Tratamientos y barreras de protección utilizadas antes y durante la pandemia en entidades de México / Treatments and protective barriers used before and during the pandemic in entities in Mexico

Introducción: los tratamientos bucodentales son procedimientos que requieren de un diagnóstico visual y táctil; existe alto riesgo de contagio por productos biológicos. Objetivo: determinar los tipos de tratamientos y barreras de protección implementados antes y durante la pandemia de COVID-19 en tres entidades de México. Material y métodos: estudio observacional, analítico y longitudinal en odontólogos de atención clínica privada, instituciones educativas y/o de salud, mediante un muestreo no probabilístico por cuotas de 100 odontólogos por entidad. La información fue recopilada en un formulario de Google distribuido vía WhatsApp y correos electrónicos. Los datos se procesaron en el SPSS v. 22. Resultados: los tratamientos implementados antes del periodo pandémico fueron los programados con 87.2%, durante la pandemia de COVID-19, la atención principal continuó programada (90.9%), las barreras de protección que más aumentaron fueron la protección ocular como gafas protectoras (84.8%) y careta facial (83.1%), presentando la sustitución de la mascarilla tricapa por ser de alta filtración KN95 (78.0%) y el traje aislante (53.0%). Conclusión: los tratamientos realizados antes y durante la pandemia fueron programados, las barreras que incrementaron fueron gafas protectoras, careta, mascarilla KN95 y traje aislante (AU)

Introduction: oral treatments are procedures that require a visual and tactile diagnosis, there is a high risk of infection by biological products. Objective: determine the types of treatments and protection barriers implemented before and during the COVID-19 pandemic in three states in Mexico. Material and methods: it was an observational, analytical and longitudinal study in private clinical care dentists, educational and/or health institutions, through a non-probabilistic sampling by quotas of 100 dentists per entity. The information was collected in a Google form distributed via WhatsApp and emails. The data was processed in SPSS v. 22. Results: the treatments implemented before the pandemic period were those scheduled with 87.2%, during the COVID-19 pandemic the main care continued as scheduled (90.9%) where the protection barriers that increased the most were eye protection such as goggles (84.8%) and facial mask (83.1%). Presenting the substitution of the three-layer mask for high filtration KN95 (78.0%) and the disposable suit (53.0%). Conclusion: the treatments carried out before and during the pandemic were programmed, the barriers that increased were googles, face shield, KN95 mask and insulating suit (AU)

Avaliação da atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO) / Evaluation of secondary care in endodontics at a Dental Specialties Center (DSC)

Resumo Objetivou-se avaliar a atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO) de Belo Horizonte (MG). A coleta de dados utilizou dois formulários: (1) sobre o tratamento endodôntico, preenchido pelos endodontistas; (2) sobre o tratamento restaurador, com dados dos prontuários. O programa SPSS 19.0 foi utilizado para analisar os resultados por meio de frequência e percentis. Foram finalizados 452 tratamentos endodônticos em pacientes adultos. Os pacientes apresentaram mediana de 39 anos de idade, a maioria era do sexo feminino (69,7%) e apresentou guia de referência da atenção básica (96,2%). A maior parte dos tratamentos endodônticos foi realizada em pré-molares superiores (23,7%), seguida de molares inferiores (22,3%), utilizando técnica mista (74,1%) e em única sessão (64,2%). O encaminhamento para o tratamento restaurador foi para o CEO em 81,2% dos casos e finalizado em 24,1% casos (n = 109). A contrarreferência após o tratamento restaurador ocorreu em 58,7% dos casos finalizados. É necessário um planejamento conjunto do tratamento odontológico entre a atenção básica e secundária e, dentro desta última, entre as especialidades, além de um adequado processo de referência e contrarreferência, visando garantir a integralidade do cuidado e a eficiência e eficácia do serviço.

Abstract This study aimed to evaluate secondary endodontic care at a Dental Specialties Center (DSC) in Belo Horizonte, MG. Data collection used two forms: (1) on endodontic treatment, completed by the endodontists (2) on the restorative treatment, with data from the medical records. The SPSS 22.0 program was used to analyze the results using frequency and percentiles. In total, 452 endodontic procedures were completed in adult patients. The patients had a median of 39 years of age, most were female (69.7%) and had a primary care referral order (96.2%). Most endodontic treatments were performed in upper premolars (23.7%) followed by lower molars (22.3%), using a mixed technique (74.1%) and in a single session (64.2%). The referral for restorative treatment was for the DSC in 81.2% of cases and finished in 24.1% (n = 109). The counter-referral following restorative treatment occurred in 58.7% of the completed cases. It is necessary to jointly plan the dental treatment between primary and secondary care and, within the latter, among the specialties, in addition to an adequate referral and counter-referral process aimed at ensuring comprehensive care and efficient and effective service.

