Resumption of brazilian oral medicine health care during the second period of the COVID-19 pandemic

Aim: This present study aims to compare the data from the Brazilian Unified Health System on the number of clinical consultations of Oral Medicine from the first 6 months (March-August 2020) of the COVID-19 pandemic in Brazil with the last 6 months (September-February 2020/2021) to update the data, verify the measures' effectiveness to return clinical activities in the following months. Methods: perform a literature review of recent articles that report the impact of the COVID-19 pandemic on Oral Medicine. Results: There was an increase in the number of Oral Medicine clinical consultations in the second half of the pandemic throughout Brazil (+64.2%), representing over 9,235 appointments in this period. Conclusion: measures for the return of health assistance and the practice of Telemedicine proved to be effective after the second period of the pandemic. Even so, strengthening security measures against the coronavirus is essential to ward off a new wave since the Omicron variant emerged in the country and, consequently, possible new lockdowns that might affect healthcare in Brazil

The Role of Socioeconomic and Health Services Organizational Factors on Infection Control Structure Score, Brazil / O Papel dos Fatores Socioeconômicos e de Organização dos Serviços de Saúde sobre o Escore da Estrutura de Controle de Infecção, Brasil

Abstract This study aimed to analyze possible associations between the Infection Control Structure Score (ICSS), health services, and social characteristics of the municipalities in Brazil. Secondary data from the third cycle 2017-2018 of the Brazilian National Program for Improving Primary Care Access and Quality (PMAQ) was analyzed. Six independent variables - FIRJAN Index of Municipal Development, number of inhabitants, number of family health teams receiving a financial incentive from the federal government, healthcare expenditure per capita, and number of Oral Health Teams modalities 1 and 2 - were included to assess their influence on ICSS, measured for each Brazilian town. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25. A total of 4,900 municipalities were included, and the mean ICSS was 0.905 (±0.092). A positive relationship was observed between healthcare expenditure per capita, municipal development, and the outcome. Conversely, towns with a higher number of family health teams receiving a financial incentive from the federal government showed lower mean ICSS. The findings suggest that inequalities in the infection control structures exist within the country, and they were related to the health services and social characteristics of the municipalities.

Resumo Este estudo objetivou analisar as possíveis associações entre o Escore da Estrutura de Controle de Infecção (EECI), os serviços de saúde e características sociais dos municípios brasileiros. Foram analisados dados secundários do terceiro ciclo 2017-2018 do Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ). Seis variáveis independentes - Índice FIRJAN de Desenvolvimento Municipal, número de habitantes, número de Equipes de Saúde da Família que recebiam incentivo financeiro do governo federal, gasto com saúde per capita e número de Equipes de Saúde Bucal modalidades 1 e 2 - foram incluídas para avaliar a influência sobre o EECI, medido para cada município brasileiro. Para a análise dos dados, foi utilizado o modelo de Árvore de Classificação e Regressão no IBM SPSS 25. Foram incluídos 4.900 municípios, e o EECI médio foi de 0,905 (±0,092). Observou-se uma associação positiva entre o gasto com saúde per capita, o desenvolvimento municipal e o desfecho. Por outro lado, municípios com maior número de Equipes de Saúde da Família com incentivo financeiro do governo federal apresentaram menor média do EECI. Os achados sugerem que existem desigualdades nas estruturas de controle de infecções no país, relacionadas aos serviços de saúde e às características sociais dos municípios.

Oral conditions of children with microcephaly associated with congenital Zika syndrome: a cross-sectional study

Abstract The aim of the present study was to compare the oral conditions of children with congenital Zika syndrome (CZS)-associated microcephaly, non-CZS-associated microcephaly, and normotypical children, as well as to characterize their sociodemographic aspects and medical history. A paired cross-sectional study was carried out on 14 children with CZS-associated microcephaly and 24 age-matched controls, in Belo Horizonte, in southeastern Brazil. Children's oral conditions were assessed: dental caries experience (dmft/DMFT indices); developmental defects of enamel (DDE) index; dental anomalies; mucosal changes; lip sealing, and malocclusion (overjet, overbite, and/or posterior crossbite alterations). The quality of oral hygiene was analyzed by the simplified oral hygiene index. The children's mothers also answered a questionnaire about sociodemographic and medical history data. The variables were analyzed descriptively. Female participants were more prevalent (60.5%), and the mean age of the participants was 4.9 years (±1.4) (range: 2-8 years) and 92.1% of their exhibited some oral condition. All participants with CZS-associated microcephaly showed absence of lip sealing and had malocclusion (100.0%). When compared to the other groups, children with CZS had a higher percentage of dental anomalies (35.7%), mucosal changes (71.4%), and unsatisfactory oral hygiene (64.3%). In a sample composed mainly of female participants aged less than 5 years, the prevalence of oral conditions and unsatisfactory oral hygiene was higher in the group with CZS-associated microcephaly, followed by the group with non-CZS-associated microcephaly. Normotypical children had the highest percentage of dental caries experience.

Atendimento odontológico de pacientes com necessidades especiais na atenção secundária em um estado do nordeste do Brasil / Dental care of special needs patients in secondary care in a northeastern state of Brazil / Atención odontológica a pacientes con necesidades especiales en la atención secundaria en un estado del nordeste de Brasil

O objetivo desse estudo foi descrever a produção dos atendimentos oferecidos aos pacientes com necessidades especiais nos Centros de Especialidades Odontológicas (CEO) da Paraíba (Brasil) e sua relação com o cumprimento das metas de produtividade, entre o período de 2019 e 2022. Trata-se de um estudo descritivo e ecológico em que foram coletados dados secundários do Sistema de Informações Ambulatoriais do SUS (SIA/SUS), através da captação da produção ambulatorial individualizada (BPA-I), por meio da ferramenta TabWin, dos 98 CEO operantes na Paraíba. Realizou-se análise descritiva e analítica, por meio dos testes Qui-Quadrado de Pearson e Exato de Fisher entre a variável dependente "alcance da meta" e a variável independente "adesão à Rede de Cuidados à Pessoa com Deficiência (RCPD)". Em todos os anos, a porcentagem de CEO cumpridores da meta (15,3% em 2019; 1% em 2020; 12,2% em 2021; e 11,2% em 2022) foi substancialmente menor que os números expressados por aqueles que não alcançaram a produção mínima. Os resultados também apontaram maior realização de procedimentos restauradores (29,6% em 2019; 28,6% em 2020; 32,7% em 2021; e 37,8% em 2022) em detrimento aos periodontais, cirúrgicos e preventivos. No que concerne a estar aderido à RCPD, no ano de 2022, 90,9% dos CEO que alcançaram a meta estavam aderidos à Rede (p<0,05). Concluiu-se que uma baixa frequência de CEO alcançou o cumprimento da meta de produtividade da especialidade de Odontologia para Pacientes com Necessidades Especiais nos CEO. No entanto, a adesão à RCPD manifestou-se como elemento influenciador para aqueles que cumpriram suas metas mensais e anuais.

