Bridging gaps: Transforming dental public health training for modern job market demands.

OBJECTIVES: To create optimal oral and overall community health, dental public health (DPH) specialists must be competent and appropriately skilled to deal with contemporary and emergent public health issues. This study aims to evaluate the current job market demands related to the DPH profession and suggest contemporary skills and qualities that would enable DPH professionals to address emerging issues more effectively in their field. METHODS: A multimethod qualitative study was conducted involving two distinct groups: employers and potential employees. Interviews of stakeholders (employers) representing different job market domains, and a survey was administered to recent DPH residency graduates (employees). Qualitative analysis was applied to the data collected. RESULTS: Employers identified the following skills as crucial for future DPH employees: proficiency in care delivery systems, health informatics, clinical training, leadership, and professional and grant writing skills. Many employers assumed the presence of a clinical component in the residency program. DPH residency graduates emphasized that the most significant barrier to securing positions is the lack of clinical experience within the residency program. CONCLUSIONS: This research highlights skills currently valued by the DPH job market and proposes that DPH specialty training may consider revising its curriculum to include these skills. Implementing such updates would ensure that graduates are well equipped and competitive, thus significantly contributing to the broader objective of attaining optimal oral health and overall well-being of the community.

Differences in dental care for pregnant women in the public sector after the creation of Previne Brasil

Aim: To compare performance differences among dental surgeons in the public sector of the state of Minas Gerais regarding prenatal dental care before and after the establishment of Previne Brasil. Methods: A cross-sectional study was conducted, gathering data through a structured questionnaire. The sample consisted of dental surgeons working in the public sector of municipalities in MG and utilizing the snowball effect. Data analysis was performed using the IBM-SPSS® version 29.0, employing Pearson's Chi-square statistical test (P<0.05). Results: Out of the 28 State Health System (SRS) present in MG. A total of 1696 responses were collected, but after applying the exclusion criteria, 1001 responses remained, specifically related to dental surgeons working in MG public sector. 78.6% comprised professionals who graduated before 2019, while 20.1% graduated after that year. The morning and the second or other gestational trimesters were the most common periods considered optimal for caring for pregnant women. A significant portion of the professionals had not undergone any specific courses or training on this topic, reporting an average satisfaction level of 5.52 regarding the accessibility of information during their education aimed at this audience. Conclusion: Variances were observed in the care provided to pregnant women by dental surgeons working in the public sector of Minas Gerais, distinguishing those trained before and after the implementation of Previne Brasil. The debunking of myths and taboos stands as crucial for enhancing the acceptance of prenatal dentistry

Self-medication associated with toothache: a systematic literature review / Automedicação associada à dor de dente: uma revisão sistemática da literatura / Automedicación asociada al dolor de dientes: una revisión sistemática de la literatura

Introduction: Self-medication consists of selecting and using medication without a poprescription or guidance from a healthcare professional. This practice has been widely reported worldwide, which has contributed to a series of adverse health outcomes, such as delayed diagnosis, worsening of clinical conditions, drug interactions, intoxication, and adverse reactions, which tend to compromise patient safety. Objective:To analyze the prevalence of self-medication associated with toothache, the main factors associated with self-medication in dental patients, as well as outline the profile of medications used by these individuals, the preferred route of administration, and the main sources of medication.Methodology:Asystematic review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Relevant articles published in the last ten years, without limitations of language were searched using the following descriptors/MeSHterms and keywords: "self-medication" and (toothache or "dental pain") not Child. Results:The initial search returned 61 manuscripts. Fourteen papers, all cross-sectional studies, were eligible for inclusion in the systematic review.Conclusions:The prevalence of self-medication for toothache ranged from 6.5% to 100.0%. Cultural and economic factors, barriers to access, the high cost of dental treatments, lack of time and money, and the perception that dental problems are not a serious problem are among the main factors associated with the practice. Regarding the drugs used, the most used classes were paracetamol, especially anti-inflammatory drugs, particularly ibuprofen, and analgesics administered orally (AU).

