of a suitable device. The aim of this study was to use clinically the relative surface reflection intensity (%SRI) by the Reflectometer Optipen to assess the acquired pellicle engineering with CaneCPI-5 rinse for the prevention of initial erosion in vivo. Nine volunteers were distributed in three cross-over phases, according to the rinse used, as follows: 1) Deionized water (negative control); 2) Elmex® (800 ppm Sn2+, 500 ppm F-; positive control); 3) 0.1 mg/mL CaneCPI-5. The following experimental steps were performed: Initially, the volunteers received prophylaxis and the initial %SRI was performed. Subsequently, they rinsed with the solutions (10 mL; 1min), followed by the formation of the acquired enamel pellicle (AEP; 120min). After, the erosive challenge with citric acid 1%, pH 2.5 (10 µL; 10s) was performed (in isolation) on the buccal surface of the maxillary central incisors (right and left). The calcium present in the acid was analyzed by Arsenazo III method. Finally, the final %SRI was performed. Data were analyzed by Kruskal-Wallis/Dunn's tests and Spearman's correlation were used (p < 0.05). For both variables, the negative control led to significantly less protection (lower reflectivity and higher calcium release) in comparison with the other groups. The best protection (higher reflectivity and lower calcium release) was observed for the Elmex® and the CaneCPI-5 groups, with no significant differences between them (p < 0.05). There was a significant correlation between both analyzes. The Reflectometer Optipen demonstrated to be a good device to assess clinically. Moreover, CaneCPI-5 rinse proved effective through acquired pellicle engineering against initial erosion in vivo.

Preventive effect of chitosan gel containing CaneCPI-5 against enamel erosive wear in situ.

OBJECTIVE: This study evaluated the preventive effect of a chitosan gel containing CaneCPI-5 against enamel erosion and erosion + abrasion in situ. METHODS: Sixteen volunteers participated in a crossover, double-blind protocol, comprising 4 phases: (1) no treatment (Nt); (2) chitosan gel (Cg); (3) chitosan gel + 12,300 ppm NaF (Cg + NaF); and (4) chitosan gel + 0.1 mg/mL CaneCPI-5 (Cg + Cane). Volunteers wore an appliance containing 4 specimens. Once/day, they applied the gel (except for Nt) (4 min/specimen). Erosive challenges were performed extra-orally (0.1% citric acid, 90 s, 4 × /day; ERO). Specimens were also abraded (toothbrush, 15 s/specimen, 2 × /day; ERO + ABR). Enamel wear was assessed by profilometry and relative surface reflection intensity (%SRI). Two-way RM-ANOVA/Sidak's tests and Spearman's correlation were used (p < 0.05). RESULTS: For profilometry, ERO + ABR promoted significantly greater wear when compared with ERO. There was a significant difference among all treatments. The lowest enamel loss occurred for Cg + Cane, followed by Cg + NaF, Cg, and Nt (p < 0.05). The %SRI was significantly lower for ERO + ABR when compared to ERO, only for the Nt group. The greatest %SRI was found for the Cg + NaF and Cg + Cane groups, which did not differ significantly, regardless of the conditions. The lowest %SRI was found for the Nt and Cg groups, which did not differ from each other, regardless of the conditions. The Nt group did not differ significantly from the Cg + NaF (ERO). There was a significant correlation between both analyses. CONCLUSION: The incorporation of CaneCPI-5 in the chitosan gel prevented erosive wear in situ. CLINICAL RELEVANCE: These results open a new perspective for the use of CaneCPI-5 in other application vehicles, such as chitosan gel.

Surface roughness evaluation and whitening efficiency on tooth enamel after using whitening toothpaste: a randomized double-blinded study

The aim of this randomized double-blinded study was to evaluate the enamel surface roughness and color change after one month of whitening toothpaste use and the color stability obtained 1 month after its interruption. 30 volunteers were divided into 3 groups (n = 10) corresponding to the dentifrices: 1) Colgate Total 12 Clean Mint (TD) (Control), 2) Colgate Luminous White (LW) and 3) Sensodyne Whitening Extra Fresh (SB). The volunteers were impression with addition silicone to obtain an epoxy resin replica of the upper central incisor for the initial surface roughness evaluation using a profilometer and the initial color of the incisors and canines was evaluated with a spectrophotometer after one week of wash-out. After 1 month, the color of the central incisors and canines was measured again, and the volunteers were molded to obtain a second replica to the final roughness analysis. Data were submitted to ANOVA-one way (p≤0.05). The results showed that there was no statistical difference between the dentifrices for color difference and surface roughness for all the studied conditions. It was possible to conclude that the whitening dentifrices used in this study were not able to alter the initial color of the teeth and did not cause changes in the surface roughness of enamel.