The objective of this study was to describe the production of care provided to special needs patients in the Dental Specialties Centers (CEO) of Paraíba (Brazil) and its relationship with the achievement of productivity goals, between the period 2019 and 2022. This is a descriptive and ecological study in which secondary data were collected from the SUS Outpatient Information System (SIA/SUS), by capturing the individualized outpatient production (BPA-I), through the TabWin tool, of the 98 operating CEOs in Paraíba. We carried out descriptive and analytical analysis, using Pearson's Chi-square and Fisher's Exact tests between the dependent variable "goal attainment" and the independent variable "adherence to the Care Network for People with Disabilities (RCPD)". In all years, the percentage of CEOs meeting the goal (15.3% in 2019; 1% in 2020; 12.2% in 2021; and 11.2% in 2022) was substantially lower than the numbers expressed by those who did not meet the minimum output. The results also indicated greater performance of restorative procedures (29.6% in 2019; 28.6% in 2020; 32.7% in 2021; and 37.8% in 2022) to the detriment of periodontal, surgical, and preventive procedures. Regarding being adhered to the RCPD, in the year 2022, 90.9% of the CEOs who reached the goal were adhered to the Network (p<0.05). It was concluded that a low frequency of CEOs achieved compliance with the productivity target of the specialty of Dentistry for Special Needs Patients in CEOs. However, adherence to the RCPD manifested itself as an influential element for those who met their monthly and annual goals.

El objetivo de este estudio fue describir la producción de la atención prestada a pacientes con necesidades especiales en los Centros de Especialidades Odontológicas (CEO) de Paraíba (Brasil) y su relación con el alcance de las metas de productividad, entre el período de 2019 y 2022. Se trata de un estudio descriptivo y ecológico en el que se recogieron datos secundarios del Sistema de Información Ambulatoria del SUS (SIA/SUS), mediante la captura de la producción ambulatoria individualizada (BPA-I), a través de la herramienta TabWin, de los 98 CEOs en funcionamiento en Paraíba. Se realizaron análisis descriptivos y analíticos, utilizando las pruebas Chi-cuadrado de Pearson y Exacta de Fisher entre la variable dependiente "cumplimiento de metas" y la variable independiente "adhesión a la Red de Atención a Personas con Discapacidad (RCPD)". En todos los años, el porcentaje de directores generales que cumplieron el objetivo (15,3% en 2019; 1% en 2020; 12,2% en 2021; y 11,2% en 2022) fue sustancialmente inferior a las cifras expresadas por los que no alcanzaron el rendimiento mínimo. Los resultados también indicaron una mayor realización de procedimientos restauradores (29,6% en 2019; 28,6% en 2020; 32,7% en 2021; y 37,8% en 2022) en detrimento de los procedimientos periodontales, quirúrgicos y preventivos. Respecto a estar adherido a la RCPD, en el año 2022, el 90,9% de los CEOs que alcanzaron el objetivo estaban adheridos a la Red (p<0,05). Se concluyó que una baja frecuencia de CEOs alcanzó el cumplimiento de la meta de productividad de la especialidad de Odontología para Pacientes con Necesidades Especiales en CEOs. Sin embargo, la adhesión al RCPD se manifestó como un elemento influyente para aquellos que cumplieron sus objetivos mensuales y anuales.

Manejo odontológico del paciente en tratamiento de anticoagulante oral sometido a cirugía oral: una revisión narrativa / Stomatological management of anticoagulated patients undergoing oral surgery: a narrative review

Resumen Los pacientes que se encuentran bajo tratamiento de anticoagulantes orales, presentan alteraciones en distintas etapas de la hemostasia, lo que conlleva a tener implicancias y consideraciones médico/quirúrgicas durante su atención. En la actualidad, no existe un consenso en relación con el manejo odontológico de estos pacientes que serán sometidos a procedimientos quirúrgicos, llevando a protocolos clínicos que siguen diversas posturas, como la de disminuir la ingesta farmacológica del anticoagulante, sustituir con heparina y la de mantener el tratamiento bajo control. Objetivo Establecer el manejo estomatológico del paciente que se encuentra en tratamiento de anticoagulante oral mediante una revisión profunda de la literatura Materiales y método Se realizó una búsqueda de revisión bibliográfica manualmente de artículos indexados a las bases de datos de PUBMED y EBSCO que correspondiesen a las palabras "cirugía bucal", "anticoagulantes", "atención dental" y "hemorragia oral". En cuanto a los criterios de inclusión, se consideraron revisiones bibliográficas, estudios observacionales, ensayos clínicos, guías, revisiones sistemáticas y metaanálisis publicados entre noviembre de 2005 y 2022, en idiomas inglés o español. Conclusiones Existen múltiples protocolos para la atención del paciente anticoagulado que será sometido bajo procedimiento de cirugía oral menor. Es importante considerar el anticoagulante utilizado, motivo, control de este, el procedimiento a realizar en el paciente y medidas hemostáticas tanto intra como postoperatorias por realizar, tras analizar lo anterior, se advierte que disminuir la ingesta del fármaco para realizar el procedimiento, puede ser más perjudicial al paciente como al clínico, por lo tanto se sugiere mantener el tratamiento antitrombótico y realizar un correcto manejo médico/quirúrgico.

Abstract Patients undertaking oral anticoagulant treatment may experience alterations in different stages of hemostasis, which lead to medical/surgical implications and considerations during their care. Currently, there is no consensus regarding the dental management of these patients, as they go through surgical procedures. This leads to clinical protocols that follow numerous approaches, such as reducing the pharmacological intake of the anticoagulant, replacing it with heparin, and maintaining the controlled treatment. Objective: To establish the stomatological management of the patient undergoing oral anticoagulant treatment through an in depth review of the literature. Materials and Method: A manual bibliographic review search of articles indexed to the PUBMED and EBSCO databases corresponding to the words "oral surgery", "oral bleeding", "anticoagulants" and "dental management" was performed. Regarding the inclusion criteria: bibliographic reviews, observational studies, clinical trials, guidelines, systematic reviews, and meta-analyses published between November 2005 and 2022, in English or Spanish, were considered. Conclusion: There are multiple protocols for the care of the anticoagulated patient who will undergo a minor oral surgery procedure. It is important to reflect on the anticoagulant used, the reason for it, its supervision, the surgical procedure that will be undertaken by the patient, and both intraoperative and postoperative hemostatic measures to be implemented. After analyzing the above, it is noted that reducing the intake of the drug to perform the surgical procedure may be harmful to the patient and to the clinician, therefore it is suggested to maintain the antithrombotic treatment and carry out a correct medical/surgical management.

