Ageism in dental students - a multicentric study in southern Brazil.

OBJECTIVES: Gerontological education and intergenerational contact are proven strategies for effectively combating ageism. In this context, this study investigates the association between gerontological education, intergenerational contact, and ageism among dental students. METHODS: Gerontological education from students' perspective, intergenerational contact, and ageism were assessed using a questionnaire containing sociodemographical aspects and an ageism scale (ASDS-Braz). The sample included students enrolled in the final year of dental programs at three public universities in southern Brazil. A multilevel Poisson regression was conducted to assess factors associated with ASDS-Braz scores. RESULTS: A modest correlation was identified between dental schools in terms of reducing ageism, and a weak correlation was found between self-reported race and ageism. Notably, statistically significant findings were observed across family relationship with older individuals: students who reported having a poor relationship with older adults in their families presented 45% higher ageism scores than did those with an excellent relationship. CONCLUSION: The results suggested that while some gerontological education was reported by the participants, it may not be sufficient to prepare dental students to provide effective oral healthcare to older adults and to reduce ageism among them. Additionally, reinforcing positive aspects of intergenerational relationships may be an additional strategy in combating ageism within this population.

A postmodern perspective regarding older adults' oral health.

This article aims to comprehend meaning assigned to oral health, by means of older adults discourses, supported by a Social Constructionist perspective. This is a qualitative study with a descriptive and comprehensive design based on the Social Constructionism theoretical support conducted by means of interviews with 19 older adults. Data were analysed by means of a Discourse Analysis with identification of Interpretative Repertoires, which structured the meanings proposed to oral health. It were created repertories to disclosure possible meanings assigned to the oral health by older people as: having a clean mouth; having good comprehensive/general health; having a beautiful smile and oral health well-being condition; and suffering in the past and accepting pain. The meaning assigned to oral health by older people, in a social constructionist perspective, allow us to comprehend the subjectivity behind oral health of older people, which can guide health professionals' approaches to deal with it.

Access to dental services and oral health-related quality of life in the context of primary health care.

The aim of the present study was to evaluate the association between access to oral health care in the Primary Health Care (PHC) and Oral Health-Related Quality of Life (OHRQoL). The present study was a cross-sectional study, and the sample was composed of 412 users living in the areas covered by the public PHC services who visited a health unit for an oral exam or treatment in the last 24 months. Participants in the study responded to a home-based interview with questions that addressed socioeconomic status, behavioral, general health, dental prostheses, access to dental services in the PHC and their OHRQoL as measured by the Oral Health Impact Profile (OHIP-14) instrument. After the interview, a dental examination was performed to count the number of teeth. Chi-square tests, Student's t tests and multivariate analyses were performed using a hierarchical model and a Poisson regression with robust variance to evaluate the association between independent variables and OHRQoL. Access to oral health services in the PHC was statistically associated with OHRQoL, and the estimated prevalence rate was PR = 1.17 (CI 95% 1.00-1.37). In this study, the definition of access was based on the availability of dental consultations on demand. The study identified that lack of access to oral health services offered by the PHC was associated with a higher prevalence of impact on the quality of life of individuals.

Vivenciando o cuidado em saúde bucal para pessoas idosas em acompanhamento em saúde mental: relato de experiência / Experiencing oral health care aimed at older people undergoing mental health care: an experience report

A interlocução entre saúde mental, pessoas idosas e saúde bucal é um assunto que precisa ser abordado na formação em Odontologia. Mesmo que em um curto período dentro dos 5 anos de formação, um momento em que estes temas se encontram em um estágio extramuros mostra-se interessante e enriquecedor. O objetivo do presente artigo é apresentar um relato de experiência de estudantes de Odontologia na promoção da saúde dentro do escopo da Odontologia em uma instituição de longa permanência em um município do Rio Grande do Sul. Metodologicamente, o presente relato de experiência foi estruturado de acordo com o referencial teórico para Sistematização de Experiências, seguindo os seguintes passos: descrição do ponto de partida, elaboração de perguntas iniciais, reflexão sobre o processo vivido e descrição e apresentação dos pontos finais da experiência. As 7 estudantes de graduação envolvidas nesta experiência planejaram e desenvolveram, com professores-tutores e supervisores locais, ações de cuidado e educação em saúde bucal para 32 pessoas institucionalizadas. As atividades desenvolvidas geraram engajamento mútuo, tanto das estagiárias quanto dos residentes e trabalhadores da instituição. Neste contexto, este texto apresenta experiências em uma narrativa permeada pelas dificuldades, potencialidades e motivações para o aprendizado da Odontologia (AU).