Ellagic acid on the quality of the adhesive interface of class I composite resin restorations after aging

To evaluate the effect of ellagic acid on the inhibition of matrix metalloproteinase by analyzing the quality of the adhesive interface with bond strength measures in periods of 24 hours and six months of storage. Method: 40 healthy human third molars were prepared with class I cavities (5x4x3mm). The teeth were divided into four experimental groups: Group 1- without application of ellagic acid and storage time of 24 hours; Group 2- with ellagic acid/24 hours; G3- without ellagic acid/six months; Group 4- with ellagic acid/six months. Then, the cavities were restored with Single Bond Universal adhesive and Z350 composite resin, with and without the previous application of ellagic acid. Subsequently, hourglass-shaped specimens were obtained and subjected to the bond strength (BS) test (n = 10) in a universal testing machine. The bond test was performed after 24 hours and six months of storage. For the standard evaluation (n = 3) the samples were infiltrated with silver nitrate and placed in a developing solution for analysis in a Scanning Electron Microscope (SEM). The data obtained were analyzed with the Kruskal-Wallis non-parametric test, showing a statistically significant difference. Results: The highest bond strength values were found for the 24-hour groups followed by the groups with six months of storage. For nano-infiltration, groups G1 and G2 showed lower infiltration than groups G3 and G4. Conclusion: The previous application of ellagic acid did not affect the BS of the adhesive interface of the adhesive system analyzed, regardless of storage time.

Effect of a sugarcane cystatin on the profile and viability of microcosm biofilm and on dentin demineralization.

To analyze the effect of a sugarcane cystatin (CaneCPI-5) on the microbial profile and viability, as well as on the prevention of dentin demineralization using a microcosm biofilm model. Ninety bovine dentine specimens were divided into five experimental groups according with the solution they were treated for 60 s: (1) PBS (negative control), (2) 0.12% chlorhexidine (positive control), (3) Fluoride (500 ppm F, as NaF), (4) 0.025 mg/ml CaneCPI-5, and (5) 0.05 mg/ml CaneCPI-5. Specimens were incubated with inoculum (McBain's saliva plus human saliva) in the first 8 h, and from then on, they were exposed to McBain saliva containing sucrose and daily treated (60 s) with the solutions for 5 days. Resazurin and colony-forming unit counting assays were performed. Dentin demineralization was measured by transverse micro-radiography (TMR). 0.12% chlorhexidine significantly reduced the metabolic activity of the microcosm biofilm in relation to the negative control and treated groups (p < 0.01). CHX and F significantly reduced the counts of total microorganisms, mutans group streptococci, and lactobacilli when compared with the negative control. None of the treatments was able to significantly reduce dentin demineralization in comparison with the negative control. In the model evaluated, CaneCPI-5 neither altered the microcosm biofilm profile and viability nor protected dentin against demineralization.

Do commercial whitening dentifrices increase enamel erosive tooth wear?