Ansiedad, sentimientos del odontólogo y medidas adoptadas en la atención clínica durante la pandemia COVID-19

Introducción: la pandemia COVID-19 ha afectado la práctica odontológica por el alto riesgo de contagio durante su ejercicio. El objetivo del estudio fue determinar el nivel de ansiedad, sentimientos manifestados y medidas adoptadas en la atención clínica por el odontólogo durante la pandemia COVID-19 en Lima Metropolitana-Perú. Métodos: estudio descriptivo, prospectivo y transversal realizado en 386 odontólogos de Lima Metropolitana-Perú en los primeros meses del 2021. El nivel de ansiedad se midió a través del: Generalized Anxiety Disorder. Se confeccionó y validó un cuestionario para medir los sentimientos y medidas adoptadas, que fue enviado a través de distintas redes sociales. Resultados: los niveles de ansiedad leve y moderada se presentaron en el 42,5% y 21,2% respectivamente, presentándose mayores niveles de severidad en las mujeres (p<0,001). A mayor edad y número de años de experiencia profesional el nivel de ansiedad fue menor (Rho=-0,132; p=0,009) y (Rho=-0,129, p=0,011). Los sentimientos experimentados aumentaron a medida que el nivel de ansiedad fue mayor p<0,001. El 97,7% manifestó haber modificado el uso de equipos de protección personal como el uso de mascarillas respiratorias tipo N95 y el protector facial, y el 48,7% reveló haber tenido alguna dificultad para obtenerlo. La medida más utilizada en la atención clínica fue el lavado de manos antes y después de cada atención (92,7%) y el uso de luz ultravioleta (42,5%) fue la menos utilizada. Conclusiones: los odontólogos han cambiado el protocolo de atención, manifestando diferentes niveles de ansiedad acompañados de sentimientos negativos durante la pandemia COVID-19.

Introduction: the COVID-19 pandemic has affected dental practice, due to the high risk of contagion during its practice. The objective of the study was to evaluate the level of anxiety; emotions and measures taken by dentists during COVID-19 pandemic in Lima Metropolitana-Peru. Methods: the study was descriptive, prospective, and cross-sectional carried out in 386 dentists practicing in Lima Metropolitan-Peru during the first months of 2021. Level of anxiety was assessed by "Generalized Anxiety Disorder 7-item" (GAD-7) scale. A questionnaire was developed and validated to evaluate emotions and measures taken and was sent through different social networks. Results: mild and moderate anxiety were present in 42.5% and 21.2% respectively, with higher levels of severity in women (p<0.001). The higher the age and number of years of professional experience, the level of anxiety was lower (Rho=-0.132; p=0.009) and (Rho=-0.129, p=0.011). The emotions increased as the level of anxiety was higher p<0.001. 97.7% stated that they had modified the use of personal protective equipment such as the use of N95-type respiratory masks and face shields, and 48.7% revealed that they had some difficulty in obtaining it. The most used measure in clinical practice was hand washing before and after treatment (92.7%), while the use of ultraviolet light (42.5%) was the least used. Conclusions: dentists have changed care protocol, manifesting different levels of anxiety accompanied by negative emotions during COVID-19 pandemic.

Panorama da cobertura de cirurgiões-dentistas em equipes de saúde na Macrorregião Norte de Minas Gerais: análise de aspectos determinantes / Overview of dentists' coverage in health teams in the Northern Macroregion of Minas Gerais: analysis of determinant aspects

Objetivo: Realizar levantamento sobre a incidência de equipes de saúde da família, equipes de saúde bucal e cirurgiões-dentistas na Macrorregião Norte de Minas Gerais de 2008 a 2023. Métodos: Estudo original, de natureza quantitativa e descritiva, elaborado entre março e abril de 2023. Os dados utilizados no presente trabalho referem-se às equipes de saúde e profissionais colaboradores e foram obtidos na plataforma DATASUS. O único critério de inclusão considerado foi município ser pertencente à Macrorregião de Saúde Norte de Minas Gerais, conforme o Plano Diretor do estado. Resultados: Dos 86 municípios da macrorregião Norte de Minas Gerais avaliados, 63 (73,2%) apresentaram aumento no número de equipe de saúde bucal e de cirurgiões-dentistas em 2023, comparado com2008. Observou-se um aumento exponencial nos municípios Várzea da Palma (733,2%), Fruta de Leite (729,4%) e Francisco Dumont (550,3%). Conclusões: Houve aumento no número de equipes de saúde bucal e equipes de saúde da família em todos os municípios, demonstrando distribuição satisfatória dos cirurgiões-dentistas no setor público e a preocupação com a saúde bucal da população por parte das autoridades do poder público.

Objective:To conduct a survey on the incidence of Family Health Teams, Oral Health Teams and dentists in the Northern Macroregion of Minas Gerais from 2008 to 2021. Methods: Original study, quantitative and descriptive nature, prepared between the months of March and April 2023. The data used in the present study refer to the health teams and collaborating professionals and were obtained from the DATASUS platform. Theonly inclusion criterion considered was a municipality belonging to the Northern Health Macro-region of Minas Gerais, according to the state's Master Plan. Results:Of the 86 municipalities in the northern macro-region of Minas Gerais evaluated, 63 (73.2%) showed an increase in the number of Health Teams and dentists in 2023, compared to 2008. An exponential increase was observed in the municipalities of Várzea da Palma (733.2%), Fruta de Leite (729.4%) and Francisco Dumont (550.3%). Conclusions:There was an increase of in the number of Oral Health Teams and Family Health Teams in all municipalities, demonstrating a satisfactory distribution of dentists in the public sector and the concern with the oral health of the population by the authorities of the public power

Resultados de la técnica ortoradial vs técnica paralela en la identificación de conductos de primeros premolares superiores y primeros molares inferiores

Fundamento: los avances en la imagenología y su implementación en la Odontología permiten lograr mejores tratamientos. Objetivo: describir los resultados de la técnica ortoradial vs técnica paralela en la identificación de conductos de primeros premolares superiores y primeros molares inferiores. Métodos: estudio observacional, descriptivo y transversal en pacientes con necesidad de tratamiento de conductos de primeros premolares superiores o primeros molares inferiores, que acudieron a la Unidad de Atención Odontológica de la Universidad Regional Autónoma de los Andes en el periodo abril-agosto de 2019. La muestra la constituyeron 62 pacientes, separados en dos grupos: premolares superiores (n=30) o primeros molares inferiores (n=32) y ambos en otros dos grupos según técnica empleada (técnica paralela y técnica ortoradial). Resultados: en los primeros premolares superiores la técnica ortoradial mostró mejores resultados que la paralela para obtener imágenes precisas (100 % vs. 20 %). En los primeros molares inferiores, la técnica ortoradial mostró resultados superiores a la técnica paralela para el conducto mesiolingual (93,75 % vs 31,25 %) y conducto disto lingual (31,25 % vs 12,5 %). La elongación de las raíces predominó en la técnica ortoradial (n=8), al igual que la superposición dental (n=10). Conclusiones: la técnica ortoradial mostró resultados superiores al momento de localizar tanto el conducto vestibular y palatino en los primeros premolares superiores como para el conducto mesiolingual y el conducto distolingual. La elongación de las raíces se observó en mayor cuantía en la técnica ortoradial, al igual que la superposición dental.

