Indicators for dental appointment scheduling in primary health care: a national cross-sectional study.

BACKGROUND: Integrated dental services within the Health System, particularly at primary health care, are crucial to reverse the current impact of oral diseases, which are among the most prevalent diseases worldwide. However, the use of dental services is determined by complex phenomena related to the individual, the environment and practices in which care is offered. Therefore, factors associated with dental appointments scheduling can affect positively or negatively the use of dental services. The aim of the present study was to evaluate the indicators for dental appointment scheduling in Primary Health Care (PHC). METHODS: The present is a cross-sectional analytical study that used data from the external assessment of the third cycle of the National Program for Improving Access and Quality in Primary Care (PMAQ-AB), carried out between 2017 and 2018, in Brazil. The final sample consisted of 85,231 patients and 22,475 Oral Health teams (OHTs). The outcome variable was the fact that the user sought for a dental appointment at the Primary Health Care Unit. A multilevel analysis was carried out to verify the association between individual variables (related to users) and contextual variables (related to the OHTs) in relation to the outcome. RESULTS: Only 58.1% of the users interviewed at these Primary Health Care Units seek the available dental care. The variables with the greatest effect on the outcome were the patient's age up to 42 years old (OR = 2.03, 95% CI: 1.96-2.10), at individual level, and 'oral health teams that assisted no more than a single family health team (FHT)' (OR = 1.29, 95% CI: 1.23-1.36) at contextual level. Other variables were also associated with the outcome, but with a smaller effect size. CONCLUSION: In conclusion, users' age and work process of OHT were indicators for dental appointment scheduling. Our results suggest that when OHT put the National Oral Health Policy guidelines into practice, by assisting only one FHT, the chance for PHC users seeking dental appointments is higher than OHTs that assist more than one FHT. Regarding age, patients aged up to 42 years are more likely to seek an appointment with a dentist.

Quality of life and socio-dental impact among underprivileged Brazilian adolescents.

PURPOSE: To evaluate the influence of clinical variables, individual and contextual characteristics on the quality of life (QL) of underprivileged adolescents in a municipality in the interior of the State of São Paulo, Brazil. METHODS: An analytical cross-sectional study was conducted in Piracicaba, in 2012, with 1,172 adolescents aged 15-19 years, from 21 state schools and 34 Family Health Units. The dependent variables included the socio-dental impact (OIDP) and quality of life (WHOQOL-bref) indices. The dependent variables were classified as individual (DMFT index, CPI Index, age, sex, income, parents' educational level) and contextual (Social Exclusion Index) variable. The multilevel regression model was estimated by the PROC GLIMMIX ("Generalized Linear Models-Mixed") procedure, considering the individuals' variables as being Level 1 and the contextual variables as being Level 2, and the statistical significance was evaluated at level of significance of 5 %. RESULTS: Girls were found to have the worst QL (p < 0.000) and greatest OIDP (p = 0.000). There was an increase in OIDP (p < 0.001) and diminished QL (p < 0.052) with an increase in the periodontal index. This result is marginally significant since the significance probability is marginally greater than 0.05. In turn, there was an increase in QL (p = 0.000) and reduction in OIDP (p < 0.000) with an increase in the family income. Adolescents who resided in areas of greatest social exclusion (p = 0.031) and with greater OIDP (p < 0.000) presented the worst QL. CONCLUSION: Individual and contextual variables were related to the OIDP and QL in underprivileged Brazilian adolescents.

Individual and contextual factors related to dental caries in underprivileged Brazilian adolescents.