El diálogo entre salud mental, personas mayores y salud bucal es un tema que es necesario abordar en la formación de Odontología. Aunque sea en un corto período dentro de los 5 años de formación, un momento en el que estos temas se encuentran en una etapa extramuros resulta interesante y enriquecedor. El objetivo de este artículo es presentar un relato de experiencia de estudiantes de Odontología en la promoción de la salud en el ámbito de la Odontología en una institución de larga duración en una ciudad de Rio Grande do Sul. Metodológicamente, este relato de experiencia se estructuró de acuerdo con el marco teórico para Sistematización de Experiencias, siguiendo los siguientes pasos: descripción del punto de partida, elaboración de preguntas iniciales, reflexión sobre el proceso vivido y descripción y presentación de los puntos finales de la experiencia. Las 7 estudiantes de pregrado involucradas en esta experiencia planificaron y desarrollaron, con profesores-tutores y supervisores locales, acciones de educación y atención en salud bucal para 32 personas institucionalizadas. Las actividades desarrolladas generaron un compromiso mutuo, tanto entre los pasantes como entre los residentes y trabajadores de la institución. En este contexto, este texto presenta experiencias en una narrativa permeada por las dificultades, potencialidades y motivaciones para aprender Odontología (AU).

The dialogue between mental health, older people and oral health is a topic that must be addressed in Dentistry training. Even if in a short period within the 5 years of training, the moment when these themes come together in an internship program outside the college walls proves to be interesting and enriching. The objective of this article is to present an experience report of Dentistry students aimed at promoting healthwithin the scope of Dentistry in a long-term institution located in a municipality in the state of Rio Grande do Sul. Methodologically, this experience report was structured according to the theoretical framework for Systematization of Experiences and followed these steps: description of the starting point, formulation of the initial questions, reflection about the process experienced and, finally, description and presentation of the end points of the experience. The 7 undergraduate students participating in this experience, together with tutor-professors and local supervisors, planned and developed care and educational actions focused on oral health for 32 institutionalized individuals. The activities developed generated mutual engagement between the interns and the institution's residents and workers. In this context, this article presents experiences that followed a narrative permeated by the difficulties, potentialities, and motivations encountered in the Dentistry learning process (AU).

Curative procedures of oral health and structural characteristics of primary dental care.

OBJECTIVE: To evaluate if the provision of clinical dental care, by means of the main curative procedures recommended in Primary Health Care, is associated with team structural characteristics, considering the presence of a minimum set of equipment, instrument, and supplies in Brazil's primary health care services. METHODS: A cross-sectional exploratory study based on data collected from 18,114 primary healthcare services with dental health teams in Brazil, in 2014. The outcome was created from the confirmation of five clinical procedures performed by the dentist, accounting for the presence of minimum equipment, instrument, and supplies to carry them out. Covariables were related to structural characteristics. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios, with 95% confidence intervals. RESULTS: A total of 1,190 (6.5%) dental health teams did not present the minimum equipment to provide clinical dental care and only 2,498 (14.8%) had all the instrument and supplies needed and provided the five curative procedures assessed. There was a positive association between the outcome and the composition of dental health teams, higher workload, performing analysis of health condition, and monitoring of oral health indicators. Additionally, the dental health teams that planned and programmed oral health actions with the primary care team monthly provided the procedures more frequently. Dentists with better employment status, career plans, graduation in public health or those who underwent permanent education activities provided the procedures more frequently. CONCLUSIONS: A relevant number of Primary Health Care services did not have the infrastructure to provide clinical dental care. However, better results were found in dental health teams with oral health technicians, with higher workload and that plan their activities, as well as in those that employed dentists with better working relationships, who had dentists with degrees in public health and who underwent permanent education activities.

Perceptions of primary health care service users regarding dental team practices in Brazil.

BACKGROUND: The Unified Health System (SUS) is the Brazilian set of public health services that offers global access to health care and disease treatments for all citizens. These services have been evaluated by means of a national survey assessing the users' perceptions.AimTo explore and characterize the SUS users' perceptions regarding primary dental team practices in the five Brazilian geographical regions. METHODS: Descriptive study. The sample consisted of 37 262 subjects. Data were collected by means of the Ministry of Health survey, conducted between 2012 and 2014. Variables used in the present study are associated with SUS users' perspectives of satisfaction, access, and use of services. The study utilized bivariate data analysis, and dichotomous variables were derived for analysis following 95% reliability.FindingsThis study observed similarities and proportionality of perceptions in the Brazilian territory. In most macro-regions, dental teams did not develop an active search for dental treatment absentees. However, the SUS users reported very good and good perceptions, which were homogeneously distributed across five Brazilian regions, thereby showing an overall positive perception of primary dental treatment.