Foundation: advances in imaging and its implementation in Dentistry allow for better treatments. Objective: to describe the results of the orthoradial technique vs parallel technique in the identification of upper first premolars canals and lower first molars. Methods: observational, descriptive and cross-sectional study in patients in need of root canal treatment of upper first premolars or lower first molars, who attended the Dental Care Unit of the Andes Regional Autonomous University from April to August 2019. The sample consisted of 62 patients, separated into two upper premolar groups (n=30) or lower first molars (n=32) and both into two other groups according to the technique used (parallel technique and orthoradial technique). Results: in the upper first premolars, the orthoradial technique showed better results than the parallel technique to obtain accurate images (100% vs. 20%). In the lower first molars, the orthoradial technique showed superior results to the parallel technique for the mesiolingual canal (93.75% vs 31.25%) and distolingual canal (31.25% vs 12.5%). Root elongation predominated in the orthoradial technique (n=8), as did dental overlap (n=10). Conclusions: the orthoradial technique showed superior results when locating both the buccal and palatine canal in the upper first premolars and for the mesiolingual canal and the distolingual canal. Root elongation was observed to a greater extent in the orthoradial technique, as was dental overlap.

Idosos Domiciliados: Saúde Geral x Higiene Bucal / Elderly People Living at Home: General Health x Oral Hygiene

O Serviço Integrado da Assistência Domiciliar (SIAD) foi criado a fim de prestar atendimento integral domiciliar a idosos que apresentam incapacidade de se locomover para as unidades de atendimento de saúde da Marinha do Brasil (MB). Com a finalidade de avaliar o perfil de saúde geral e de higiene dental desses pacientes, foi realizado um estudo transversal, quantitativo e descritivo, no qual foram incluídos idosos com 60 anos ou mais, assistidos entre fevereiro de 2017 a dezembro de 2022. Pode-se observar que a maioria dos idosos eram longevos, com média de idade de 82,52 anos (±8,66), mulheres (63,52%) e possuíam dependência total para realizar atividades básicas de vida diária (88,9%). Conclui-se que a síndrome demencial foi o diagnóstico principal mais encontrado (44,3%), a maioria possuía comorbidade associada (71,9%), sendo a Hipertensão Arterial Sistêmica (59,2%) e o Diabetes Mellitus (28,9%) as mais recorrentes. Foi encontrada uma elevada prevalência de idosos domiciliados com higiene bucal insatisfatória (34,7%) ou irregular (57,2%). No entanto, não houve associação entre higiene dental, comorbidades e grau de dependência. Assim sendo, é imprescindível que os idosos domiciliados recebam orientações e sejam submetidos a um acompanhamento rigoroso e constante, juntamente com seus cuidadores, a fim de promover a melhoria da higiene oral desses pacientes.

The Integrated Home Assistance Service (IHAS) was created to provide integral home care for elderly people who are unable to go to the health care units of the Brazilian Navy. A cross-sectional, quantitative, and descriptive study was carried out to evaluate the general health and dental hygiene profile of these patients. The study included elderly people aged 60 years or older who were assisted between February 2017 and December 2022. Most of them were long-lived, with a mean age of 82.52 (±8.66) years, women (63.52%) and totally dependent on performing basic activities of daily living (88.9%). The most common diagnosis among them was dementia syndrome, accounting for 44.3% of cases. Additionally, a large portion of the elderly had associated comorbidities (71.9%), with Systemic Arterial Hypertension (59.2%) and Diabetes Mellitus (28.9%) as the most recurrent conditions. The study found a high prevalence of elderly with unsatisfactory (34.7%) or irregular (57.2%) oral hygiene. Nevertheless, there was no significant association between dental hygiene and comorbidities or the degree of dependence. Therefore, it is imperative that elderly people living at home receive guidance and undergo meticulous and ongoing monitoring, in conjunction with their caregivers to promote improvements in the oral hygiene of these patients.

Medidas de bioseguridad contra la COVID-19 durante la atención odontológica, en una región del Perú

Introducción: La atención odontológica, por su propia naturaleza, implica un mayor riesgo de trasmisión del SARS-CoV-2. Por tanto, es esencial que el personal del centro odontológico extreme las medidas de bioseguridad durante y después de la crisis sanitaria. Objetivo: evaluar el cumplimiento de las medidas de bioseguridad contra la COVID-19 durante la atención odontológica, en una región del Perú. Materiales y métodos: Estudio transversal realizado en la región de Ica, en Perú. Participaron 304 odontólogos de la práctica pública y privada. Se recogieron características sociolaborales y de salud. El cumplimiento de medidas de bioseguridad fue evaluado con la Escala de Bioseguridad para COVID-19, diseñada y validada por los investigadores. Se realizó un análisis descriptivo y se evaluaron diferencias con la prueba chi-cuadrado. Resultados: El 72,7 % de los participantes incumplen las medidas de bioseguridad. Se observaron mayores proporciones de incumplimiento entre los odontólogos de 41 a 50 años de edad (76 %), sin segunda especialidad (76,4 %), y en quienes recibieron la primera (100 %) y la segunda dosis (90,4 %) de la vacuna contra la COVID-19. Asimismo, entre los odontólogos que laboran en el sector privado que no tienen segunda especialidad (75,3 %); entre los que recibieron la primera dosis de la vacuna contra la COVID-19 (100 %) y la segunda dosis (92,2 %) respectivamente; en quienes tuvieron dos veces (100 %) y más de dos veces (100 %) COVID-19, y en aquellos que no tuvieron familiar fallecido por el coronavirus. Todas estas diferencias alcanzaron significancia estadística (p < 0,05). Conclusión: Durante la atención odontológica se incumplen las medidas de bioseguridad. Existen ciertos factores como la edad entre 41 y 50 años, no tener segunda especialidad, entre otros, que podrían incrementar la probabilidad de incumplir estas medidas.

Introduction: Dental care, by its proper nature, implies a higher risk of SARS-CoV-2 transmission. It is therefore essential that the dental center staff carry to extremes biosecurity measures during and after the health crisis. Objective: To evaluate compliance with biosecurity measures against COVID-19 during dental care in a region of Peru. Materials and methods: Cross-sectional study carried out in the region of Ica, in Peru. 304 dentists from public and private practice participated. Socio-occupational and health characteristics were collected. Compliance with biosecurity measures was evaluated with the Biosecurity Scale for COVID-19, designed and validated by the researchers. A descriptive analysis was performed and differences were evaluated with the chi-square test. Results: 72.7% of the participants fail to comply with the biosecurity measures. Higher proportions of non-compliance were found among the dentists from 41 to 50 years old (76%), without a second specialization (76.4%), and in those who received the first (100%) and the second (90.4%) doses of the vaccine against COVID-19. Likewise, among dentists who work in the private sector and do not have second specialty (75.3%); among those who received the first dose (100%) and the second dose (92.2%) of the vaccine against COVID-19 respectively; in those who had COVID-19 twice (100%) and more than twice (100%), and in those dentist who did not have relatives deceased by coronavirus. All these differences reached statistical significance (p < 0, 05). Conclusions: Biosafety measures are breached during dental care. There are several factors like age between 41 and 50 years, not having a second specialty among others that could increase the probability of failing to comply with these measures.