BACKGROUND: Investigate the individual and contextual variables related to caries in underprivileged adolescents, and the disparity in distribution of the disease. METHODS: Cross-sectional analytical study, conducted in the city of Piracicaba, SP, Brazil, in 2012. The probabilistic sample was composed of 1,179 adolescents from 15-19 years of age, randomly selected from 21 state schools and 34 Primary Health Units--Family Health (PHU-FH). The dependent variables studied were number of decayed teeth and caries experience (DMFT). The independent variables were classified into individual (clinical, sociodemographic, psychosocial, self-perception, impact on oral health, access to services, and quality of life) and contextual (social exclusion index, total number of residents in suburb, literacy rate, and the following variables given in percentages: residences in the home ownership category, provision of domestic sewerage, trash collection, families with income of over 1 minimum wage per month, and families without monthly income) variables. The multilevel regression model was estimated by the PROC GLIMMIX (Generalized Linear Models-Mixed) procedure, considering the individual variables as Level 1 and the contextual variables of the suburbs as Level 2. Adjustment of the model was evaluated by -2 Res Log Likelihood with α = 0.05. RESULTS: As regards the individual variables, adolescents who declared having a prison inmate in the Family and resided in homes with a larger number of persons, showed a higher number of decayed teeth. There were a larger number of decayed teeth, a higher DMFT value, and worse self-perception as regards the health of their teeth and mouth. Other variables, such as being of the female gender, age and time since last visit to the dentist were related to the DMFT index. As regards the contextual variables, the DMFT was lower in suburbs with greater access to domestic sewage, and the number of decayed teeth was higher in suburbs with the worst social exclusion indices. CONCLUSION: Individual and contextual variables were associated with the presence of caries and DMFT index in underprivileged adolescents, indicating that they must be taken into consideration in the formulation of policies directed towards oral health promotion and prevention activities in this group.

A cohort study of caries incidence and baseline socioeconomic, clinical and demographic variables: a Kaplan-Meier survival analysis.

PURPOSE: To determine the incidence of dental caries and evaluate the influence of socioeconomic, clinical and demographic variables on the time for disease to appear in the permanent teeth after 3 years of follow-up. MATERIALS AND METHODS: The random sample of this cohort study consisted of 427 5-year-old preschool children attending 22 public preschools in Piracicaba, SP, Brazil. Dental caries was measured using the dmf/DMF indices. The Kaplan- Meier survival analysis method was used to study the isolated effect of socioeconomic, clinical and demographic variables on caries incidence after 3 years. A Cox proportional hazards regression model was built to test the influence of the variables collected at baseline on time to develop DMFT increment. RESULTS: Survival analysis showed that children without past caries experience in primary teeth at baseline remained caries free in permanent teeth for a longer period than children with past caries experience at baseline. The variables monthly family income, parents' educational level, number of people living in the household, home ownership and car ownership were not significant. CONCLUSION: Children who presented past caries experience in primary teeth at baseline are at greater risk of developing DMFT increment than children who have no past caries experience at baseline.

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.

Determinants of adherence to dental treatment of socially vulnerable adolescents: a cohort study.

OBJECTIVE: Different studies with adolescents address the difficulty they have to adhere to oral dental treatments. Therefore, better understanding the processes involved in adherence to treatment in this population is necessary. The aim of this study was to investigate the factors that influence adherence to dental treatment in socially underprivileged adolescents in primary care. RESULTS: Non-adherence to treatment showed high rate in the studied sample (49.5%). Family income (p = 0.039) and number of individuals in the family (p = 0.003) were associated with non-adherence to dental treatment. It is concluded that the adolescents' social vulnerability condition resulted in situations that are incompatible with adherence, which hinders dental treatment and health service planning.

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.

Malocclusion and dental appearance in underprivileged Brazilian adolescents.

Satisfaction with dental aesthetics is a subjective indicator used in epidemiological studies and is related to health behaviours. Little is known about the factors that influence this indicator, particularly among adolescents who live in a situation of social vulnerability. The aim of this study was to investigate the relationship between malocclusion and dental appearance in underprivileged Brazilian adolescents. This analytical cross-sectional study was conducted in Piracicaba, Brazil, and evaluated 884 adolescents from 13 to 19 years of age. The dependent variable was satisfaction with dental appearance, and the independent variables were classified as individual (components of the Dental Aesthetic Index - DAI, sex and age) and contextual (social exclusion index). For statistical analysis, multilevel regression models were estimated. The individual variables were considered Level 1, and the contextual variable was considered Level 2, with a level of significance of 5%. The mean age of the adolescents was 15.3 years. Female adolescents more frequently affirmed that they were satisfied with their dental appearance than did male individuals. There was an increase in dissatisfaction with oral health with the increase in anterior maxillary overjet, midline diastema, larger anterior irregularity in the maxilla, larger anterior irregularity in the mandible, anterior open bite and antero-posterior molar relation. Satisfaction with dental appearance was associated with individual factors such as sex and DAI components.