Perfil informacional de cirurgiões-dentistas do serviço público sobre a segurança do paciente na assistência odontológica / Informational profile of public service dentists on patient safety in dental treatment

Aim: To analyze the perceptions of public service dentists on informational aspects regarding patient safety in dental care. Materials and methods: Descriptive research in which a composite outcome was constructed to present the perceptions of research subjects on the subject. The outcome proposes the perception of three informational aspects related to patient safety: knowledge about the notification system, knowledge about the National Patient Safety Program (PNSP) and information about safety available in the workplace. Data collection took place online, through a self-administered questionnaire, with dental surgeons working in the public health service in Porto Alegre/RS. Results: Of the total number of 47 participants, 74.4% were women, 91.4% declared themselves to be white, 65.9% were 31 years of age or older, 74.5% had graduated more than five years and 59.6% worked in the Unified Health System for more than 5 years. The prevalence of the outcome was 12.8%. When separately analyzing each outcome variable, the prevalence was 34% for knowledge about the reporting system, 34% for the knowledge in regards of the National Patient Security Program and for the presence of information available in the workplace was 38.3%. Discussion: The results point to the need to work on informational issues with these professionals so that in the stressful day-to-day work, patient safety is something naturally present during dental care in the workspaces. Conclusion: It is concluded that reports of dental incidents were few and the informational context on the subject needs to be worked on so that patient safety is always the focus of attention in dental practice.

Objetivo: Analisar as percepções de cirurgiões-dentistas do serviço público sobre aspectos informacionais a respeito da segurança do paciente no cuidado odontológico. Materiais e métodos: Pesquisa descritiva em que um desfecho composto foi construído para apresentar as percepções dos sujeitos de pesquisa sobre o tema. O desfecho propõe a percepção positiva de três aspectos informacionais relacionados à segurança do paciente: conhecimento acerca do sistema de notificações, conhecimento sobre o Programa Nacional de Segurança do Paciente (PNSP) e informações sobre segurança disponíveis no local de trabalho. A coleta de dados aconteceu online, por meio de um questionário autoaplicável, com cirurgiões-dentistas trabalhadores do serviço público de saúde de Porto Alegre/RS. Resultados: Participaram deste estudo 47 cirurgiões(ãs)-dentistas, sendo 74,4% mulheres, 91,4% autodeclarados da raça/cor branca, 65,9% possuíam 31 anos ou mais de idade, 74,5% estavam formados há mais de cinco anos e 59,6% trabalhavam no Sistema Único de Saúde há mais de cinco anos. A prevalência do desfecho composto foi de 12,8%. Observou-se que as prevalências foram de 34% para o conhecimento sobre o Sistema de Notificação e, 34% para o conhecimento sobre o Programa Nacional de Segurança do Paciente e 38,3% para a presença de informações disponíveis no local de trabalho. Discussão: Os resultados apontam a necessidade de trabalhar questões informacionais com estes profissionais de maneira que no dia a dia estressante de trabalho a segurança do paciente seja algo naturalmente presente durante o cuidado odontológico nos espaços de trabalho. Conclusão: Conclui-se que os relatos de incidentes odontológicos foram poucos e o contexto informacional sobre o tema necessita ser trabalhado para que a segurança do paciente seja sempre foco de atenção na prática odontológica.

O estágio curricular na atenção primária à saúde durante a pandemia de COVID-19: desafios e reinvenções para a formação em Odontologia / La pasantía curricular en atención primaria de salud durante la pandemia COVID-19: desafíos y reinvenciones para la formación en Odontología / The curricular internship in primary health care during the COVID-19 pandemic: challenges and reinventions for Dentistry education

O Decreto Legislativo n. 6/2020 reconheceu a ocorrência do estado de calamidade pública em razão da COVID-19, o que suscitou a suspensão das atividades presenciais nas instituições de ensino superior. O objetivo deste relato foi descrever e analisar a experiência de docentes e estudantes de graduação em Odontologia nos estágios curriculares na Atenção Primária à Saúde (APS) durante o Ensino Remoto Emergencial (ERE). Trata-se de um relato de experiência de docentes e monitoras com três turmas do penúltimo semestre de um curso diurno de Odontologia, no período letivo entre 2020/1 a 2021/2, totalizando 109 estudantes. Foram consultados documentos institucionais e registros dos docentes sobre as atividades de ensino. O método utilizado foi o de Sistematização deExperiências. Em agosto de 2020, com o início do ERE, o percurso do estágio foi reorganizado e a carga horária redistribuída, com os estudantes sendo preparados para posterior atuação na APS. A partir de janeiro de 2021, o estágio, que enfrentou desafios e reinvenções, foi desenvolvido na modalidade híbrida com vivências práticas nas Unidades Básicas de Saúde (UBS). Em relação aos desafios, destacam-se a capacitação para o ensino virtual; o aprendizado de lidar com as vidas perdidas; a rescisão de contratos dos profissionais das UBS, o número restrito de serviços para atender as turmas acumuladas e a expectativa de atuação clínica dos estudantes versus as restrições sanitárias. Relacionado às reinvenções, destacam-se o preenchimento e assinatura dos termos virtualmente e abertura de campos de estágio nas cidades do interior. As reconfigurações do estágio buscaram a integração entre a teoria e a prática e possibilitaram, além da formatura dos estudantes, a aquisição do arcabouço didático-pedagógico para o desenvolvimento de competências profissionais (AU).

