Perceptions of the oral health of their patients reported by Brazilian medical residents in psychiatry.

Persons with severe mental disorders have higher chances of presenting oral health problems than persons in the general population. Mental disorders are considered public-health problems worldwide. Interpreting statements on oral health made by medical students receiving instruction in psychiatry is essential to provide elements for reflection on their difficulties, barriers or limited knowledge in managing their patients' oral health. Based on the presupposition that doctors provide their patients with no instruction or support concerning oral complaints, because these do not symbolize the same challenges as those emerging from severe mental disorders. The aim of this study was to interpret symbolic meanings of statements expressed by medical residents in psychiatry at a specialized university outpatient clinic, about their patients' oral health. Qualitative research using the Qualitative-Clinical method was conducted, adopting the theoretical reference of medical psychology. Data were analyzed by the Clinical-Qualitative Content method and the Seven-Step technique. Based on 06 interviews analyzed, the following categories emerged: "What do I do? Psychiatrists' dilemmas about not understanding their role in patients' oral health; and "Dentists do not participate in Balint' so-called "collusion in anonymity". It was concluded that among others, the paradigm consisted of a sociological composition, therefore it was stronger than personal decisions that might eventually oppose the barriers to interdisciplinary work posed by the institutional model, which were intertwined with paradigmatic barriers. Thus, specialist training should include a dental perspective, so that oral examinations would always be included in the physical examinations, from an interdisciplinary perspective of the integrity of health-care.

Factors associated with the need for a complete denture in one arch or both arches among the elderly population.

This study aimed to identify factors associated with the need for complete dentures in one dental arch or both, among the elderly population. The cross-sectional household study was conducted with a representative sample of elderly people (65 years or older) in the state of São Paulo, Brazil, in 2015. The dependent variable was the need for complete dentures (in one arch or both), and independent variables were socioeconomic and demographic conditions, social capital, self-perception of oral health and access to dental services. Simple and multinomial logistic regression models tested effect measures (p < 0.05). A total of 5,948 elderly people participated. Results indicated that those with greater chances of needing a complete denture in one arch were male (OR = 1.54; CI95%:1.04-2.29), with fewer household goods (OR = 2.25; CI95%:1.50-3.38), lower monthly household income: R$501-1500 (OR = 3.44; CI95%:1.27-9.35), R$1501-2500 (OR = 4.11; CI95%:1.50-11.27), R$2501-4500 (OR = 2.76; CI95%:1.10-6.95), self-reported need for a complete denture (OR = 4.75; CI95%:3.08-7.35), ≥3 years since last dental appointment (OR = 1.80; CI95%:1.06-3.05), and dissatisfaction with last dental appointment (OR = 1.80; CI95%:1.06-3.05). There were more chances of the need for complete dentures in both arches among older elders (OR = 1.44; CI95%:1.06-1.88), with lower monthly household income: R$ < 501 (OR = 4.45; CI95%:1.71-11.60), R$501-1500 (OR = 4.01; CI95%:2.14-7.51), R$1501-2500 (OR = 2.95; CI95%:1.64-5.32), < 3 years of education (OR = 1.45; CI95%:1.13-1.85), feeling unhappy (OR = 2.74; CI95%:1.35-5.57), self-reported need for a complete denture (OR = 8.48; CI95%:5.75-12.50), dissatisfaction with their mouth (OR = 2.38; CI95%:1.64-3.46), ≥3 years since last dental appointment (OR = 4.28; CI95%:2.85-6.43), and dissatisfaction with last dental appointment (OR = 4.28; CI95%:2.85-6.43). The several dimensions of the determinants of the need for a complete denture reflect the influence of both demographic and socioeconomic aspects, social capital, self-perception of oral health and access to dental services.

Tooth loss in adults: factors associated with the position and number of lost teeth.

OBJECTIVE: To evaluate the factors associated with tooth loss in adults from the position and number of teeth lost in the dental arches. METHODS: This is a cross-sectional, population-based study with adults participating in the epidemiological survey of oral health of São Paulo in 2015. The outcome of the study was tooth loss, assessed by the proposed classification, namely: I) lost up to 12 back teeth; II) lost up to 12 teeth (including front teeth); and III) lost more than 12 teeth. A four-block analysis was conducted, supported by a conceptual theoretical model adapted for tooth loss. For the multinomial logistic regression, "individuals who did not lose teeth due to caries or periodontal disease" was used as reference (p < 0.05). RESULTS: Of 6,051 adults evaluated, 25.3% (n = 1,530) were classified in category I, 32.7% (n = 1,977) in II, 9.4% (n = 568) in III, and 1.9% (n = 117) were edentulous. Lower income and schooling, the perception of need for treatment and the last appointment motivated by routine, pain or extraction were associated with tooth loss, regardless of the classification. The negative evaluation of the dental service was associated with individuals who lost up to 12 teeth, both front and back. The presence of women and periodontal pocket were associated with tooth loss of up to 12 teeth, including front, and more than 12 teeth. Caries were associated with adults who lost up to 12 teeth, including front teeth. CONCLUSION: The proposed classification allowed the identification of differences between the associated factors. Thus, the need to consider such classification in future studies is evident.