Social capital and factors associated with the caries experience in adults - a population-based study in Brazil.

The objective of this study was to investigate the experience of caries related to social capital and associated factors in adults in large-scale population-based study. A Cross-sectional study was performed in 163 municipalities in the State of São Paulo, Brazil (SBSP-2015). 17,560 people were evaluated, of which 6051 were adults aged 35-44 years. Hierarchical logistic regression analysis was proposed. Outcome variables (decayed teeth, missing teeth and DMFT) and independent variables were included in the model, considering the distal (income and schooling); intermediate (social capital) and proximal levels (sex and ethnicity). Results showed that income up to 1,500 reais - US$ 367.6 in 11/11/2019 - (OR = 1.91;1.75-2.08), schooling up to 8 years (OR = 1.32;1.12-1.56) and non-white ethnicity (OR = 1.54;1.35-1.76) were more likely to have decayed teeth. Income up to 1500 reais (OR = 1.29;1.15-1.44), schooling up to 8 years (OR = 2.13;1.90-2.38), low social capital (OR = 1.84;1.65-2.04), medium social capital (OR = 1.15;1.01-1.30) and females were more likely to have lost teeth (OR = 1.13;1.03-1.23). Schooling up to 8 years (OR = 1.51;1.35-1.69), low social capital (OR = 1.25; 1.14-1.37) and female (OR = 1.40,1.19-1.53) were associated with DMFT. It was concluded that sociodemographic factors and low social capital were associated with the experience of caries, which should be taken into account in the formulation of public policies.

Consequences of the pandemic on dental practices: a literature review / Consequências da pandemia nas práticas odontológicas: revisão de literatura

ABSTRACT SARS-CoV-2 is caused by an RNA virus responsible for the disease known as COVID-19. First diagnosed in 2019, in a human being in the city of Wuhan, China, this disease is classified as a severe respiratory disease. Propagation occurs through coughing, sneezing, inhalation of droplets, or even indirect contact with the nasal, oral, and ocular mucous membranes. Preventive measures involving social distancing, quarantine, and mask use were implemented to prevent its spread. Such measures challenge dental practices, since they depend on proximity and do not allow the use of personal protective equipment, which cover the patient's oral cavity. This integrative literature review sought to identify articles discussing preventive measures of adequate use in current dental practices, reducing the risk of COVID-19 contamination and spread. Results showed the importance of dentists acting on the disease transmission routes, following care protocols, implementing new dental clinic management practices, such as avoiding crowds, longer time between appointments, use of teledentistry, and adopting preventive measures inside the dental office like hand washing, use of N95 mask, face shield, and air filters. However, oral health professionals must be prepared to face any imminent challenge imposed by infectious diseases in dental practice, following protocol before, during, and after dental care.

RESUMO O SARS-CoV-2 é causado por um vírus RNA responsável pela doença conhecida como COVID-19. Essa doença foi diagnosticada pela primeira vez em 2019, em um humano na cidade de Wuhan, na China, sendo classificada como uma doença respiratória grave. A propagação da mesma se dá através da tosse, espirros, inalação de gotículas ou, então, contato indireto com as mucosas nasal, oral e ocular. Para evitar o avanço da doença, medidas preventivas foram implantadas, envolvendo o distanciamento social, quarentena e a utilização de máscaras. Tais medidas desafiam as práticas odontológicas, uma vez que os cirurgiões-dentistas dependem da proximidade; além do que a prática odontológica não permite o uso de equipamentos de proteção individuais que cubram a cavidade oral do paciente, obviamente. Este trabalho teve como objetivo reunir, através de uma revisão integrativa de literatura, artigos com medidas preventivas que possam ser utilizadas nas práticas odontológicas atuais, diminuindo o risco de contaminação e disseminação da COVID-19. Pôde-se observar a importância do cirurgião-dentista em atuar nas rotas de transmissão da doença, seguindo protocolos de atendimento, fazendo novo gerenciamento da clínica odontológica como por exemplo; evitando aglomerações, maior tempo entre uma consulta e outra, uso da teleodontologia e também medidas preventivas dentro do consultório, como: lavagem das mãos, uso de máscara N95, protetor facial e filtros de ar. Com tudo, os profissionais da saúde bucal devem estar preparados para enfrentar qualquer desafio iminente, imposto pelas doenças infecciosas na prática odontológica, seguindo protocolo, antes, durante e depois dos atendimentos odontológicos.