Introdução:A automedicação consiste na escolha e uso de medicamentos sem prescrição ou orientação de um profissional de saúde. Essa prática tem sido amplamente divulgada em todo o mundo, o que tem contribuído para uma série de desfechos adversos à saúde, como atraso no diagnóstico, piora do quadro clínico, interações medicamentosas, intoxicações e reações adversas, que tendem a comprometer a segurança do paciente. Objetivo:Analisar a prevalência da automedicação associada à dor de dente, os principais fatores associados à automedicação em pacientes odontológicos, bem como traçar o perfil dos medicamentos utilizados por esses indivíduos, a via preferencial de administração e as principais fontes de medicação. Metodologia:Uma revisão sistemática foi desenvolvida de acordo com os itens de relatório preferidos para revisões sistemáticas e meta-análises (PRISMA). Foram pesquisados artigos relevantes publicados nos últimos dez anos, sem limitação de linguagem, utilizando os seguintes descritores/MeSHterms e palavras-chave: "self-medication" e (toothache or "dental pain") não Child. Resultados:A busca inicial encontrou61manuscritos. Quatorze artigos, de delineamento transversal,foram considerados elegíveis e incluídos para a revisão.Conclusões:A prevalência de automedicação para dor de dente variou de 6,5% a 100,0%. Fatores culturais e econômicos, barreiras de acesso, alto custo dos tratamentos odontológicos, falta de tempo e dinheiro e a percepção de que os problemas odontológicos não são um problema grave estão entre os principais fatores associados à prática. Em relação aos medicamentos utilizados, as classes mais utilizadas foram o paracetamol, principalmente os anti-inflamatórios, principalmente o ibuprofeno, e os analgésicos por via oral (AU).

Introducción: La automedicación consiste en seleccionar y utilizar medicamentos sin receta ni orientación de un profesional sanitario. Esta práctica ha sido ampliamente reportada a nivel mundial, lo que ha contribuido a una serie de resultados adversos para la salud, como retraso en el diagnóstico, empeoramiento de las condiciones clínicas, interacciones medicamentosas, intoxicaciones y reacciones adversas, que tienden a comprometer la seguridad del paciente.Objetivo: Analizar la prevalencia de automedicación asociada al dolor de muelas, los principales factores asociados a la automedicación en pacientes odontológicos, así como delinear el perfil de medicamentos utilizados por estos individuos, la vía de administración preferida y las principales fuentes de medicación. Metodología: Se desarrolló una revisión sistemática de acuerdo con los Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Se buscaron artículos relevantes publicados en los últimos diez años, sin limitaciones de idioma, utilizando los siguientes descriptores/MeSHterms y palabras clave: "self-medication" y (toothache or "dental pain") not Child. Resultados: La búsqueda inicial arrojó 61 manuscritos. Catorce artículos, todos estudios transversales, fueron elegibles para su inclusión en la revisión sistemática.Conclusiones: La prevalencia de automedicación para el dolor de muelas osciló entre 6,5% y 100,0%. Los factoresculturales y económicos, las barreras de acceso, el alto costo de los tratamientos dentales, la falta de tiempo y dinero, y la percepción de que los problemas dentales no son un problema grave se encuentran entre los principales factores asociados con la práctica. En cuanto a los fármacos utilizados, las clases más utilizadas fueron el paracetamol, especialmente los antiinflamatorios, especialmente el ibuprofeno, y los analgésicos por vía oral (AU).

The British Association for the Study of Community Dentistry, its journal, Community Dental Health, and the origins of dental public health: a 50-year celebration.

This paper examines the founding and development of the British Association for the Study of Community Dentistry, 36 years after establishment of the American Association of Public Health Dentistry, and its achievements over 50 years. Especially important are its major role in national and other epidemiological surveys, establishment of NHS dental public health specialist and consultant posts, and its journal, Community Dental Health.