Decreto Legislativo núm. 6/2020 reconoció la ocurrencia de un estado de calamidad pública por causa del COVID-19, que motivó la suspensión de actividades presenciales en las instituciones de educación superior. El objetivo de este informe fue describir y analizar la experiencia de profesores y estudiantes de pregrado en Odontología en prácticas curriculares en Atención Primaria a la Salud (APS) durante la Educación a Distancia de Emergencia (ERE). Se trata de un informe de la experiencia de docentes y monitores con tres clases del penúltimo semestre de una carrera diurna de Odontología, en el periodo académico comprendido entre 2020/1 y 2021/2, totalizando 109 estudiantes. Se consultaron documentos institucionales y registros docentes sobre la actividad docente. El método utilizado fue la Sistematización de Experiencias. En agosto de 2020, con el inicio del ERE, se reorganizó la ruta de prácticas y se redistribuyó la carga horaria, preparándose los estudiantes para su posterior trabajo en la APS. A partir de enero de 2021, la pasantía, que enfrentó desafíos y reinvenciones, se desarrolló en una modalidad híbrida con experiencias prácticas en Unidades Básicas de Salud (UBS). En cuanto a los desafíos, destaca la formación para la docencia virtual; aprender a lidiar con las vidas perdidas; la rescisión de contratos de los profesionales de la UBS, la restricción del número de servicios para atender las clases acumuladas y la expectativa de desempeño clínico de los estudiantes versus las restricciones sanitarias. Enrelación con las reinvenciones, las más destacadas son la cumplimentación y firma de plazos de forma virtual y la apertura de campamentos de pasantías en ciudades del interior. Las reconfiguraciones de la pasantía buscaron la integración entre teoría y práctica y permitieron, además de la graduación de los estudiantes, la adquisición del marco didáctico-pedagógico para el desarrollo de habilidades profesionales (AU).

The Law Decree n. 6/2020 recognized the occurrence of public calamity due to COVID-19, which led to the interruption of in-person activities in higher education institutions. The aim of this report is to describe and analyze the experience of professors and undergraduate Dentistry students in curricular internships in Primary Health Care (PHC) during Emergency Distance Learning (EDL). This paper reports the experience of professors and monitors with three classes from the last but one semester of adaytime Dentistry course in the academic period between 2020/1 and 2021/2, adding up to 109 students. Institutional documents and professors' records on teaching activities were consulted. The method used was Systematization of Experiences. In August 2020, with the onset of EDL, the internship was reorganized, and the workload redistributed, preparing the students for later work at PHC. After January 2021, the internship, which faced challenges and reinventions, was developed in hybrid modality with practical experiences in Basic Health Units (UBS). Regarding the challenges, the training for virtual teaching is highlighted, as well as learning to deal with lost lives, the termination of contracts of UBS professionals, the restricted number of services to assist the accumulated classes and the expectation of clinical performance of students as opposed to the health restrictions. Concerning the reinventions, the most outstanding are filling and signing terms virtually and opening internship fields in countryside cities. The reconfigurations of internship aimed at the integration between theory and practice; besides the students' graduation, it enabled the acquisition of didactic-pedagogical framework for the development of professional skills (AU).

Living, collective and political organisms for construction of the attributes of the National Oral Health Policy / Organismos vivos, coletivos e políticos pela construção dos atributos da Política Nacional de Saúde Bucal

ABSTRACT The last few decades have witnessed a growth in the value of dentists as health professionals as they act as protagonists in the construction of public health policies. This change comes from powerful and representative dentists in the Unified Health System (acronym in Portuguese is SUS). This short theoretical essay aims to bring the reader closer to the attributes necessary for the building of a social policy and draws a parallel with the National Oral Health Policy (acronym in Portuguese is PNSB). Issues such as context-oriented health policy and the National Oral Health Policy associated with the attributes of a social policy are presented in a narrative and reflective manner. In this process, the exercise of citizenship is demonstrated, emphasizing the importance of the collective role and policy of dentist surgeons in the stages of health policies in Brazil

RESUMO A valorização do cirurgião dentista como um profissional da saúde que pode ser protagonista na construção de políticas públicas de saúde vem se fortalecendo nas últimas décadas. Este fortalecimento se dá pela atuação potente e representativa da odontologia no Sistema Único de Saúde. Este breve ensaio teórico tem o objetivo de aproximar o leitor aos atributos necessários para a construção de uma política social e traçar um paralelo com a Política Nacional de Saúde Bucal. Deste modo, questões como contextos produtores de uma política de saúde e a Política Nacional de Saúde Bucal associada aos atributos de uma política social são apresentadas de forma narrativa e reflexiva. Neste processo o exercício de cidadania se faz presente, ressaltando a importância do papel coletivo e político do cirurgião dentista no ciclo vivo das políticas de saúde no Brasil.