Alterações bucais associadas ao tratamento antineoplásico e a importância da assistência odontológica ao paciente oncológico: uma revisão integrativa / Oral alterations associated with antineoplastic treatment and the importance of dental care for oncology patients: an integrative review / Alteraciones orales asociadas al tratamiento antineoplásico y la importancia de la atención dental en pacientes oncológicos: una revisión integrativa

O tratamento oncológico por meio da quimioterapia e radioterapia consiste em destruir ou impedir o crescimento das células tumorais, visando a cura ou controle da doença. No entanto, esses tratamentos podem ocasionar danos às células saudáveis e consequentes efeitos colaterais, especialmente na cavidade oral, causando alterações como: mucosite, xerostomia, disgeusia, infecções orais, trismo e osteorradionecrose. Objetivo:Sumarizar estudos sobre a importância da prevenção ecuidado das alterações bucais no manejo odontológico a pacientes em tratamento oncológico.Metodologia:Revisão integrativa, a partir da identificação do tema e elaboração da questão norteadora com busca sistematizada da literatura realizada entre os meses de setembro e novembro de 2022. Foram realizadas buscasnas bases de dados da Biblioteca Virtual em Saúde, Google Acadêmicoe PubMed, excluindo-se artigos publicados há mais de cinco anos.Resultados:Obteve-se uma amostra final de seteestudos, após aplicação dos critérios de inclusão e exclusão.Houve concordância entre todos eles acerca das alterações bucais durante o tratamento oncológico, enfatizando a necessidade de assistência odontológica nesses pacientes antes, durante e após a terapia antineoplásica, além deminimizar efeitos desta intervenção. Conclusões:A atuação do cirurgião-dentista no cuidado aos pacientes oncológicos tem grande relevância, uma vez que as condições de saúde bucal impactam a qualidade de vida desses indivíduos. Em suma, o presente estudo contribuino entendimento das alterações bucais e cuidados para o bem-estar do paciente (AU).

Oncologicaltreatment through chemotherapy and radiotherapy consists of destroying or preventing the growth of tumor cells, aiming at curing or controlling the disease. However, these treatments can cause damage to healthy cells and consequent side effects, especially in the oral cavity, causing changes such as: mucositis, xerostomia, dysgeusia, oral infections, trismus and osteoradionecrosis. Objective:To summarize studies on the importance of prevention and care for oral changes in the dental management for patients undergoing oncologicaltreatment.Methodology:Integrative reviewfrom theidentification of the theme and elaboration of the guiding question with a systematic search of the literature carried out between September and November 2022. They were carried out searchesin the Virtual Health Librarydatabase, Google Scholar and PubMed, excluding articles published more than five years ago.Results:A final sample of 07 studies was obtained, after applying the inclusion and exclusion criteria. There was agreement among all of them about oral changes during cancer treatment, emphasizing the need for dental care in these patients before, during and after antineoplastic therapy, in addition to minimizing the effects of this intervention.Conclusions:The performance of the dental surgeon in the care of cancer patients is of great relevance, since oral health conditions impact the quality of life of these individuals. In short, the presentstudy contributesto the of oral changesand care for the patient's well-being (AU).

El tratamiento oncológicopor mediodequimioterapia y radioterapia consiste en destruir o impedir el crecimiento de las células tumorales, visando lacurar o controla de la enfermedad. Sin embargo, estos tratamientos pueden causar daño a las células sanasy en consecuenciaefectos secundarios, especialmenteen la cavidad oral, causandoalteraciones como: mucositis, xerostomía, disgeusia, infecciones orales, trismoy osteorradionecrosis.Objetivo: Resumir estudios acerca de la importancia de la prevención y cuidados de las alteracionesorales en el manejo dental apacientes en tratamiento oncológico.Metodología: Revisión integrativa, apartir de la identificación detema y elaboración de la pregunta guía con buscasistematizadade la literatura realizada entre los meses de septiembre y noviembre de 2022. Fueron realizadas búsquedas en las bases de datos de la Biblioteca Virtual en Salud, Google Académico y PubMed, excluyéndoseartículos publicados hace más de cinco años. Resultados: Se obtuvo una muestra final de siete estudios, después aplicaciones de los criterios de inclusión y exclusión. Hubo concordancia entre todos acerca de las alteracionesorales durante el tratamiento oncológico, enfatizando la necesidad de asistencia odontológica en esespacientes antes, durante y después de la terapia antineoplásica, además de minimizar efectos de esta intervención.Conclusiones: La actuación del cirujano dentistaen el cuidado a lospacientes oncológicos tienegran relevancia, una vez que las condiciones de salud oral impactan la calidad de vida de los individuos. En suma, el presente estudio contribuyeen el entendimientode las alteraciones orales y cuidados para el bienestar del paciente (AU).

Modelo para el desarrollo de competencias profesionales específicas en la atención a pacientes con enfermedades estomatognáticas / Model for the development of specific professional competence in the care of patients with stomatognathic diseases i: en

Introducción: Las competencias profesionales son cualidades humanas que permiten una visión personalizada en un individuo, el cual se desempeña en un contexto único y, a la vez, cambiante, buscando desarrollar los recursos personológicos que debe utilizar en su vida laboral. Objetivo: Valorar la implementación de un modelo para el desarrollo de competencias profesionales específicas en la atención a pacientes con enfermedades estomatognáticas. Métodos: Se realizó un estudio en educación médica en la Facultad de Estomatología de la Universidad de Ciencias Médicas en Santiago de Cuba, durante el curso 2018-2019. La población estuvo constituida por los 59 residentes que cursaban el primer año de la especialidad de Estomatología General Integral, en quienes se aplicó un modelo para el desarrollo de competencias profesionales específicas. Durante la investigación se usaron métodos teóricos y empíricos, así como estadísticos, particularmente la distribución de frecuencias absoluta y relativa y la prueba de McNemar para determinar el nivel de desarrollo después de implementado el modelo. Resultados: Se obtuvieron opiniones positivas en el taller de socialización luego de la implementación práctica del modelo. De los residentes en estomatología, 96,4 % aprobó su pertinencia, mientras que 83,1 % estuvo muy satisfecho con él. Conclusiones: Luego de aplicado el modelo propuesto, se evidenció el desarrollo de las competencias profesionales específicas en la atención a pacientes con afecciones odontológicas.