Salud bucal de niños y niñas intervenidos por el programa odontológico Sembrando Sonrisas, Comuna de Ovalle, año 2019 / Oral health in children treated by the Sembrando Sonrisas dental program, Ovalle, in 2019

Objetivo: Evaluar el estado actual de la salud bucal de niños(as) de 2 a 5 años intervenidos por el programa Sembrando Sonrisas, Comuna de Ovalle, año 2019. Materiales y Métodos: Estudio observacional, de corte transversal, realizado en niños(as) con examen clínico dental que asistían a establecimientos educacionales beneficiados por el programa Sembrando Sonrisas. La información fue solicitada a la Municipalidad de Ovalle mediante ley de transparencia, no teniendo control del levantamiento de los datos. Se abordó la prevalencia de niños(as) sin/con historias de caries según el índice dientes cariados-extraídos-obturados e intensidad del daño, relacionándolas con variables sociodemográficas. Resultados: De los n=4.201 niños(as) evaluados(as), el 62,8% no presentaba historia de caries, disminuyendo de 92,0% (2 años) a 48,9% (5 años) (P<0,001). No hubo diferencias según sexo (P≥0,159) pero fue significativamente menor en niños(as) de sectores urbanos (P≤0,048). Por tipo de establecimiento educacional, la prevalencia de niños(as) con historia de caries y la intensidad del daño fue siempre mayor en el sector rural, mientras que en el sector urbano los menores valores fueron registrados en colegios particulares subvencionados. Conclusiones: El estudio mostró mejoras importantes en la prevalencia de historia de caries, pero sigue evidenciando las desigualdades en acceso a la salud que están presentes en nuestra sociedad.

Objective: To evaluate the current oral health status of children aged 2 to 5 years in Ovalle, treated in the Sembrando Sonrisas program, year 2019. Materials and Methods: Observational, cross-sectional study, carried out in children with a clinical dental examination, who attended educational establishments benefiting from the Sembrando Sonrisas program. The information was requested from the Municipality of Ovalle through the transparency law, without control of the data collection. The prevalence of children with and without caries history according to the decayed, extracted, filled teeth index, and the intensity of the damage were addressed, relating them to sociodemographic variables. Results: A n=4,201 of children was evaluated, where 62.8% did not present a history of caries, decreasing from 92.0% (2 years) to 48.9% (5 years) (P<0.001). There were no differences between sexes (P≥0.159) but it was significantly lower in children from urban sectors (P≤0.048). By type of educational establishment, the prevalence of children with a history of caries and the intensity of the damage was always higher in the rural sector, while in the urban sector the lowest prevalence was registered in private subsidized schools. Conclusions: The study showed important improvements in the prevalence of this disease, but it also showed that inequalities in access to health are still present in our society.

American Board of Dental Public Health diplomate survey, 2021: Competency domains and practice.

OBJECTIVE: To describe current Dental Public Health diplomates and list the competency domains that diplomates considered either essential or optional elements of their practice. METHODS: The American Board of Dental Public Health administered an electronic survey to active and life member diplomates during September 2021. The survey included 101 items in three sections: (1) Education and Work Experience; (2) Dental Public Health Tasks; and (3) Demographics. The Dental Public Health Tasks section asked individuals how essential work-related tasks were to their current practice. Descriptive analyses were conducted using SAS. RESULTS: The overall response rate was 82.6% (157 eligible of 190 returned). Most respondents were women, 35 to 54 years of age, and either non-Hispanic white or non-Hispanic Asian. Twice as many had DDS or DMD degrees than BDS degrees. The vast majority completed a Dental Public Health residency and received masters level training from an accredited program. About three-fourths worked in the United States and held a U.S. license. More than 37% reported a second doctoral degree and 70% worked in academia. Responses to questions about tasks closely aligned with working in academia and less so with positions related to advocacy, regulation, and program evaluation. CONCLUSIONS: Current diplomates are concentrated in academia. If this trend continues, it may be necessary to restructure the competencies, so training and skills acquisition remain timely and relevant. The specialty may also need to encourage future generations to consider non-academic positions so Dental Public Health remains an impactful component of the public health care system.

Policy Agenda Setting in Public Health Dentistry: Implementing North America's First Universal School-Based Dental Program in Saskatchewan.

