Healthy or diseased mouth? representations of oral health in vulnerable populations / ¿Boca sana o boca enferma? representaciones de la salud bucal en sectores vulnerables

Background: The society and the State must provide dental care and help prevent oral health problems by implementing public policies with cultural relevance that allow society to address and improve the inequity in health care that systematically affects people's well-being. The present study seeks to understand the representations of dental health in people who attend primary care services in vulnerable urban and rural areas of the central zone of Chile. Specifically, the representations of the causes, morbidities, and symptoms attributed to the healthy and diseased mouth. Material and Methods: A qualitative study based on the Grounded Theory was conducted, analyzing the social representations of oral health in a sample of 161 adult people receiving treatment at public primary care services and dental emergency units in rural and urban communes. Empirical saturation and triangulation by time, place, and subjects give reliability to the study. Results: The data obtained show that dental health is mainly valued for its implications for self-esteem and social integration. A naturalization of dental health problems is evidenced as an adaptive strategy to traditional access barriers, which is counterproductive with preventive strategies. Conclusion: The results of the study suggest the need to reinforce education in dental health implemented in a transversal manner, having aesthetic values and the population's expectations of sociability as the key to action.

Antecedentes: Como sociedad y desde el Estado debemos cuidar y prevenir los problemas de salud oral invirtiendo en políticas públicas con pertinencia cultural que nos permitan subsanar la inequidad sanitaria que afecta de manera integral el bienestar de las personas. El estudio busca comprender las representaciones de la salud dental en personas que asisten a la atención primaria en sectores urbanos y rurales vulnerables de la zona central de Chile; en especial las representaciones de las causas, morbilidades y síntomas atribuidos a la boca sana y enferma. Material y Métodos: Estudio cualitativo que analiza desde la Teoría Fundamentada las representaciones sociales de la salud bucodental en una muestra de 161 personas adultas consultantes de los servicios públicos de atención primaria y de urgencia odontológica en comunas rurales y urbanas. La saturación empírica y la triangulación por tiempo, lugar y sujetos otorgan confiabilidad al estudio. Resultados: Los datos obtenidos dan cuenta que la salud dental es principalmente valorada por sus implicancias para la autoestima y la integración social. Se evidencia una naturalización de los problemas de salud dental, como estrategia adaptativa a las tradicionales barreras de acceso, lo que es contraproducente con las estrategias preventivas. Conclusión: Los resultados del estudio nos alertan respecto de la necesidad de reforzar la educación en salud dental, teniendo como clave para la acción, de manera transversal, los valores estéticos y las expectativas de sociabilidad de la población.

What do people do before going to the dentist? qualitative study of cultural practices of pain relief in primary care

Objective: to describe and classify the main cultural practices used to relieve orodental pain in people who seek emergency dental care in vulnerable urban and rural areas of central Chile. methodology: a sample of 88 adults residing in urban and rural sectors, who received treatment at primary care emergency dental services in three districts of the central area of Chile was studied using a qualitative descriptive approach of sociocultural epidemiological orientation based on grounded theory. interviews were conducted in the waiting room of the emergency service or at the patient's home. empirical saturation and triangulation of temporal data were protected. results: practices of biomedical origin (self-medication and care received at dental emergency services) and socio-cultural practices were documented. they include the use of chemical products (iodine, phosphorus, battery acid, hydrogen peroxide, gasoline, and alcoholic drinks, among others), herbal infusions (buddleja globosa, aloe vera), mechanical-physical techniques (use of cold or heat, massage); subjects also perform the mechanical manipulation of the area with sharp objects, occasionally extracting the tooth itself. practices occur more frequently at home when the person feels the pain in the affected area, and end on the dental chair with the tooth extraction. conclusions: the coexistence of biomedical practices and alternative cultural strategies was observed. these practices complement each other and make people postpone seeking professional dental care, which may worsen their health condition.

Patient satisfaction and quality of emergency dental care in chilean public health services

The provision of dental care services, related to the quality requirements of health policies and patient satisfaction rates, increasingly requires the creation of qualitative indicators, instruments and criteria based on specific objectives, to validate the quality of the services provided. objective: the aim of this study is to determine the main dimensions of the dentist-patient relationship associated with patient satisfaction in a clinical context, with emphasis on the needs and expectations of patients themselves. method: a sample of 88 adults who attend primary care units at public emergency services in the central area of Chile were studied using a qualitative approach based on the social psychology of health and on grounded theory. from these, categories emerged that identify processes, attitudes and behaviors that define the assessment of care providers based on their practices. results: in an interactional context characterized by the patient's expectation regarding the provision of care and anxiety due to potential pain, two already recognized main axes emerged, namely: the capacity to generate trust through interpersonal and communicative good treatment strategies, and the capacity or technical skills of the professional care provider. conclusion: this study proposes a protocol of good care practices, which takes into account the needs and expectations of patients regarding the role of the dentist.