Introduction: Professional competencies are human qualities that allow a personalized vision in an individual, who performs his functions in an unique, and at the same time, changing context, and seeks to develop the personological features that he must use in his working life. Objective: To assess the implementation of a model for the development of specific professional competence in the care of patients with stomatognathic diseases. Methods: A study in medical education was conducted at the Faculty of Dentistry in the University of Medical Sciences from Santiago de Cuba, during the 2018-2019 academic year. The population consisted of the 59 residents who were in the first year of the specialty of Comprehensive General Dentistry, in whom a model for the development of specific professional competence in dental care was applied. During the investigation theoretical and empirical methods were used, as well as statistics, particularly the distribution of absolute and relative frequencies, and McNemar test to evaluate the level of development after the model has been implemented. Results: In the socialization workshop, after the practical implementation of the model, positive opinions were obtained. Among the residents in dentistry, 96.4% approved the relevance of the model, while 83.1% were very satisfied. Conclusions: After applying the proposed model, the development of specific professional competence in the care of patients with dental conditions was evidenced.

Uso de óxido nitroso como sedação consciente por profissionais de odontologia no Rio Grande do Sul: um estudo transversal / Prevalence of nitrous oxide use as conscious sedation by dentistry professionals in Rio Grande do Sul: a cross-sectional study

Objetivo: Avaliar fatores associados, percepção e prevalência do uso de óxido nitroso por cirurgiões-dentistas do Rio Grande do Sul, Brasil. Metodologia: Realizou-se um estudo transversal, de base eletrônica, com profissionais registrados no Rio Grande do Sul. A coleta de dados baseou-se no envio, por e-mails e campanhas no Instagram, de um questionário via plataforma Google Forms contendo 27 questões acerca do uso de óxido nitroso em atendimentos odontológicos, bem como o perfil e as percepções dos profissionais sobre a técnica. Resultados: Dos 220 participantes, apenas 12,3% utilizava o óxido nitroso em sua prática clínica, sendo as especialidades que mais utilizavam, cirurgia e odontopediatria. Dentre os que reportaram utilizar a técnica, 81,5% tinham mais de 29 anos (p<0,001) e possuíam curso de pós-graduação, sendo que destes, 55,6% realizou o curso de habilitação (p<0,01) e mais da metade (55,6%) relatou utilizar em pacientes adultos (p<0,001). O alto custo do equipamento, bem como a falta de interesse dos profissionais, foram as principais razões para o não uso da técnica. Conclusão: A técnica de sedação consciente com óxido nitroso é pouco usada pelos cirurgiões-dentistas no Estado do Rio Grande do Sul. É possível que a ampliação do conhecimento acerca da indicação e aplicação do óxido nitroso, ainda durante a graduação, possa expandir o uso e contribuir para uma melhor qualidade no atendimento de pacientes com medo e ansiedade odontológicos. (AU)

Objective: The aim of this study is to evaluate associated factors, perception and prevalence of nitrous oxide use by dental surgeons in Rio Grande do Sul, Brazil. Methodology: A cross-sectional, electronic-based study was carried out with professionals registered in Rio Grande do Sul. Data collection was based on sending, via emails and Instagram campaigns, a questionnaire via the Google Forms platform containing 27 questions about the use of nitrous oxide in dental care, as well as the profile and perceptions of professionals about the technique. Results: Of the 220 participants, only 12.3% used nitrous oxide in their clinical practice, the specialties they used most being surgery and pediatric dentistry. Among those who reported using the technique, 81.5% were over 29 years old (p<0.001) and had a postgraduate course, of which 55.6% completed the qualification course (p<0.01) and more than half (55.6%) reported using it in adult patients (p<0.001). The high cost of the equipment, as well as the lack of interest from professionals, were the main reasons for not using the technique. Conclusion: The conscious sedation technique with nitrous oxide is little used by dental surgeons in the State of Rio Grande do Sul. It is possible that expanding knowledge about the indication and application of nitrous oxide, even during graduation, can expand its use and contribute to a better quality of care for patients with dental fear and anxiety. (AU)

Typical esthetic outcomes using 5 different modalities to treat MIH affected teeth: a case series

Therapeutic options for incisors affected by Molar Incisor Hypomineralization range from very conservative procedures to those considered to be more invasive. Clinicians must select the appropriate approach, considering the outcomes of the procedures. This case series presents clinical outcomes of five female patients with aesthetic complaints associated with the Molar Incisor Hipomineralization. Macroabrasion, microabrasion and dental vital bleaching were used as combination techniques in three cases. Resin infiltration was indicated for a specific case, considering the oncoming orthodontic treatment. Composite restoration was performed in one patient with posteruptive enamel breakdown. Clinicians must select the appropriate approach according to an individualized evaluation of each case, considering factors such as the patient's expectations, dental age, psychosocial period, the severity of the condition, presence of sensitivity and the presumed aesthetic result of the selected treatment. The advantages and disadvantages of the techniques are presented.

Las opciones terapéuticas para los incisivos afectados por hipomineralización incisivo molar van desde procedimientos muy conservadores hasta los considerados más invasivos. Los clínicos deben seleccionar el enfoque adecuado, teniendo en cuenta los resultados de los procedimientos. Esta serie de casos presenta los resultados clínicos de cinco pacientes femeninas con quejas estéticas asociadas a la Hipomineralización Incisivo Molar. En tres casos se utilizaron la macroabrasión, la microabrasión y el blanqueamiento dental vital como técnicas combinadas. La infiltración de resina fue indicada para un caso específico, considerando el tratamiento de ortodoncia próximo. Se realizó una restauración con composite en un paciente con rotura posteruptiva del esmalte. Los clínicos deben seleccionar el abordaje adecuado de acuerdo con una evaluación individualizada de cada caso, considerando factores como las expectativas del paciente, la edad dental, el período psicosocial, la gravedad de la afección, la presencia de sensibilidad y el resultado estético presumible del tratamiento seleccionado. Se presentan las ventajas e inconvenientes de las técnicas.

Impact of Early Childhood Caries and Parental Oral Health Literacy on the Use of Oral Health Care Services by Children. Caries, Health Literacy and Health Care / Impacto de la Caries de la Primera Infancia y la Alfabetización en Salud Bucal de los Padres en el Uso de los Servicios de Atención de la Salud Oral por Parte de los Niños Caries, Alfabetización en Salud y Cuidado de la Salud

The objective of this study was to verify the impact of early childhood caries (ECC) and parental oral health literacy (OHL) on the use of oral health care services by preschool children. A population-based study was conducted with 449 dyads of preschool children aged 4-6 years and their parents/caregivers in the city of Ribeirão das Neves, Brazil. Two examiners performed the diagnosis of ECC using the International Caries Detection and Assessment System (ICDAS- Epi). The Brazilian version of the Hong Kong Oral Health Literacy Assessment Task for Pediatric Dentistry was administered to measure parents' OHL. Parents/caregivers answered the question "When was your child's last visit to the dentist?" to measure the use of oral health care services by the preschool children. The multiple logistic regression (p<0.05) revealed that children with presence of cavitated caries lesions were 1.82-fold more likely to use oral health care services (OR=1.82; 95%CI: 1.23-2.70) compared to those with absence of cavitated caries lesions. Children whose parents/caregivers had lower OHL were 34 % less likely to use oral health care services compared to those whose parents had higher OHL (OR=0.66; 95%CI: 0.45-0.99). Preschool children Dental services are used more by preschool children with presence of cavitated caries lesions and whose parents/caregivers have higher scores of OHL.