The Saskatchewan Dental Plan in Canada was the first universal dental care plan for children in North America. Based on a similar New Zealand program, it would take over two decades from the time that the provincial government first considered the New Zealand policy until a final decision was made to implement the program. This article reviews the reasons for the long gestation of the policy, including the hostility of organized dentistry in Saskatchewan and Canada and the caution of the government's bureaucracy. It would take until a social democratic government was elected in 1971 before the political stream joined with the pre-existing problem and policy streams to open the policy window. Established in 1974, the program was terminated in 1987 due to opposition of organized dentistry combined with the pro-market ideology of a newly elected government.

Résumé. La Saskatchewan a été la première à instaurer un régime de soins dentaires universels pour les enfants en Amérique du Nord, le Saskatchewan Dental Plan. S'inspirant d'un programme semblable établi en Nouvelle-Zélande, le gouvernement provincial allait mettre vingt ans, entre le début de l'évaluation de la politique néozélandaise et sa décision, à implanter son programme. Cet article passe en revue les raisons de cette longue gestation, notamment l'hostilité du milieu bien organisé de la médecine dentaire en Saskatchewan et au Canada et la prudence des fonctionnaires gouvernementaux. Il allait falloir l'élection d'un gouvernement social-démocrate, en 1971, pour que le milieu politique s'empare du problème et des politiques existantes et que s'ouvre une fenêtre d'opportunité politique. Établi en 1974, le programme a été aboli en 1987, renversé par l'opposition combinée de la dentisterie organisée et de l'idéologie du libre marché prônée par le gouvernement nouvellement élu.

How Brazilian oral health care workers face COVID-19: surveillance, biosafety, and education strategies

Aim: To investigate surveillance, biosafety, and education strategies of Brazilian oral health care workers (OHCWs) during the first wave of the COVID-19 outbreak. Methods: This was a cross-sectional study covering OHCWs from a single multicenter research centre. A self-administered and validated online questionnaire was used for data collection, including the following variables: sociodemographic, medical history, biosafety, professional experience, surveillance, and education. Results: The sample consisted of 644 OHCWs (82.5% dentists, 13.2% dental assistants and 4.3% technicians), most without comorbidities (84.8%), from the public (51.7%) and private (48.3%) health systems, in 140 cities of a southern state. The most prominent measures of surveillance were waiting room distancing and visual alerts, symptom assessment, and availability of guidelines on COVID-19. Regarding biosafety measures, the lowest adherence was related to intraoral radiographs (2.7±1.4; 95%CI: 2.6­2.9), use of dental dams (2.1±1.4; 95%CI: 2.0­2.2), and availability of high-power suction systems (2.5±1.7; 95%CI: 2.3­2.6). Among OHCWs, 52.6% received guidance on measures to take during dental care in the workplace. Continuing education was mainly through documents from non-governmental health authorities (77.4%). Conclusion: Surveillance and biosafety measures were adopted, but activities that reduce the spread of aerosols had less adherence. These findings underscore the importance of considering dental practices, and surveillance and education strategies to formulate policies and relevant support to address health system challenges during the COVID-19 pandemic. A coordinated action of permanent education by policymakers is necessary

Cost-related variables in the public purchase of dental materials for endodontic application: 10-year analysis

Aim: This study analyzed public procurements for different endodontic materials used in the Brazilian public health system and evaluated the variables related to their cost. Methods: A time-series study was performed by screening materials for endodontic application in the public Brazilian Databank of Healthcare Prices from 2010 to 2019. Data were categorized according to material composition and clinical application. The collated variables were used in a multiple linear regression model to predict the impact of unit price in procurement processes. Results: A total of 5,973 procurement processes (1,524,693 items) were evaluated. Calcium hydroxides were found in 79% of the observations (4,669 processes). Prices drop each year by US$1.87 while MTAs and epoxy resins are increasingly purchased at higher prices (US$50.87; US$67.69, respectively). The microregion, the procurement modality, and the type of institution had no influence on unit prices in the adjusted model (p > 0.05). Conclusions: Calcium hydroxide-based materials were the cheapest and most frequently purchased endodontic materials in the public health care system. Novel formulations are being implemented into clinical practice over time and their cost may be a barrier to the broad application of materials such as MTAs, despite their effectiveness

Race in public health dentistry: a critical review of the literature.