Assessment of quality of life and associated factors in nursing students / Avaliação da qualidade de vida e fatores associados em graduandos de Enfermagem

ABSTRACT Objective: To assess the quality of life of nursing undergraduate students and factors associated with socioeconomic variables and internship field. Methods: A cross-sectional study was conducted in an educational institution located in the northern region of the state of Ceará, Brazil, involving 309 nursing undergraduates from the 1st to the 10th semester. The WHOQOL-bref instrument was used to evaluate the quality of life. Each domain and total score of the instrument were considered as outcome variables. Results: 69.3% of the individuals were women, the mean age of the sample was 28 years, and 67.7% defined their quality of life as "good" or "very good." Undergraduates who consumed well water and those with lower income had a higher chance of presenting lower scores in the physical domain and environmental domain of quality of life, respectively (p < 0.05), and of having a lower total quality of life score. Conclusion: The students considered their quality of life to be good/very good, and sociodemographic factors influenced the lower quality of life score.

RESUMO Objetivo: Avaliar a qualidade de vida de graduandos de enfermagem e fatores associados a variáveis socioeconômicas e campo de estágio. Métodos: Estudo transversal realizado em uma instituição de ensino localizada na região norte do estado do Ceará, Brasil, envolvendo 309 graduandos de enfermagem do 1º ao 10º semestre. O instrumento WHOQOL-bref foi utilizado para avaliar a qualidade de vida. Cada domínio e escore total do instrumento foram considerados como variáveis de desfecho. Resultados: 69,3% dos indivíduos eram mulheres, a média de idade da amostra foi de 28 anos e 67,7% definiram sua qualidade de vida como "boa" ou "muito boa". Universitários que consumiam água de poço e aqueles com menor renda tiveram maior chance de apresentar menores escores no domínio físico e meio ambiente de qualidade de vida, respectivamente (p < 0,05), e de ter menor escore total de qualidade de vida. Conclusão: Os estudantes consideraram sua qualidade de vida boa/muito boa, e fatores sociodemográficos influenciaram o menor escore de qualidade de vida.

A medicalização na prática de dentistas no SUS: um olhar qualitativo para os sentidos da prática / Dentistry medicalization at SUS: a qualitative practice-based perspective

Resumo Este artigo explora sentidos e significados do trabalho odontológico no SUS, no contexto da relação profissional-paciente. Pesquisa qualitativa com 20 cirurgiões-dentistas que atuavam em um município paulista de médio porte, abordada por meio de três grupos focais, com a pergunta disparadora "Qual é o sentido ou significado do seu trabalho, aqui na prefeitura, para você?". O material foi áudio-gravado, transcrito na íntegra e analisado pelo método de análise de conteúdo temática. Procedemos a realização de leitura flutuante, categorização e discussão dos achados junto aos pares de pesquisadores para validação final. Como resultados, aponta-se a construção das categorias 1) Estranheza às necessidades percebidas pelos pacientes e a consequente medicalização da vida, e 2) Poder e consumo como significados da prática. O trabalho do cirurgião dentista, nesse contexto, evidenciou as diferenças entre as necessidades percebidas pelo paciente e aquelas que o dentista considera. Além disso, revelou o poder que emana da assimetria entre paciente e profissional como dificultador da produção de autonomia do paciente. Tais significações parecem trazer sofrimento para esses profissionais no seu trabalho. Concluiu-se que há necessidade de reflexão sobre o trabalho em saúde como forma de se evitar sofrimento, e que a prática desses dentistas é carregada de sentidos e significados.

Abstract This study explores the senses and meanings attributed to dental work in the Brazilian National Health System (SUS) focusing on dentist-patient relations. A qualitative research was conducted with 20 dentists working in a medium-sized municipality in São Paulo, divided into three focus groups and asked the guiding question "What sense or meaning do you attribute to your work here in the city?" Data were audio-recorded, fully transcribed, and analyzed using thematic content analysis. Floating reading, categorization, and peer discussion of the findings were performed for the final validation, resulting in two categories: 1) Strangeness to patients' needs and the subsequent medicalization of life, and 2) Power and consumption as meanings of practice. In this context, the dental practices showed the differences between patients' needs and those considered relevant by dentists. It also showed the power imbalance between patients and professionals as a hindrance to patients' autonomy. Such meanings seem to cause suffering to these professionals. In conclusion, reflections on health work are paramount to avoid suffering and understand that the practice of these dentists bears many senses and meanings.