El objetivo de este estudio fue verificar el impacto de la caries de la primera infancia (CPI) y la alfabetización en salud oral de los padres (ASB) en el uso de los servicios de salud oral por parte de los niños en edad preescolar. Se realizó un estudio de base poblacional con 449 díadas de preescolares de 4 a 6 años y sus padres/cuidadores en la ciudad de Ribeirão das Neves, Brasil. Dos examinadores realizaron el diagnóstico de CPI utilizando el Sistema Internacional de Evaluación y Detección de Caries (ICDAS-Epi). Se administró la versión brasileña de Hong Kong Oral Health Literacy Assessment Task for Pediatric Dentistry para medir la ASB de los padres. Los padres/cuidadores respondieron la pregunta "¿Cuándo fue la última visita de su hijo al dentista?" medir la utilización de los servicios de salud oral por parte de los preescolares. La regresión logística múltiple (p<0,05) reveló que los niños con presencia de lesiones de caries cavitadas tenían 1,82 veces más probabilidades de utilizar los servicios de salud oral (OR=1,82; IC95%: 1,23-2,70) en comparación con aquellos con ausencia de lesiones de caries cavitadas. Los niños cuyos padres/cuidadores tenían un ASB más bajo tenían un 34 % menos de probabilidades de utilizar los servicios de atención de la salud bucodental en comparación con aquellos cuyos padres tenían un ASB más alto (OR = 0,66; IC del 95%: 0,45-0,99). Los servicios dentales para niños en edad preescolar son utilizados con mayor frecuencia por niños preescolares con presencia de lesiones cariosas cavitadas y cuyos padres/cuidadores tienen puntuaciones más altas de ASB.

Asociación entre el acceso a los servicios odontológicos y la altitud de la residencia de niños peruanos

Introducción: El acceso a servicios odontológicos es importante para garantizar una adecuada salud bucal. Por ello, es importante evaluar las barreras geográficas que pueden repercutir en el acceso, como la altitud. Objetivo: Determinar la asociación entre el acceso a los servicios odontológicos y la altitud de residencia de los niños menores de 12 años en Perú, 2019. Métodos: El estudio fue de tipo transversal con una muestra de 42 350 registros de niños menores de 12 años. Las variables fueron acceso a la atención odontológica, tiempo de la atención odontológica, lugar de la atención odontológica, altitud, región, área de residencia, lugar de residencia, región natural, seguro de salud, índice de riqueza, sexo y edad. Se realizó un análisis descriptivo y bivariado con la prueba de chi cuadrado. Los resultados pasaron por un análisis multivariado mediante la regresión de Poisson para obtener las razones de prevalencia y razones de prevalencia ajustadas. Se contó con un nivel de confianza de 95 % y un p < 0,05. Resultados: Se encontró que la altitud estuvo vinculada con el acceso a la atención odontológica (RP = 1,15; IC95 %:1,12 - 1,18; p < 0,001), también cuando se consideran las variables área de residencia, lugar de residencia, región natural, seguro de salud, índice de riqueza, sexo y edad (RPa = 1,10; IC95 %: ºº1,04 - 1,16; p < 0,001). Conclusiones: En 2019, los niños peruanos menores de 12 años, que viven a más de 2500 msnm, tuvieron mayor probabilidad de recibir una atención odontológica en los últimos 2 años.

Introduction: Access to dental services is important to guarantee adequate oral health. Therefore, it is important to assess the geographical barriers that may affect access, such as altitude. Objective: To determine the association between access to dental services and the altitude of residence of children under 12 years of age in Peru, 2019. Methods: The study was a cross-sectional with a sample of 42,350 records of children under 12 years of age. The variables were access to dental care, time of dental care, place of dental care, altitude, region, area of residence, place of residence, natural region, health insurance, wealth index, sex and age. A descriptive and bivariate analysis was performed with the chi square test. The results underwent multivariate analysis using Poisson regression to obtain prevalence ratios and adjusted prevalence ratios. There was a confidence level of 95% and p < 0.05. Results: It was found that altitude was linked to access to dental care (PR = 1.15; 95% CI: 1.12 - 1.18; p < 0.001), it was also found when considering the variables area of residence, place of residence, natural region, health insurance, wealth index, sex and age (RPa = 1.10; 95% CI: ºº1.04 - 1.16; p < 0.001). Conclusions: In 2019, Peruvian children under 12 years, living at more than 2500 masl, were more likely to receive dental care in the last 2 years.

Política de Saúde Bucal no Brasil: transformações e rupturas entre 2018-2021 / Oral Health Policy in Brazil: changes and ruptures during the period 2018-2021

Resumo Analisou-se a implementação da Política de Saúde Bucal no Brasil no período 2018-2021, através das ações institucionais, implantação dos serviços, resultados alcançados e financiamento federal. Estudo de monitoramento, a partir da análise documental e de dados secundários, obtidos em sites institucionais, sistemas de informações governamentais e notícias publicadas por entidades odontológicas. Todos os indicadores de resultados monitorados apresentaram expressiva redução dos valores entre 2020-2021, com agravamento desde 2018, como a cobertura da primeira consulta odontológica e ação coletiva de escovação dental supervisionada, que chegou a 1,8% e 0,02% em 2021, respectivamente. Observa-se uma queda do financiamento federal nos anos 2018-2019 (8,45%), com crescimento em 2020 (59,53%) e nova diminuição em 2021 (5,18%). O período analisado foi marcado por crise econômica e política, agravadas pela crise sanitária, decorrente da pandemia do COVID-19. Contexto que influenciou o funcionamento dos serviços de saúde no Brasil. No caso particular da saúde bucal, verificou-se progressiva e acentuada redução dos resultados, ainda que a implantação dos serviços de atenção básica e especializada tenha se mantido estável.

Abstract This study analyzed the implementation of Brazil's National Oral Health Policy during the period 2018-2021, covering institutional actions, implementation of public dental services, results achieved, and federal funding. We conducted a retrospective descriptive study using documentary analysis and secondary data obtained from institutional websites, government information systems, and reports published by dental organizations. The findings show a significant reduction in funding between 2020 and 2021 and declining performance against indicators since 2018, such as coverage of first dental appointments and group supervised tooth brushing, which stood at 1.8% and 0.02%, respectively, in 2021. Federal funding dropped in 2018 and 2019 (8.45%), followed by an increase in 2020 (59.53%) and decrease in 2021 (-5.18%). The study period was marked by economic and political crises aggravated by the COVID-19 pandemic. This context influenced the functioning of health services in Brazil. There was a sharp reduction in performance against oral health indicators, while performance in primary health care and specialized care services remained stable.