OBJECTIVE: To carry out a critical review of the literature on the use of race, color, and ethnicity in the field of public health dentistry. METHODS: A literature search was conducted in MEDLINE via PubMed for articles published between 2014 and 2019. Using a data extraction form, we collected information on (1) bibliographic characteristics of the selected papers; (2) race, color, and ethnicity of the study participants and their sociodemographic profiles; and (3) the extent to which the original publications followed the recommendations by Kaplan and Bennett (2003) on the use of race, color, or ethnicity in biomedical research. RESULTS: Our initial search identified 2,032 articles, 53 of which were selected for full-text examination and assessment following pre-established eligibility criteria. Around 60% (n = 32) of the included studies did not justify the use of race, color, or ethnicity in their analyses, and 9% (n = 5) took these variables as indicators of the participants' genetic makeup. On the other hand, 68% (n = 36) of the reviewed papers considered race, color, and ethnicity as risk markers - not risk factors - for adverse oral health outcomes, whereas 80% (n = 42) adjusted racial/ethnic inequities for a range of socioeconomic and demographic factors in statistical models. Only one study (2%) explicitly took race, color, or ethnicity as a contextually dependent dimension of the participants' identities. CONCLUSION: Our findings indicate that research on oral health inequities is often based on reductionist and stigmatizing conceptions of race, color, or ethnicity. Such harmful misconceptions should be replaced with anti-racist narratives in order to effectively address racial oral health inequities.

Assessment of Dental and Medical School students on the awareness of Oral Cancer

Oral cancer (OC) is a public health problem due to its high prevalence in the world po-pulation. Due to its late diagnosis, this pathology has been causing many sequelae for the patient and constitutes a risk of death when treated in advanced stages. One of the main aggravating factors is the difficulty in its early identification, both by health professio-nals and the population, since there are no explicit symptoms in the initial stages or the changes are often like other oral lesions, such as ulcers. Thus, they can go unnoticed by the individual and even by a health professional. This study evaluated the level of kno-wledge about OC in medical and dental students at the University of Santo Amaro. The study was carried out through a questionnaire with 38 (thirty-eight) questions. With that, we established a comparative parameter between both courses to show if the students were well prepared to deal with oral and oropharyngeal cancer. The survey also aimed to show how oral health is being neglected within medicine, making future physicians feel unprepared to care for their patients. (AU)

Bibliometric analysis of three international journals on public health dentistry: A comparative study from 2011 to 2020.

Background and Objective: The research question was to conduct a comparative analysis of articles published, citations, grants and authors co-occurence in three journals of Public health dentistry namely Journal of Public Health (JIF-1.821), Community Dentistry and Oral Epidemiology (JIF-3.803) and Community Dentistry Health(JIF-1.079). This study was triggered, because of the constant growth of the academic production of articles in the world. The objective of this study is to describe the design of studies published in the period 2011 - 2020 of the three mentioned journals. Material and Methods: A retrospective, observational, comparative study was conducted for JPHD, CDOE ad CDH. All issues of JPHD, CDH and CDOE from 2011 to 2020 were manual searched and also assessed through Scopus database. The data were organized and analyzed using software SPSS version 21.0; and citation mapping process using VOSviewer software. Results: A total of 1544 articles were retrieved from all the three journals. The largest number of manuscripts was published in the Community Dentistry and Oral Epidemiology journal. The pattern of study design in JPHD (65.69%) and CDH(74.79%) was majorly cross sectional studies followed by cohort studies(19.46%) and randomized controlled trials (8.34%) respectively. In all the three journals, maximum authors were more than three in number. Majority of the original research work focused on oral health such as oral health status, literacy, oral health quality of life. Conclusion: The publication pattern in all the three journals were interestingly related to each other; most articles published were original research work intending an enhanced inclination of researchers toward observational affirmations.