Abstract Objective This in vitro study evaluated the effect of commercial whitening dentifrices on erosive tooth wear (ETW) of bovine enamel samples, in comparison with commercial regular dentifrices. Methodology Sixty bovine crowns were embedded in acrylic resin, polished and then had their baseline profile determined. They were randomly assigned to 5 groups (n=12/group), according to the type of commercial dentifrice to be tested: GI - Crest Anti-cavity Regular; GII - Crest 3D White; GIII - Colgate Total 12 Clean Mint; GIV - Colgate Optic White; GV - Placebo (negative control, fluoride-free dentifrice). The samples were submitted to daily erosive and abrasive challenges for 3 days. The erosive challenges were performed 3 times a day by immersing the specimens in 0.1% citric acid solution (pH 2.5) for 90 s. Each day after the first and last erosive challenges, the specimens were subjected to the abrasive challenge for 15 s, using a toothbrushing machine (Biopdi, São Carlos, SP, Brazil), soft toothbrushes and slurry (1:3 g/ml) of the tested toothpastes (1.5 N). The specimens were kept in artificial saliva between the challenges. The final profile was obtained and the ETW (µm) was calculated. Data were analyzed by Kruskal-Wallis and Dunn's tests (p<0.05). Results All dentifrices tested significantly reduced the enamel wear in comparison with the Placebo, except GIII. The median (95% CI) ETW was 1.35 (1.25-1.46)bc for GI, 1.17 (1.01-1.34)cd for GII, 1.36 (1.28-1.45)ab for GIII, 1.08 (1.04-1.14)d for GIV and 2.28 (2.18-2.39)a for GV. Conclusion When dentifrices from the same manufacturer were compared, the whitening dentifrices led to similar or less wear than the regular ones.

Cariology education for undergraduate Brazilian dental students / Ensino da cariologia para estudantes de graduação em odontologia no Brasil

ABSTRACT This study sought to provide an overview of current cariology education for undergraduate Brazilian dental students. Data collection was via a Portuguese version of a 12-item questionnaire (Schulte et al., 2011) that was sent to all Brazilian dental schools (n = 219). The response rate was 57.0% (n = 125). Of the schools that returned the questionnaire, 84.8% supported the development of a Brazilian cariology curriculum. The units responsible for teaching cariology were predominantly operative dentistry (49.6%), pediatric dentistry (49.6%), dental public health (44.8%), and cariology (32%). Theoretical teaching of cariology (74.4%) and pre-clinical exercises (63.2%) were cited to occur mainly during the second year of the course, while clinical activities were placed in the third (71.2%) and fourth (64.8%) years. Among respondents, 76.8% of the schools included dental erosion and 86.4% included defects of dental hard tissues, such as abrasion, in teaching cariology. This survey was able to determine the panorama of cariology education in Brazil and to detect some differences among Brazilian geographic areas. The promotion of a workshop to discuss the topics that should be taught to undergraduate dental students and the development of a Brazilian core curriculum in cariology would be likely to reduce the differences in teaching cariology in Brazil.

RESUMO Este estudo teve como objetivo apresentar um panorama do ensino de cariologia nos cursos de graduação em Odontologia no Brasil. A coleta de dados foi realizada por meio de uma versão em Português Brasileiro de um questionário de 12 itens (Schulte et al., 2011) que foi enviado a todas as faculdades de Odontologia brasileiras (n = 219). A taxa de resposta foi de 57,0% (n = 125). Dentre as faculdades que responderam o questionário, 84,8% apoiam o desenvolvimento de um currículo brasileiro de cariologia. As disciplinas responsáveis por lecionar os conteúdos de cariologia são principalmente dentística (49,6%), odontopediatria (49,6%), saúde bucal coletiva (44,8%), e cariologia (32%). O ensino teórico de cariologia (74,4%) e os exercícios de pré-clínica (63,2%) são abordados principalmente durante o segundo ano do curso, enquanto as atividades clínicas ocorrem, em geral, no terceiro (71,2%) e quarto (64,8%) anos. Dentre os respondentes, 76,8% das faculdades incluem erosão dentária e 86,4% incluem defeitos dos tecidos dentários duros, como abrasão, no ensino da cariologia. Essa pesquisa foi capaz de determinar o panorama do ensino da cariologia no Brasil e detectar algumas diferenças de currículo entre as regiões do país. A promoção de um workshop para discutir os assuntos que devem ser ministrados aos estudantes de graduação em Odontologia e para desenvolver um currículo brasileiro de cariologia seria válida para reduzir as diferenças no ensino de cariologia no Brasil.