Pessoas idosas institucionalizadas, transtornos depressivos e questões odontológicas: qual o estado da arte? / Institutionalized old people, depressive disorders, and dental issues: what is the state of the art?

Resumo Objetivo Fazer um mapeamento e uma discussão sobre o conhecimento científico envolvendo o objeto de pesquisa Condições de saúde bucal e depressão em idosos institucionalizados. Método Revisão de Escopo do tipo mapeamento da literatura. O mapeamento dos dados selecionados foi feito pela técnica de sistematização de dados por meio da Análise de Conteúdo Somativa na perspectiva de Temas Manifestos nos textos. Após as exclusões foram selecionados 27 artigos. Resultados Com a análise dos artigos foi possível dividi-los em dois temas. Todos os continentes possuem publicações acerca do tema. Sobre sua metodologia, muitas pesquisas com desenho de estudos dedutivos foram realizadas e poucas pesquisas foram desenvolvidas com métodos indutivos. Conclusão O presente estudo identificou que existe uma interlocução entre algumas condições de saúde bucal (xerostomia e perda dentária) e prevalência de transtornos depressivos em idosos institucionalizados.

Abstract Objective To map and discuss scientific knowledge involving the research object Oral health conditions and depression in institutionalized old people. Method Scope review of the literature mapping type. The mapping of the selected data was done using the data systematization technique through the Summative Content Analysis from the perspective of Manifest Themes in the texts. After the exclusions, 27 articles were selected. Results With the analysis of the articles it was possible to divide them into two themes. All continents have publications on the topic. Regarding its methodology, a lot of research with the design of deductive studies was carried out and few researches were developed with inductive methods. Conclusion The present study identified that there is a communication between some oral health conditions (xerostomia and tooth loss) and the prevalence of depressive disorders in institutionalized old people.

O apoio institucional e as ações das equipes de saúde bucal na atenção primária à saúde no Brasil / Institutional support and actions of oral health teams in primary health care in Brazil

O apoio institucional é uma ferramenta de articulação de práticas e de estratégias de gestão colegiada fundamental para construção de espaços de produção de saúde bucal no escopo da atenção primária à saúde. O presente estudo tem o objetivo de analisar a atuação do apoio institucional em relação a participação das equipes de saúde bucal em ações de monitoramento, reunião de equipe e organização de processo de trabalho na Atenção Primária. Trata-se de um estudo transversal de base em serviço, com dados coletados pelo segundo ciclo do PMAQ- AB-SB por meio do instrumento de Avaliação Externa para as Equipes de Saúde Bucal. Para análise dos dados foi proposto um desfecho construído a partir do conjunto de ações realizadas pelo apoio institucional nas Unidades Básicas de Saúde. O desfecho foi analisado segundo ações não clínicas realizadas por equipes de saúde bucal na atenção primária. Os dados foram analisados por descrição de prevalência e associações bivariadas por meio do Teste do Qui-quadrado e do Teste Exato de Fisher. Como resultado observou-se que a taxa de prevalência nacional do conjunto de ações do apoio institucional foi de 23,3%. As macrorregiões Nordeste (25,2%) e Sudeste (26,6%) apresentaram melhores resultados. Houve associação entre o conjunto de ações do apoio institucional com realização de discussão dos dados de monitoramento, participação em reuniões da equipe de atenção primária e planejamento e organização do processo de trabalho. Conclui-se que há necessidade de maiores investimentos na implementação do apoio institucional em Unidades de Saúde qualificando processos de trabalho.

Institutional support is a tool for the articulation regarding practices and strategies of collegiate management, which are important for the construction of oral health production spaces at the primary health care space. This study aims to analyze the role of institutional support in relation to the participation of oral health teams in monitoring actions, teamwork and work process organization in Primary Care. This is a cross-sectional in-service study, with data collected by the second cycle of PMAQ- AB-SB through the External Assessment Tool for Oral Health Teams. For data analysis, an outcome was proposed based on the set of actions performed by institutional support. The outcome was analyzed according to actions performed by oral health teams in primary care. The data were analyzed by the description of prevalence and bivariate associations using the cChi-square test and Fisher's exact test. As a result, it was observed that the national prevalence rate of institutional support actions was 23.3%. The Northeast (25.2%) and Southeast (26.6%) macroregions had better results. There was an association between the set of institutional support actions and the discussion of monitoring data, participation in primary care team meetings, and planning and organization of the work process. It is concluded that there is a need for greater investment in the implementation of institutional support in Health Units, qualifying work processes.