Representações cotidianas da prática para o cirurgião-dentista na atenção primária: uma revisão de escopo da literatura / Day-to-day representations about practice by dentists in primary care: a scope review of the literature

Embora se saiba muito sobre os dados mensuráveis da Saúde Bucal na Atenção Primária à Saúde (APS), pouco se sabe sobre os aspectos individuais e subjetivos do profissional da odontologia. No desempenho de suas funções, o cirurgião-dentista entra em contatocom ambientes, tecnologias e pessoas em sua total complexidade, desencadeando, como resposta, uma série de emoções do organismo, as quais se expressam de forma consciente através dos sentimentos.Diante desse cenário, o presente trabalho partiu do pressuposto de que os dentistas têm muito a dizer sobre as representações cotidianas que possuem sobre seu trabalho. O objetivo deste estudo foi identificar -a partir do que se tem produzido na literatura -os sentimentos expressos pelos dentistas na sua práticana APS. Optou-se por conduzir uma revisão de escopo por ser um campo pouco pesquisado. O presente estudo foi elaborado obedecendo os vinte itens essenciais e os dois itens opcionais da Extensão Prisma para revisões de escopo apresentado por Tricco et al.em 2018. As buscas foram realizadas no período de agosto a outubro de 2020, utilizando-se para a construção da pergunta da pesquisa do mnemônico que representa População, Conceito e Contexto, definido assim: P = cirurgiões-dentistas, C = sentimento e C = atenção básica. Por meiodeste estudo percebe-secomo a prática odontológica está sujeita a emoções e sentimentos muitas vezes antagônicos e, assim, necessários de elaboração (AU).

Although much is known about measurable data on Oral Health in Primary Health Care (PHC), little is known about the individual and subjective aspects of the dental professional. In the performance of their functions, dentists keep in touch with some environmental and technological aspects, and with people in their total complexity. In response, these conditions trigger a series of emotions in the [dentist's] body, which are consciously expressed through their feelings. Given this scenario, the present studyarose from the assumption that dentists have a great deal to say about the everyday representations they have about their job. The objective of this study was to identify the feelings expressed by dentists in their practice in PHC, based on the data that has been produced in the. The scope of the review was chosen due to the limited number of researches in this field. The present study was conducted taking into consideration the twenty essential items and the two optional items of the Prisma Extension for scope reviews presented by Tricco et al. in 2018. The search was conducted in the period from August to October 2020, by using the construction of the mnemonic research question that represented Population, Concept and Context, which was defined as follows: P = Dentists, C = feeling and C = primary care. Based on this study, we were able to perceive the extent to which dental practice was subject to emotions and feelings that were frequently antagonistic and, therefore, it was necessary to examine them in greater depth (AU).

Fatores associados à ansiedade dos pacientes durante o tratamento endodôntico / Factors associated with the anxiety of patients during endodontic treatmen

Introdução: A ansiedade do paciente é uma barreira para o início e término do tratamento odontológico, principalmente na especialidade de Endodontia. Objetivo: Investigar a presença de ansiedade entre pacientes em tratamento endodôntico e seus fatores associados. Materiais e Métodos: Esse é um estudo transversal, analítico, realizado no município de Piracicaba, São Paulo, Brasil. Foram entrevistados 41 pacientes, e 41 Cirurgiões-Dentistas (CD) estudantes de pós-graduação em Endodontia de uma instituição de ensino. A variável dependente foi à ansiedade mensurada pelo inventário de Ansiedade de Beck. As variáveis independentes foram às condições socioeconômicas, motivo do tratamento, experiências negativas, número de atendimentos e percepção do CD para identificar a ansiedade do paciente. Foi realizada a análise bivariada pelo teste qui-quadrado, no nível de significância de 5%. Resultados: A maioria dos pacientes apresentou ansiedade leve/mínima. Os que demonstraram ansiedade moderada/grave tinham como características pais com menor escolaridade, sem residência própria, com pais e mães acima de 70 anos de idade, com experiência negativa com o CD e já haviam realizado a consulta de retorno. Dos CD entrevistados, 16,7% relataram perceber ansiedade moderada/grave nos pacientes que retornaram às consultas. Na análise, foi observado que não houve associação significativa da ansiedade com as variáveis investigadas (p>0,05). Conclusão: Os pacientes de endodontia apresentaram ansiedade leve/mínima, esse estado emocional precisa ser mais bem compreendido, a fim de garantir um tratamento atraumático e com menores riscos de abandono.

Introduction: Patient anxiety is a barrier to the beginning and end of dental treatment, especially in the specialty of Endodontics. Objective: To investigate the presence of anxiety among endodontic patients and their associated factors. Materials and methods: This is a cross-sectional, analytical study carried out in the city of Piracicaba, São Paulo, Brazil. We interviewed 41 patients, and 41 Dental Surgeons (DS) graduate students in Endodontics of a teaching institution. The dependent variable was the anxiety measured by the Beck Anxiety Inventory. The independent variables were socioeconomic conditions, reason for treatment, negative experiences, number of visits and perception of the DS to identify the patient's anxiety. The bivariate analysis was performed using the chi-square test, at the significance level of 5%. Results: Most patients had mild / minimal anxiety. Those who showed moderate/severe anxiety had the characteristics of lower educational level, with no residence of their own, with fathers and mothers over 70 years of age, with negative experience with the DS and had already made the return visit. Of the DS respondents, only 16.7% reported perceiving moderate / severe anxiety in the patients who returned to the consultations. In the analysis, it was observed that there was no significant association of anxiety with the variables investigated (p> 0.05). Conclusion: Endodontic patients presented mild anxiety, this emotional state needs to be better understood in order to guarantee an atraumatic treatment and with lower risks of abandonment.