Análise qualitativa do interior de imperfeições presentes em 5 marcas de implantes brasileiros por microscopia eletrônica de varredura e espectroscopia por energia dispersiva / Qualitative analysis of inner imperfections present in 5 brands of brazilian dental implants by scanning electron microscopy and dispersive energy spectroscopy

O titânio é um dos 10 mais comuns elementos da terra, existem diferentes pesos atômicos, isótopos estáveis e radioisótopos conhecidos, está presente em ligas comerciais e semicomerciais, sendo que o titânio puro apresenta diferentes graus de pureza. Além disso, as ligas possuem classificações que agregam outros elementos neutros e/ou estabilizadores, são submetidas a diferentes tipos de tratamento de superfícies. Na fabricação dos implantes, o processo industrial da extração da rocha até a colocação na boca pode corromper o grau de pureza. A proposta do presente estudo foi avaliar qualitativamente buracos presentes em 5 implantes dentários brasileiros. As amostras foram preparadas em resina acrílica e realizados cortes sagitais com lâmina de diamante e analisadas no Microscópio Eletrônico de Varredura TM 3030 PLUS TABLESTOP MICROSCOPE HITACHI e reanalisadas no Microscópio Fei Quanta 400. Os resultados evidenciaram que os implantes apresentaram impurezas e estas impurezas podem ser os estabilizadores ou elementos neutros presentes no titânio ou nas ligas utilizadas. Implantodontistas devem ficar alertas sobre a qualidade do implante

Titanium is one of the 10 most common elements of the earth, there are different atomic weights, stable isotopes and known radioisotopes, it is present in commercial and semi-commercial alloys and pure titanium has different degrees of purity. In addition, alloys have classifications that add other neutral elements and/or stabi¬lizers, they are submitted to different types of surface treatments. In manufacturing the implants, the industrial process of extracting the rock into the mouth can corrupt the degree of purity. The purpose of the present study was to qualitatively evaluate holes present in 5 Brazilian dental implants. The samples were prepared in acrylic resin and sagittal cuts with diamond blade and analyzed in the Scanning Electron Microscope TM 3030 PLUS TABLESTOP MICROSCOPE HITACHI and Fei quanta 400. The results showed that the implants presented impurities and these impurities may be the stabilizers or neutral elements present in the titanium or the alloys used. Implant dentists should be alert to the quality of the implant

Pró-saúde e a reforma curricular em uma escola de odontologia à luz da teoria da estruturação / Pró-saúde and curriculum reform in a school of dentistry in light of the structuration theory

O presente estudo de caso analisou em que medida a adesão ao Pró-Saúde contribuiu para o andamento da reforma curricular em uma faculdade pública de Odontologia no Rio de Janeiro. Para essa análise foram coletados documentos e realizadas treze entrevistas semiestruturadas com atores-chave. Utilizou-se como referencial teórico a Teoria da Estruturação de Giddens. Os resultados da pesquisa apontaram avanços e entraves no novo Projeto Político Pedagógico. Entretanto, desafiando as características de uma instituição tradicional de formação, o Pró-Saúde, associado ao interesse dos dirigentes locais em realizar a reforma, cumpriu o papel de indutor das transformações curriculares

The present case study analyzed how the adherence to Pró-Saúde contributed to the process of the curriculum reform done by a public school of dentistry in Rio de Janeiro state. In order to find evidences, documents were collected and thirteen semi-structured interviews with key actors were conducted. The data analysis was performed in light of Giddens' Structuration Theory. The results of the research show both advances and obstacles in the new pedagogical project. In conclusion, challenging the characteristics inherent to an institution of traditional education, Pró-Saúde, associated with school managers interests, fulfilled the role of a catalyst to curricular transformation.

Análise qualitativa da estrutura química de quatro marcas comerciais de implantes dentários brasileiros: Estudo-piloto / Qualitative analysis of the chemical composition of four Brazilian dental implant manufacturers: a pilot study

Objetivo: avaliar qualitativamente a estrutura química de quatro marcas comerciais de implantes dentários brasileiros. Material e métodos: 12 amostras de diferentes lotes foram fixadas em resina acrílica usando um processo padronizado, e cortes sagitais foram realizados. As amostras foram analisadas em dois microscópios eletrônicos de varredura (FEI Quanta 400, TM 3030 Plus Tablestop Microscope Hitachi). Resultados: a maioria apresentou na sua porção interna (8 das 12) diferentes níveis de níquel, variando de uma marca para outra. Entretanto, este metal não foi detectado na superfície externa. A presença de níquel talvez seja atribuída às matérias-primas e metodologia de produção, desde a sua extração até a comercialização. Conclusão: dentro dos limites desta investigação, há necessidade de mais estudos qualitativos, em todo o processo de fabricação de todos os implantes comercializados, assim como estudos quantitativos com relação ao elemento níquel nos implantes dentários.