Envelhecimento e vulnerabilidades: a odontogeriatria na graduação como estratégia de valorização da vida / Aging and vulnerabilities: the geriatric dentistry in graduation as strategy of life valuation

O envelhecimento populacional suscita desafios sociais que se tornam mais evidentes pela pandemia de COVID-19, e o Brasil tem observado a morte de seus idosos e de jovens que não terão a oportunidade de envelhecer. A gerontologia, nesse contexto, faz-se imperativa e sua inserção na formação de profissionais de saúde é uma demanda urgente que a Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul atende por meio de estágios curriculares voltados à pessoa idosa, construindo e consolidando conhecimentos relacionados ao envelhecimento na formação de estudantes de graduação em odontologia. As atividades ocorrem no curso diurno em unidades de saúde e em instituições de longa permanência para idosos, e no curso noturno através de visitas domiciliares a idosos vinculados a unidades de saúde. A problematização que esses estágios geram parece ter um impacto positivo no processo de formação, pois proporciona aos estudantes a possibilidade de desenvolverem outras formas de cuidado, que vão além da clínica biomédica tradicional e que os capacita como atores sociais. Essas diferentes práticas de ensino fortalecem a valorização da vida e do envelhecer, a autonomia e a participação do idoso como agente de formação e transformação social, e o protagonismo do próprio estudante.

Aspectos emocionais, apoio social e funcionalidade bucal de idosos robustos e residentes em instituição de longa permanência / Emotional aspects, social support and oral functionality regarding robust older adults' residents in a long-term institution

Objetivo: analisar as questões envolvendo aspectos emocionais e o acesso à informação, escuta qualificada,componentes do macroconceito de apoio social e suas relações com condições sociodemográficas e de funcionalidadebucal em idosos robustos e independentes moradores de uma instituição de longa permanência.Métodos: estudo descritivo observacional e transversal. Para coleta dos dados, foi aplicado o instrumento Escala de Apoio Social e, para análise dos dados, foi proposto um desfecho composto representando o apoio social recebido e análises bivariadas para observação de associações significantes entre o desfecho e as variáveissociodemográficas e de funcionalidade bucal. Resultados: a prevalência da percepção positiva do apoio foi de 54,4%, e é maior em idosos com idade variando entre 60-79 anos e com menor número de dentes.Conclusão: questões emocionais e de informação aos idosos, concebidas por meio das relações interpessoais dentro de uma instituição de longa permanência, precisam ser acessadas por idosos com dentição funcionale em idades mais avançadas.(AU)

Objective: to analyze issues involving emotional aspects and access to information, components of the macro concept of social support, and their relationship with sociodemographic and oral health conditions regarding older people living in long- -term care facilities. Methodology: research design with a transversa approach. To collect the data, the Social Support Scale instrument was applied, and data analysis was performed to compose the social support received and bivariate analyzes for the observation of significant associations between the outcome and socio demographic and oral health variables. Results: the prevalence of positive perception of the social support was 54.4%, higher in older individuals aged 60-79 years, with a higher number of teeth and a non-white colour. Conclusion: emotional and informational issues for the elderly, conceived through interpersonal relationships within a long-term institution need to be optimized.(AU)

A postmodern perspective regarding older adults' oral health / Uma perspectiva pós-moderna sobre a saúde bucal de idosos

Abstract This article aims to comprehend meaning assigned to oral health, by means of older adults discourses, supported by a Social Constructionist perspective. This is a qualitative study with a descriptive and comprehensive design based on the Social Constructionism theoretical support conducted by means of interviews with 19 older adults. Data were analysed by means of a Discourse Analysis with identification of Interpretative Repertoires, which structured the meanings proposed to oral health. It were created repertories to disclosure possible meanings assigned to the oral health by older people as: having a clean mouth; having good comprehensive/general health; having a beautiful smile and oral health well-being condition; and suffering in the past and accepting pain. The meaning assigned to oral health by older people, in a social constructionist perspective, allow us to comprehend the subjectivity behind oral health of older people, which can guide health professionals' approaches to deal with it.

Resumo O objetivo deste artigo é compreender o significado da saúde bucal, por meio de discursos de idosos, com apoio da perspectiva teórica Construcionista Social. Trata-se de um estudo qualitativo com um desenho descritivo e compreensivista, baseado no referencial teórico do Construcionismo Social realizado por meio entrevistas com 19 idosos. Os dados foram analisados por meio de uma Análise de Discurso com identificação de Repertórios Interpretativos, que estruturou os significados atribuídos à saúde bucal. Foram criados repertórios para a compreensão de significados possíveis atribuídos à saúde bucal por pessoas idosas. Deste modo, saúde bucal é: ter uma boca limpa; ter boa saúde geral; ter um sorriso bonito e se sentir bem com a condição bucal; ter tido algum sofrimento no passado aceitando a dor. Os significados atribuídos à saúde bucal pelos idosos, numa perspectiva construcionista social, nos permite compreender a subjetividade por trás da saúde bucal das pessoas idosas na atualidade, o que pode orientar as abordagens dos profissionais de saúde para lidar com isso.