Comparison between oral midazolam versus oral ketamine plus midazolam as preanesthetic medication in autism spectrum disorder: double-blind randomized clinical trial

Abstract Background: Conventional dental care is often impossible in patients with Autism Spectrum Disorder (ASD). Non-collaborative behaviors, sometimes associated with aggressiveness, are usual justifications for premedication in this population. Thereby, this research focuses on the effects of oral midazolam versus oral ketamine plus midazolam as preanesthetic medication in ASD. Methods: The sample included 64 persons with ASD, aged 2-59 years, scheduled for dental care under general anesthesia. The primary objective of this study was to compare degrees of sedation between two parallel, double-blinded, equally proportional groups randomized to receive oral midazolam (0.5 mg.kg−1, maximum 15 mg) or oral midazolam (0.5 mg.kg−1) associated with oral S(+)-ketamine (3 mg.kg−1, maximum 300 mg). The secondary outcomes were the need of physical stabilization to obtain intravenous line, awakening time, and occurrence of adverse events. Results: According to the dichotomous analysis of sedation level (Ramsay score 1 and 2 versus Ramsay ≥ 3), oral association of S(+)-ketamine and midazolam improved sedation, with increased probability of Ramsay ≥ 3, Relative Risk (RR) = 3.2 (95% Confidence Interval [95% CI] = 1.32 to 7.76) compared to midazolam alone. Combined treatment also made it easier to obtain venous access without physical stabilization, RR = 2.05 (95% CI = 1.14 to 3.68). There were no differences between groups regarding awakening time and the occurrence of adverse events. Conclusion: The association of oral S(+)-ketamine with midazolam provides better preanesthetic sedation rates than midazolam alone and facilitates intravenous line access in patients with autism.

O uso dos serviços odontológicos no último ano na população brasileira: revisão sistemática com metanálise / The use of dental services in the past year in the brazilian population: a systematic review with meta-analysis

Resumo O objetivo foi analisar os fatores associados ao uso dos serviços odontológicos no Brasil. A estratégia de revisão incluiu as bases PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS e Google Scholar, além de repositórios e bancos de dissertações e teses. Os estudos foram selecionados ​​usando a estratégia PEO (população/exposição/desfechos). O desfecho deste estudo foi o uso dos serviços odontológicos no último ano pela população brasileira, tratado como variáveis dicotômicas para as análises: ≤ 1 ano e > 1 ano. Foi realizada uma metanálise de efeito randômico de Mantel-Haenszel, estimando-se razões de prevalência (RP) e intervalos de confiança de 95% (IC95%). Foram selecionados 94 estudos. A maioria (98%) tinha delineamento transversal, sendo 63% oriundos de dados primários. Para a metanálise, 25 estudos foram incluídos. O uso dos serviços odontológicos no último ano esteve associado com maior escolaridade (≥ 8 anos de estudo) (RP = 0,49, (IC95%: 0,39-0,60)); maior renda familiar (≥ 2 salários-mínimos) (RP = 0,79, (IC95%: 0,74-0,84)); e residir na zona urbana (RP = 0,79, (IC95%: 0,64-0,97)). A oferta de serviços odontológicos no Sistema Único de Saúde precisa ser ampliada entre pessoas com menor renda, menor escolaridade e moradores da zona rural.

Abstract The scope of this study was to analyze the factors associated with the use of dental services in Brazil. The review strategy included PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS and Google Scholar databases, in addition to repositories and databases of dissertations and theses. Studies were selected using the PEO (Population/Exposure/Outcomes) strategy. The outcome of this study was the use of dental services in the last year by the Brazilian population, treated as dichotomous variables for the following analyses: ≤ 1 year and > 1 year. Mantel-Haenszel random effect meta-analysis was performed, estimating Prevalence Ratios (PR) and 95% confidence intervals (95%CI). A total of 94 studies were selected. The majority (98%) had a cross-sectional design, with 63% derived from primary data. For the meta-analysis, 25 studies were included. The use of oral health services in the last year was associated with higher education (≥ 8 years of schooling) (PR = 0.49, (95%CI: 0.39-0.60)); higher family income (≥ 2 minimum wages) (RP = 0.79, (95%CI: 0.74-0.84)); and living in urban areas (RP = 0.79, (95%CI: 0.64-0.97)). The availability of dental services in the Unified Health System needs to be made readily accessible to people with lower income, less education and those living in rural areas.

Calidad de vida relacionada con la salud bucal en escolares

Introducción: La presencia de factores socioeconómicos, nivel educativo y el acceso a atención sanitaria pueden condicionar los niveles de calidad de vida relacionada con la salud bucal, especialmente en etapas de vida como la niñez. Objetivo: Determinar la asociación de las condiciones orales en la calidad de vida relacionada con la salud bucal en escolares. Métodos: Estudio observacional, descriptivo y transversal desde una base de datos de 144 escolares (11-12 años). La variable dependiente fue calidad de vida relacionada con la salud bucal, medida con el índice Child Oral Impacts on Daily Performances. Se realizó un análisis descriptivo y pruebas de U de Mann Whitney y ji cuadrado, además se aplicó una regresión logística lineal, con un nivel de confianza de 95 % y p< 0,05. Resultados: El 69,44 % (n= 100) presentó muy poca intensidad del impacto. La procedencia presentó diferencias significativas con limpiarse la boca e impacto total (p< 0,05) y el sexo con hablar y estudiar (p< 0,05). De la regresión lineal, la procedencia se asoció a la gravedad del desempeño limpiarse la boca (R2%= 0,039; a= 0,527; b= 0,347; p= 0,017) e impacto total (R2%= 0,036; a= 4,831; b= 4,824; p= 0,023), el sexo presentó asociación con hablar (R2%= 0,034; a= 0,498; b= -0,137; p= 0,026). Conclusión: La intensidad del impacto es muy poca en la calidad de vida relacionada con la salud bucodental; además, la procedencia se asoció con limpiarse la boca e impacto total, mientras que el sexo se asoció con el desempeño hablar; todo ello en escolares de 11 y 12 años.

Introduction: The presence of certain socioeconomic factors, educational level and access to health care can condition the levels of oral health-related Quality of Life, especially in life stages such as childhood. Objective: To determine the association of oral conditions on oral health-related quality of life in students. Methods: Observational, descriptive and cross-sectional study from a database of 144 schoolchildren (11-12 years old). The dependent variable was Quality of Life related to oral health, measured with the Child Oral Impacts on Daily Performances index. A descriptive analysis and Mann Whitney U and Chi-square tests were performed, and a linear logistic regression was applied, with a confidence level of 95% and p< 0,05. Results: The 69.44% (n= 100) presented very low impact intensity. The provenance presented significant differences with cleaning the mouth and total impact (p< 0.05), and sex with talking and studying (p< 0.05). From the linear regression, provenance was associated with severity of cleaning mouth performance (R2%= 0.039, a= 0.527, b= 0.347, p= 0.017) and total impact (R2%= 0.036, a= 4.831, b= 4.824, p= 0.023), sex was associated with talking (R2%= 0.034, a= 0.498, b= -0.137, p= 0.026). Conclusion: The intensity of the impact was very little in the quality of life related to oral health; in addition, the origin was associated with cleaning the mouth and total impact, while gender was associated with speaking; all this in schoolchildren aged 11 and 12.