Objective: to perform a qualitative evaluation of the chemical structure of four commercial dental implant Brazilian brands. Material and methods: 12 samples of different batches were embedded in acrylic resin according to a standardized process, and sagittal sections were made accordingly. All the samples were analyzed under two SEM devices (FEI Quanta 400, TM 3030 Plus Tablestop Microscope Hitachi). Results: most samples (8 of 12) revealed at their internal portions different levels of Nickel, from one manufacturer to the other. However, this metal was not detected at the external implant portion. The presence of Nickel maybe can be attributed to the raw materials and production process, from extraction to commercialization. Conclusion: within the limits of this investigation, more qualitative studies are necessary throughout the fabrication process of all investigated implants in the market, as well as quantitative evaluations regarding the presence of Nickel on dental implants.

Direito e saúde mental de pessoas físicas e jurídicas / Law and mental health to person individual and companies

O objetivo do presente trabalho foi levar ao conhecimento da comunidade científica uma revisão bibliográfica percebida ao longo da carreira acadêmica de um dos autores onde a personalidade física presente em coordenadores de alguns cursos de especialização em Odontologia é transmitida à personalidade jurídica tanto em instituições públicas quanto em privadas. A Legislação vigente, diferenças de personalidades físicas e jurídicas, transtornos mentais e de personalidade são explicitados, além de se projetar algumas possibilidades de acometimentos na medicação, os autores também questionaram a o fechamento de hospitais. Foi usada metodologia exploratória, através de palavras-chave no portal Capes e Scielo, com os descritores: Direito Administrativo ? Saúde Mental ? Ensino Odontológico ? Políticas públicas de saúde; além de revistas e jornais virtuais. Concluiu-se que a falta de conhecimento em direito por parte dos docentes prejudica o processo de ensino e aprendizagem dos alunos. Existe, em alguns casos, o descaso contratual, pela falta de dissociação pessoal e institucional onde docentes e discentes se inserem, podendo este ser repassado num processo cíclico onde aprendidos e ensinados podem fazer parte de um sistema imutável. Existe a necessidade da revisão dos valores na metodologia de ensino odontológico para que transtornos de personalidade física não sejam perpetuados em pessoas jurídicas e assim não haja prejuízo e judicialização de ações por parte dos que têm noção de diretos e deveres como regras básicas de convívio social

The aim of this study was to inform the scientific community through literature review, along the academic career of one of the authors where physical personality of some coordinated specialization courses of dentistry is transmitted to the legal personality, both in public and private institutions. The current legislation, differences in physical and legal personalities, mental and personality disorders are explained, in addition to design some bouts of possibilities in medication, the authors also questioned the closure of hospitals. An exploratory methodology was used through key words in the CAPES and Scielo website, with the following keywords: Administrative Law ? Mental Health ? Dental Education ? Public health policies; as well as magazines and online newspapers. It concludes that the lack of knowledge in law by teachers, weaken the teaching and learning process of students, there are in some cases, the contractual carelessness and lack of differentiation personal and institutional where teachers and students are engaged. This may being passed in a cyclic process where learned and taught may be part of an unchanging system. There is the need to review the values in dental teaching methodology for those personality disorders do not perpetuate in persons and corporations, that there may prejudice those who has the notion of law and duties as basic rules of social life

As novas tecnologias para diagnóstico da cárie e seu impacto na prática profissional / New technologies for diagnosis of caries and its impact on professional practice

Com o objetivo de contribuir para o melhor conhecimento do diagnóstico em Odontologia, reforça-se a necessidade de se fazer progressos mais consistentes na tradução da pesquisa em Cariologia para o planejamento do cuidado clínico de rotina e para a prática, consistindo em determinar como melhor administrar o processo de tradução dos laboratórios de pesquisa para o consultório, para o paciente, para populações e para as autoridades políticas, em um cenário mais amplo. A cárie e as sequelas de sua evolução são responsáveis pela grande maioria dos tratamentos invasivos realizados pelos cirurgiões-dentistas. Seu diagnóstico pode ser realizado por vários métodos, que serão descritos nesse artigo, assim como os pontos mais relevantes do diagnóstico translacional, radiográfico, de atividade da doença, clínico, diferencial e métodos auxiliares para cumprir sua finalidade de orientar a prática clínica odontológica voltada à promoção de saúde.