Questões fonoaudiológicas e odontológicas na percepção de idosos que acessam serviços do Sistema Único de Saúde / Speech therapy and oral health issues in the perception of the older adults that access the Unified Health System

RESUMO: Modelo de estudo: Estudo observacional e transversal com dados coletados a partir de questionários aplicados aos idosos em visitas domiciliares, sobre acesso a serviços de saúde. Objetivo: Analisar a percepção de idosos independentes sobre questões fonoaudiológicas e odontológicas nos serviços de Atenção Primária à Saúde do Sistema Único de Saúde. Métodos: Foram analisadas frequências absolutas das variáveis de estudo relacionadas a questões fonoaudiológicas e odontológicas através do teste do Qui-quadrado e Teste Exato-de-Fisher, ambos com nível de 0,05% de significância. Resultados: Os idosos entrevistados foram predominantemente mulheres (76,5%), cor branca (73,5%), com no mínimo ensino médio de escolaridade (64,7%). Destes idosos, 92,6% afirmaram não possuir dificuldades para se alimentar, apesar de 51,5% nunca ter feito uma avaliação fonoaudiológica. Houve maior proporção indicando que os idosos não necessitaram de consulta com fonoaudióloga (73,5%). Quanto à utilização de serviços da atenção primária, 68,7% utilizavam o sistema público e desses, 94,1% autoperceberam sua condição de saúde bucal como regular/ruim. Conclusão: Sugere-se o fortalecimento do cuidado dos idosos de forma interdisciplinar e integral, a fim de abranger as necessidades e especificidades dessa população. A baixa percepção da importância do cuidado sugere a necessidade do fortalecimento dos serviços de fonoaudiologia para a saúde da população idosa brasileira. (AU)

ABSTRACT: Study design: Cross-sectional study with data collected from questionnaires applied to older adults at domiciliary visits regarding access to health services. Objective: Analyzing the perception of independent elderly about speech-language and dental issues in the Primary Health Care Services of the Unified Health System/SUS. Methods: Absolute frequencies of the study variables related to speech-language and dental questions were analyzed using the Chi-square test and Fisher's Exact Test, both with a 0.05% significance level. Results: The elderly interviewed were predominantly women (76.5%), white (73.5%), with at least high school education (64.7%). Of these, 92.6% said they had no difficulty in eating, although 51.5% never had a speech therapist evaluation. There was also a higher proportion indicating that the elderly did not need an appointment with the speech therapist (73.5%). Regarding the use of primary care services, 68.7% used the public system, and of these, 94.1% self-perceived their oral health condition as fair/poor. Conclusion: It is suggested to strengthen the care of the elderly in an interdisciplinary and integral way to cover the needs and specificities of this population. The low perception of the importance of care suggests the need for strengthening speech therapy services for the health of the elderly Brazilian population. (AU)

Access to dental services and oral health-related quality of life in the context of primary health care

Abstract The aim of the present study was to evaluate the association between access to oral health care in the Primary Health Care (PHC) and Oral Health-Related Quality of Life (OHRQoL). The present study was a cross-sectional study, and the sample was composed of 412 users living in the areas covered by the public PHC services who visited a health unit for an oral exam or treatment in the last 24 months. Participants in the study responded to a home-based interview with questions that addressed socioeconomic status, behavioral, general health, dental prostheses, access to dental services in the PHC and their OHRQoL as measured by the Oral Health Impact Profile (OHIP-14) instrument. After the interview, a dental examination was performed to count the number of teeth. Chi-square tests, Student's t tests and multivariate analyses were performed using a hierarchical model and a Poisson regression with robust variance to evaluate the association between independent variables and OHRQoL. Access to oral health services in the PHC was statistically associated with OHRQoL, and the estimated prevalence rate was PR = 1.17 (CI 95% 1.00-1.37). In this study, the definition of access was based on the availability of dental consultations on demand. The study identified that lack of access to oral health services offered by the PHC was associated with a higher prevalence of impact on the quality of life of individuals.

Curative procedures of oral health and structural characteristics of primary dental care