Os desafios e as potencialidades da saúde bucal na Estratégia Saúde da Família: uma análise dos processos de trabalho / Challenges and potentialities of oral health in the Family Health Strategy: an analysis of work processes

Resumo A saúde bucal foi inserida no Programa Saúde da Família por meio da Portaria do Ministério da Saúde nº 1.444/2000, mas somente após a publicação da Política Nacional de Saúde Bucal houve uma reorganização das práticas e ações em saúde bucal. O objetivo deste estudo foi identificar os principais desafios e potencialidades dos processos de trabalho em saúde bucal no âmbito da Estratégia Saúde da Família. Trata-se de uma pesquisa de abordagem qualitativa realizada com as Equipes de Saúde Bucal e a Coordenação de Saúde Bucal do município de Coreaú, Ceará, Brasil, totalizando 11 participantes. A coleta das informações ocorreu entre abril e agosto de 2019, a partir de grupo focal, diário de campo e entrevista semiestruturada. Utilizou-se a Análise de Conteúdo de Bardin, sendo realizadas triangulação e interpretação das informações definidas em cinco categorias: organização do processo de trabalho; educação em saúde; interprofissionalidade e prática colaborativa; gestão participativa e satisfação dos usuários. Concluiu-se que, no processo de trabalho, a maior problemática é a marcação dos atendimentos em saúde bucal. As potencialidades identificadas foram a inserção da Odontologia na Estratégia Saúde da Família e a integração da equipe de saúde bucal com o efetivo interesse de transformação das práticas.

Abstract Oral health was included in the Family Health Program through Ministry of Health Ordinance No. 1444/2000, but only after the publication of the National Oral Health Policy was there a reorganization of oral health practices and actions. This study aimed to identify the main challenges and potential of the oral health work processes within the scope of the Family Health Strategy. This research has a qualitative approach carried out with the Oral Health and Oral Health Coordination Teams in the municipality of Coreaú, Ceará, Brazil, totaling 11 participants. Information was collected between April and August 2019 from a focus group, field diary and semi-structured interviews. Bardin's Content Analysis was used, with triangulation and interpretation of the information defined in five categories: organization of the work process; health education; inter-professionality and collaborative practice; participatory management and user satisfaction. It was concluded that in the work process the biggest problem is the scheduling of oral health care. The potentialities identified were the insertion of Dentistry in the Family Health Strategy and the integration of the oral health team with the effective interest in transforming practices.

Race in public health dentistry: a critical review of the literature

ABSTRACT OBJECTIVE To carry out a critical review of the literature on the use of race, color, and ethnicity in the field of public health dentistry. METHODS A literature search was conducted in MEDLINE via PubMed for articles published between 2014 and 2019. Using a data extraction form, we collected information on (1) bibliographic characteristics of the selected papers; (2) race, color, and ethnicity of the study participants and their sociodemographic profiles; and (3) the extent to which the original publications followed the recommendations by Kaplan and Bennett (2003) on the use of race, color, or ethnicity in biomedical research. RESULTS Our initial search identified 2,032 articles, 53 of which were selected for full-text examination and assessment following pre-established eligibility criteria. Around 60% (n = 32) of the included studies did not justify the use of race, color, or ethnicity in their analyses, and 9% (n = 5) took these variables as indicators of the participants' genetic makeup. On the other hand, 68% (n = 36) of the reviewed papers considered race, color, and ethnicity as risk markers - not risk factors - for adverse oral health outcomes, whereas 80% (n = 42) adjusted racial/ethnic inequities for a range of socioeconomic and demographic factors in statistical models. Only one study (2%) explicitly took race, color, or ethnicity as a contextually dependent dimension of the participants' identities. CONCLUSION Our findings indicate that research on oral health inequities is often based on reductionist and stigmatizing conceptions of race, color, or ethnicity. Such harmful misconceptions should be replaced with anti-racist narratives in order to effectively address racial oral health inequities.