Protocolo de atendimento odontológico durante a gestação / Protocol of dental care during pregnancy

A Medicina e a Odontologia recentemente abraçaram decisões clínicas baseadas em evidências para otimizar os resultados da saúde durante o pré-natal, considerando a avaliação da saúde oral como integrante aos demais cuidados médicos durante este período, abrangendo todas as mulheres, independente do trimestre gestacional. Para o sucesso destas ações, as entidades nacionais e internacionais recomendam aos profissionais que utilizem protocolos desenvolvidos com base na literatura científica para favorecer a qualidade e a segurança no atendimento odontológico, a fim de prevenir ou restabelecer a saúde oral da gestante, sem gerar riscos a sua prole.

Comparação entre a utilização do Cariescan Pro e outros métodos para diagnóstico precoce da cárie dentária / Comparison between the use of CarieScan Pro and other methods for early diagnosis of dental caries

A redução da doença cárie ainda é um desafio. Partindo da premissa que a perda de mineral começa bem antes da cavitação da lesão, o diagnóstico precoce da atividade da doença torna-se cada vez mais importante. O propósito deste trabalho foi realizar uma revisão da literatura acerca da utilização do CarieScan Pro, comparando-o com outros métodos empregados para diagnóstico precoce da perda mineral, decorrente da cárie dentária. O CarieScan Pro é um dispositivo portátil que usa a espectroscopia de impedância elétrica (EIS) para determinar as propriedades elétricas do dente. O dispositivo quantifica os níveis de desmineralização da estrutura dentária, sendo capaz de detectar e monitorar perdas minerais precocemente. Ainda que sejam poucos os estudos realizados com o CarieScan Pro, concluiu-se que o dispositivo é um método promissor para o diagnóstico precoce de lesões cariosas, apresentando expressivos índices quando comparados aos outros métodos de diagnóstico, e que as informações fornecidas pelo sistema permite ao profissional eleger as medidas terapêuticas preventivas, a fim de impedir a progressão da perda mineral, evitando a ocorrência de lesões cariosas cavitadas.

Métodos moleculares para diagnóstico microbiológico de cárie / Molecular methods for microbiological diagnosis of caries

Os estudos genéticos moleculares utilizam técnicas variadas para analisar os ácidos nucleicos (ADN e ARN). Assim, avanços no conhecimento da biologia molecular e do genoma humano forneceram evidências de que a maioria das doenças é influenciada por alterações em estruturas genéticas, o que possibilitou também o desenvolvimento de novas terapias e tratamentos. Os resultados desses estudos podem ser úteis no diagnóstico, prognóstico, determinação da terapia a ser utilizada, avaliação da susceptibilidade da doença e até mesmo em ações de prevenção. O objetivo deste estudo foi reunir as técnicas moleculares mais utilizadas em Odontologia para o diagnóstico microbiológico de grupos bacterianos envolvidos com o processo carioso.

Poder, finanças, direito e saúde / Power, finance, law and health

O objetivo do presente trabalho é levar ao conhecimento da comunidade científica temas atuais e polêmicos como o processo democrático e de representação brasileiro contemporâneo. O princípio da divisão dos poderes, tipos e propostas de orçamento público, legislação e execução de políticas públicas em saúde são explicitados. Além de projetarem algumas possibilidades de resultados, os autores utilizaram metodologia exploratória a partir de palavras-chave no portal Capes, assim como nos principais meios de comunicação. Ressaltaram, ainda, a possibilidade de inconvenientes futuros e ponderamentos sobre o direito e o assunto da saúde no congresso nacional brasileiro. Concluiu-se a necessidade do voto por mérito, na criação de escolas legislativas e executivas, e um estudo sobre partidos de fim, não ideológicos, desacreditados pelo povo que foi às ruas em recentes manifestações. É notório que os poderes públicos associados ao aporte financeiro constituem a base da verdadeira democracia brasileira