Evaluation of secondary care in endodontics at a Dental Specialties Center (DSC). / Avaliação da atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO).

This study aimed to evaluate secondary endodontic care at a Dental Specialties Center (DSC) in Belo Horizonte, MG. Data collection used two forms: (1) on endodontic treatment, completed by the endodontists (2) on the restorative treatment, with data from the medical records. The SPSS 22.0 program was used to analyze the results using frequency and percentiles. In total, 452 endodontic procedures were completed in adult patients. The patients had a median of 39 years of age, most were female (69.7%) and had a primary care referral order (96.2%). Most endodontic treatments were performed in upper premolars (23.7%) followed by lower molars (22.3%), using a mixed technique (74.1%) and in a single session (64.2%). The referral for restorative treatment was for the DSC in 81.2% of cases and finished in 24.1% (n = 109). The counter-referral following restorative treatment occurred in 58.7% of the completed cases. It is necessary to jointly plan the dental treatment between primary and secondary care and, within the latter, among the specialties, in addition to an adequate referral and counter-referral process aimed at ensuring comprehensive care and efficient and effective service.

Objetivou-se avaliar a atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO) de Belo Horizonte (MG). A coleta de dados utilizou dois formulários: (1) sobre o tratamento endodôntico, preenchido pelos endodontistas; (2) sobre o tratamento restaurador, com dados dos prontuários. O programa SPSS 19.0  foi utilizado para analisar os resultados por meio de frequência e percentis. Foram finalizados 452 tratamentos endodônticos em pacientes adultos. Os pacientes apresentaram mediana de 39 anos de idade, a maioria era do sexo feminino (69,7%) e apresentou guia de referência da atenção básica (96,2%). A maior parte dos tratamentos endodônticos foi realizada em pré-molares superiores (23,7%), seguida de molares inferiores (22,3%), utilizando técnica mista (74,1%) e em única sessão (64,2%). O encaminhamento para o tratamento restaurador foi para o CEO em 81,2% dos casos e finalizado em 24,1%  casos (n = 109). A contrarreferência após o tratamento restaurador ocorreu em 58,7% dos casos finalizados. É necessário um planejamento conjunto do tratamento odontológico entre a atenção básica e secundária e, dentro desta última, entre as especialidades, além de um adequado processo de referência e contrarreferência, visando garantir a integralidade do cuidado e a eficiência e eficácia do serviço.

Status of the dental health care workforce in Shanghai, China.

OBJECTIVES: The status of the dental health care workforce in Shanghai was investigated in order to support and improve regional planning of this workforce. METHODS: Questionnaires were used to survey all dental medical units in Shanghai. Data were collected on the quantity, structure and levels of dental health personnel. RESULTS: A total of 852 dental medical units and 3,218 dentists were identified in Shanghai. The ratio of dentists to population is 1 : 5,201. CONCLUSIONS: Presently, the total dental health workforce in Shanghai is relatively sufficient, but its distribution is inequitable because there are fewer dental health personnel employed in the suburbs. Moreover, the structure of the dental health workforce in Shanghai is inequitable and specialists in preventive dentistry are lacking. The results of this study can be applied to help Shanghai achieve the rational distribution and efficient utilisation of the dental health workforce available.

A preliminary analysis of the US dental health care system's capacity to treat children with special health care needs.

PURPOSE: The purpose of this study was to use existing data to determine capacity of the US dental care system to treat children with special health care needs (CSHCN). METHODS: A deductive analysis using recent existing data was used to determine the: possible available appointments for CSHCN in hospitals and educational programs/institutions; and the ratio of CSHCN to potential available and able providers in the United States sorted by 6 American Academy of Pediatric Dentistry (AAPD) districts. RESULTS: Using existing data sets, this analysis found 57 dental schools, 61 advanced education in general dentistry programs, 174 general practice residencies, and 87 children's hospital dental clinics in the United States. Nationally, the number of CSHCN was determined to be 10,221,436. The distribution, on average, of CSHCN per care source/provider ranged from 1,327 to 2,357 in the 6 AAPD districts. Children's hospital dental clinics had fewer than 1 clinic appointment or 1 operating room appointment available per CSHCN. The mean number of CSHCN patients per provider, if distributed equally, was 1,792. CONCLUSIONS: The current US dental care system has extremely limited capacity to care for children with special health care needs.

Non-doctor consultations and self-medication practices in patients seen at a tertiary dental center in Ibadan.