ABSTRACT OBJECTIVE To evaluate if the provision of clinical dental care, by means of the main curative procedures recommended in Primary Health Care, is associated with team structural characteristics, considering the presence of a minimum set of equipment, instrument, and supplies in Brazil's primary health care services. METHODS A cross-sectional exploratory study based on data collected from 18,114 primary healthcare services with dental health teams in Brazil, in 2014. The outcome was created from the confirmation of five clinical procedures performed by the dentist, accounting for the presence of minimum equipment, instrument, and supplies to carry them out. Covariables were related to structural characteristics. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios, with 95% confidence intervals. RESULTS A total of 1,190 (6.5%) dental health teams did not present the minimum equipment to provide clinical dental care and only 2,498 (14.8%) had all the instrument and supplies needed and provided the five curative procedures assessed. There was a positive association between the outcome and the composition of dental health teams, higher workload, performing analysis of health condition, and monitoring of oral health indicators. Additionally, the dental health teams that planned and programmed oral health actions with the primary care team monthly provided the procedures more frequently. Dentists with better employment status, career plans, graduation in public health or those who underwent permanent education activities provided the procedures more frequently. CONCLUSIONS A relevant number of Primary Health Care services did not have the infrastructure to provide clinical dental care. However, better results were found in dental health teams with oral health technicians, with higher workload and that plan their activities, as well as in those that employed dentists with better working relationships, who had dentists with degrees in public health and who underwent permanent education activities.

Dentistry students' perceptions about an extramural experience with a Brazilian indigenous community.

OBJECTIVE: The aim of the present study was to evaluate dentistry students' perceptions about an extramural activity designed to deliver dental care to an indigenous community. MATERIALS AND METHODS: This was a qualitative investigation involving 4 students of dentistry who had just had the experience of delivering treatment to indigenous Brazilian people. These students answered questions about the relevance of the experience to their personal and professional lives. We performed Content Analysis to data treatment and it was analysed by Social Representation Theory. RESULTS: Two social representations were reached: a) Being capable to promote oral health; b) Facing human feeling and respect each other. CONCLUSION: We concluded that participation in an extramural project improves the students' understanding of primary health care in dentistry. Such experiences help students develop a sense of cultural respect, comprehensive care, and to understand patients in their totality as social beings with their own values, beliefs, and attitudes regarding oral health care.

Percepções de estudantes de Odontologia sobre a experiência em um estágio não obrigatório no SUS / Perceptions of Dental students regarding their experiences in a non-mandatory internship in the Brazilian Unified Health System (SUS)

O estudo teve por objetivo analisar as percepções de estudantes de Odontologia sobre a experiência em um estágio não obrigatório no sistema público de saúde brasileiro em um município de São Paulo e sua contribuição na formação profissional. Trata-se de um estudo descritivo, de natureza qualitativa com estudantes de uma universidade pública, no período de 2013-2015. Foram realizadas entrevistas semidirigidas que foram gravadas e transcritas. Os dados foram sistematizados e analisados por meio da técnica da Análise de Conteúdo na perspectiva temática com suporte teórico das Diretrizes Curriculares Nacionais para o Curso de Odontologia. Observou-se que os estudantes perceberam o estágio como uma oportunidade para vivenciar a realidade do trabalho nos serviços de saúde, desenvolveram e aperfeiçoaram habilidades e competências como comunicação, gerenciamento e organização de seu trabalho e construção de sua identidade profissional. Conclui-se que os estudantes se aproximaram dos conceitos de atenção à saúde, humanização, autonomia e aprendizagem no trabalho, experiência que se mostrou significativa (AU).

This study aimed to analyze the perceptions of Dental undergraduate students about the experience in a non-mandatory internship in the Brazilian Public Health System, in a municipality of São Paulo, Brazil, and its contribution to professional education. We performed a descriptive study in a qualitative approach with undergraduate students of a public university, from 2013 to 2015. Semi-structured interviews were conducted, audio-recorded and transcribed. The data were organized and analyzed using Content Analysis technique in the thematic perspective with the theoretical support of the National Curriculum Guidelines for Dentistry Course (Diretrizes Curriculares Nacionais). The undergraduate students perceived the internship as an opportunity to experience the work reality in health services, developed and improved skills and competencies like communication, management and organization of their work, and construction of their professional identity. In conclusion, the students came closer to the concepts of health care, humanization, autonomy and learning at work, experiences that emerged as significant for them (AU).

[Primary healthcare and the construction of meanings of oral health: a social constructionist interpretation of discourses of the elderly]. / Atenção primária à saúde e a construção de sentidos para a saúde bucal: leitura construcionista social sobre discursos de idosos.

Dentistry currently reveals itself to be open to new ideas about the construction of meanings for oral health. This openness leads to the social production of health revealing the contextualization of the social and historical aspects of the sundry knowledge in the development of oral health for different communities. With this research, we seek to build meanings for oral health with a group of elderly people. With this objective in mind, we propose an approximation between discourses on oral health mentioned by the elderly and the Social Constructionist discourse. We interviewed 14 elderly people enrolled in a Family Health Unit in Ribeirão Preto, State of São Paulo, in the first semester of 2010, and identified two interpretative repertoires through Discourse Analysis, which showed the relationship between 1 - Lack of information and dental assistance in childhood, and 2 - Primary Health Care building the meaning of oral health. We concluded that Social Constructionism works epistemologically for the construction of meanings for oral health and that primary health is essential for appreciation and health care that enables the construction of meanings in oral health by the elderly that create conditions for self-care and healthy attitudes.