The aim of this study is to inform the scientific community current issues and controversial as the Brazilian democratic process and contemporary representation. The principle of powers separation, types and public budget proposal, legislation and public health policies are explained, in addition to designing some possible results, the authors used exploratory methodology from keywords on the website as well as in Capes mainstream media; also highlighted the possibility of future inconveniences on the right and the subject of health in Brazilian national Congress. The conclusion is the need to vote on merit, on establishing legislative and executive schools, and a study of parties and ideological purposes and not discredited by the people who were to the streets in recent demonstrations, since public power is associated with the financial support, and constitutes the basis of a true growing democracy in Brazil

Poder legislativo, leis, democracia e saúde dos brasileiros / Legislative power, laws, democracy and brazilian´s health

O objetivo do presente trabalho foi examinar os sítios das Assembleias Legislativas Estaduais de todo o Brasil de modo a verificar a atuação do Poder legislativo, avaliando e comparando projetos de lei, leis ordinárias e complementares, traçando um paralelo com a saúde da população regional. A metodologia utilizada foi exploratória, nos sítios das Assembleias Legislativas e do D.F. Observou-se: menor quantidade de leis em Saúde Bucal na Região Centro-Oeste e mais leis com preocupação oral na Região Sul, alguns sítios não disponibilizam projetos de lei em tramitação, assim como a página de Alagoas e existem problemas para verificar todos os projetos de lei existentes no sítio do Rio de Janeiro e na página de Santa Catarina. Conclui-se que existe a necessidade de uma padronização dos domínios e sítios do Poder Legislativo, assim como a informatização e atualização diária das atividades legislativas para consulta pública dos eleitores, o que fortalece a democracia e proporciona cobrança da população e pode haver transferência estadual de informações legislativas regionais relevantes, o que poderá contribuir para o desenvolvimento dos Estados e do Distrito Federal no Brasil

The objective of this study is to examine the sites of the State Legislative Assemblies throughout Brazil in order to verify the performance of the Legislature, evaluating and comparing bills, common and complementary laws, drawing a parallel with the health of the population. The methodology was exploratory, on the websites of Legislative Assemblies and Federal District. It was observed: Least amount of laws on Oral Health in the Midwest Region and more laws with oral concern in the South Region, some sites do not provide processing bills, as well as the page of Alagoas and there are problems to verify all bills available on the website of Rio de Janeiro and Santa Catarina. It is concluded that there is a need for standardization of the domains and websites of the Legislature, as well as the computerization and daily update of legislative activities for public voters consultation, which strengthens democracy and provides recovery of the population and there may be state transfer of relevant information, regional laws which may contribute to the development of the states and the Federal District in Brazil

Histórico do monitoramento e avaliação da Estratégia de Saúde da Família no Brasil / History of monitoring and evaluation of the Family Health Program in Brazil

A Estratégia de Saúde da Família representa hoje o eixo central da Atenção Básica no Brasil, solucionando 80% dos problemas de saúde da população. O processo de avaliação vem sendo inserido a partir do conhecimento das demandas de saúde da população e do planejamento das ações. O objetivo do estudo foi descrever a inserção dos programas de avaliação na Atenção Básica e descrever o primeiro ciclo do PMAQ-AB. Conclui-se que melhorias no acesso e na qualidade dos serviços de saúde dependem de políticas públicas voltadas à gestão descentralizada, da contratação de profissionais capacitados, do planejamento das ações e do monitoramento das políticas setoriais adotadas.

The Family Health Strategy currently represents the central axis of Primary Care in Brazil, solving 80% of the population's health problems. The evaluation process has been inserted in primary care over time, after the population's demands are known and health actions are planned. The goal of this study was to describe the insertion of the monitoring and evaluation programs in Primary Care and describe the first cycle of PMAQ-AB [Brazilian acronym]. It can be concluded that improvements in access and quality of health services depend on public policies for decentralized management, hiring qualified professionals as well as planning of actions and monitoring of the public policies adopted.