AIM: The aim of this study was to determine the prevalence of self-medication practices among dental out patients presenting at a tertiary health care center in Ibadan, and to determine factors that are associated with these practices. MATERIALS AND METHODS: All patients presenting over a 4-month period, who consented to participate in the study, had a semi-structured questionnaire, highlighting age, sex, income and educational qualification, history of past practice of self-medication, substances used and reasons for resorting to self-medication administered to them. Data obtained were analyzed with the SPSS 12.0.1 software. Frequency tables were generated and statistical relationship between the variables was analyzed using the Chi-square test. Statistical significance was set at P>0.05. RESULTS: There were 108 (38.03%) males and 176 (61.97%) females. A total of 139 (48.9%) of the respondents claimed that they have been involved in self-medication. 54.7% of the people involved in self-medication were female, while 41.7% were male. There was a statistically significant difference in self-medication between males and females (P=0.001). 71.2% of the respondents had post-secondary education and only 28.8% had secondary education or less. CONCLUSION: Self-medication practices were quite high in this study, and these practices were also prevalent among the educated people. Drug control enforcement needs to be intensified and dental public health education needs to be given greater priority in the overall public health campaigns.

Evaluación de la satisfacción de los pacientes en las clínicas odontológicas de las FOC Bogotá Cundinamarca, 2008 / Evaluation of the patient´s satisfaction in the dental clinics of the FOC Bogota Cundinamarca, 2008

Se realizó un estudio descriptivo para evaluar la satisfacción de los pacientes que recibieron servicios odontológicos en las clínicas de la FOC Teusaquillo y Américas, entre el mes de enero y agosto de 2008. Los resultados fueron positivos, porque los ocho aspectos evaluados fueron calificados mayoritariamente como excelentes y buenos. La mejor calificación se obtuvo en el punto 8, relacionado con la dedicación total del odontólogo al cuidado y atención del paciente en el momento de la consulta o sesión de tratamiento.

Evolution of dental school clinics as patient care delivery centers.

Dental school clinics, originally envisioned as closely similar to private practice, evolved instead as teaching clinics. In the former, graduate and licensed dentists perform the treatment while undergraduate dental students are assigned treatment within their capabilities. In the latter, dental students provide the treatment under faculty supervision. It is generally recognized that the care provided by the teaching clinics is inefficient. However, in the last quarter of the twentieth century, dental school clinics began to pay much more attention to how treatment is rendered. The comprehensive care movement and quality assurance systems are leading towards more efficient patient-centered care. Case studies at the University of Maryland, Columbia University, and University of Louisville describe activities to make their clinic programs more efficient and patient-friendly. This article explores whether the potential exists for faculty to take a direct patient care delivery role in dental clinics in order for those clinics to become efficient patient care delivery systems as originally envisioned in the early part of the twentieth century.

Prescripción de medicamentos en una clínica odontológica de una universidad mexicana / No disponible

Objetivo: Evaluar la prescripción de medicamentos en una clínica odontológica de una universidad mexicana. Método: Mediante un estudio observacional y descriptivo, se analizaron 698 prescripciones odontológicas en 14 servicios clínicos que conforman la clínica en estudio, enfocados a la conservación y restauración de la salud bucal en enero-junio 2005. Se registraron criterios como: medicamento prescrito, indicación, dosis, intervalo de dosificación, individualización de la terapia, duración de tratamiento y presencia de interacciones farmacológicas potenciales. Para determinar la inadecuación en los criterios de prescripción se comparó la información obtenida en recetas y expedientes clínicos, con la de la literatura especializada. Resultados: Los medicamentos más prescritos fueron paracetamol, naproxeno, ampicilina y dicloxacilina en 43,26, 15,38, 7,45 y 7,02%. La indicación, dosis e intervalo de dosificación fueron los criterios con mayor inadecuación en la prescripción. Las principales interacciones potenciales fueron entre los antiinflamatorios no esteroideos con el captopril y la amoxicilina. Conclusiones: Con lo anterior, se determinó que el 37,25% de las prescripciones fueron inadecuadas. A través de este estudio se establecieron estrategias que permitirán en un futuro tener una política de uso racional de los medicamentos empleados

Objective: To assess the drug prescription service in a dental clinic of a Mexican university hospital. Method: An observational, descriptive study was carried out which analysed 698 drugs prescribed for dental problems in 14 dental health care departments in our clinic between the period of January-June 2005. The following criteria were established: prescribed drug, indication, dosage, dosage interval, individualised treatment, treatment duration and potential drug interactions. Information taken from prescriptions and clinical records was compared with information from literature on the subject in order to determine the adequacy of prescription criteria. Results: The most frequently prescribed drugs were paracetamol, naproxen, ampicillin and dicloxacillin (43.26, 15.38, 7.45 and 7.02%). The prescription criteria which showed the least adequacy were as follows: indication, dosage and dosage interval. The main potential drug interactions occurred between non-steroidal anti-inflammatory drugs and captopril/amoxicillin. Conclusions: Taking the above into consideration, it was determined that 37.25% of prescriptions were inadequate. This study has helped to establish strategies which will facilitate the appropriate use of drugs in the future

Evolution of dental school clinics as patient care delivery centers.

Dental school clinics, originally envisioned as closely similar to private practice, evolved instead as teaching clinics. In the former, graduate and licensed dentists perform the treatment while undergraduate dental students are assigned treatment within their capabilities. In the latter, dental students provide the treatment under faculty supervision. It is generally recognized that the care provided by the teaching clinics is inefficient. However, in the last quarter of the twentieth century, dental school clinics began to pay much more attention to how treatment is rendered. The comprehensive care movement and quality assurance systems are leading towards more efficient patient-centered care. Case studies at the University of Maryland, Columbia University, and University of Louisville describe activities to make their clinic programs more efficient and patient-friendly. This article explores whether the potential exists for faculty to take a direct patient care delivery role in dental clinics in order for those clinics to become efficient patient care delivery systems as originally envisioned in the early part of the twentieth century.

Factors associated with comprehensive dental care following an initial emergency dental visit.

PURPOSE: The purpose of this study was to characterize the patient population utilization of a dental home as grouped by: (1) age; (2) sex; and (3) payment method. METHODS: A retrospective chart review of 1,020 patients, who initially presented for an emergency visit, was performed. From the original data pool, 2 groups were delineated: (1) those patients who returned for comprehensive dental care; and (2) those who did not return for comprehensive dental care. RESULTS: Patients with private dental insurance or Medicaid dental benefits were statistically more likely to return for comprehensive oral health care than those with no form of dental insurance. Younger patients (< or =3 years of age) were least likely to return for comprehensive dental care. CONCLUSIONS: Socioeconomic factors play a crucial role in care-seeking behaviors. These obstacles are often a barrier to preventive and comprehensive oral health care.

A review of community dental service provision for children attending special day schools.

OBJECTIVE: To review current practices used to screen children attending special day and mainstream schools by the Community Dental Service (CDS) nationally and document the provision of care to children attending special day schools. BASIC RESEARCH DESIGN: The investigation used postal questionnaires requesting information relating to two types of special day schools. PARTICIPANTS: All CDS managers within the United Kingdom. RESULTS: Special day schools continue to remain priority schools for the CDS as two thirds of districts reported screening these schools more frequently than their mainstream schools. The majority of districts provide dental care to children at special day schools from fixed clinic locations with a minority using mobile dental units to provide dental care (40%). CONCLUSIONS; The continued integration of children with special needs into mainstream schools rather than their segregation into special schools will make the identification of this priority group more difficult for the CDS. The service should explore new methods of identifying these children rather than continuing to rely on the traditional methods of targeting establishments.

[The organization of the treatment and observation of patients with congenital facial clefts at an interprovincial center]. / Organizatsiia i nabliudeniia bol'nykh s vrozhdennymi rasshchelinami litsa v mezhoblastnom tsentre.

Analysis of the treatment of 600 patients with facial clefts according to the treatment strategy developed at the Stavropol center has shown that such centers should render comprehensive care to all patients of the district. The efficacy of the center's activity directly depends on the activities of its consultation and methodology department, on the treatment strategy, scientifically-based system of follow-up of patients with facial clefts and the status of specialized pediatric service in the district.

Patterns of patient attendance and dental service utilization in northern Labrador 1985-1989.

The purpose of the present study was to identify patterns of dental patient attendance and service utilization using both epidemiological and service record data from six satellite clinics in Northern Labrador, Canada, between 1985-1989. Baseline attendances were derived for the region from the analysis of 1985-1988 data, the period prior to the introduction of a non-insured health benefit scheme. The results demonstrated that females and persons under the age of 21 years frequented the dentist the most. The effects of this non-insured health benefit scheme introduced in January 1989, was then compared to the baseline pattern of attendance. This dental coverage removed all financial barriers for dental treatment for a population of Inuit origin in this northern area (or 91% of the population). An increase in the uptake of all dental treatments by 10-40%, and a doubling of fillings and denture treatments was observed. About 7% more patients frequented the dentist in 1989. Attendances of the middle-aged and elderly patients increased by 4%. Mean number of appointments per person per year increased from the baseline level of 1.8 to 2.5. The largest increase in population attendances was observed in Hopedale, while Nain remained the community with the best attendance record. No better monthly patterns of attendance were identified for 1989 compared to the baseline. Future studies should continue to evaluate changes in treatment needs, demands and service utilization in the area on a longitudinal basis. There is also a need for more literature on patterns of dental attendances in northern areas.