Factors influencing the impact of oral health on the daily activities of adolescents, adults and older adults.

OBJECTIVE: Analyze if clinical, sociodemographic and access to dental services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults. METHODS: A cross-sectional study with secondary data from the State Oral Health Survey (SB São Paulo 2015) conducted in 163 cities of São Paulo. A total of 17,560 individuals from three age groups: 15-19-year-old (n = 5,558), 35-44-year-old (n = 6,051), and older people of 65 years or more (n = 5,951) participated in the survey. The selection was made by probabilistic sample by conglomerates in two stages. The endpoint variable was the impact of oral health on daily activities, evaluated by the Oral Impacts on Daily Performances questionnaire, containing questions about eating, talking, oral hygiene, relaxation, sports practice, smile, study or work, social contact, and sleep. Oral Impacts on Daily Performances was dichotomized with and without impact. The independent variables were sociodemographic, clinical and access variables, divided into three blocks. A hierarchical multiple logistic regression analysis was performed considering the complex sampling plan of clusters. Each observation received a specific weight, depending on the location that resulted in weighted frequencies and adjusted for the design effect. RESULTS: The presence of oral health impact was observed in 27.9% of the individuals. In block 1, female gender and black/brown ethnic group had a greater chance of impact of oral health on quality of life, as well as the adults and the older adults in relation to adolescents. In block 2, family income up to R$1,500 was associated with the presence of impact. In block 3, individuals who reported toothache, used the public service and sought dental treatment had a greater chance of impact. CONCLUSIONS: Sociodemographic, clinical and access to health services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults.

Variables associated with the oral impact on daily performance of adults in the state of São Paulo: A population-based study.

OBJECTIVE: This study aimed to assess the oral impact on daily performance and its association with sociodemographic characteristics, tooth pain, need for prosthesis, and periodontal disease of adults in the state of São Paulo, Brazil. METHODS: This was a cross-sectional epidemiological study with secondary data obtained from the Oral Health Conditions Project- 2015 conducted in 163 municipalities in the state of São Paulo with the participation of 17,560 individuals. This study evaluated adults in the age-range between 35-44 years (n = 5,855), selected by means of probabilistic cluster sampling in two stages. The outcome variable was the OIDP (Oral Impacts on Daily Performances), obtained by using this instrument to assess daily activities (eating, speaking, oral hygiene, relaxation, sports practice, smile, study/work, social contact, and sleep). The independent variables were collected and grouped into three blocks: Block 1 (sex, age group, and ethnic group); Block 2 (household income and education); and Block 3 (tooth pain, need for prosthesis, bleeding, calculus, and periodontal pockets). A hierarchical multiple logistic regression analysis was performed considering the complex cluster sampling plan. Each observation was assigned a specific weight, depending on the location, which resulted in weighted frequencies adjusted for the effect of outlining. RESULTS: the female sex (p<0.0001), ethnic group black/mulatto (p<0.0001), low household income (p = 0.0112), up to 8 years of education (p<0.0001), tooth pain (p<0.0001), presence of bleeding (p<0.0001), and presence of periodontal pockets (p<0.0001) had greater oral impact on daily performance. CONCLUSION: sociodemographic characteristics, tooth pain, and presence of periodontal disease were associated with oral impact on daily performance of the adult population in the state of São Paulo, Brazil.

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).

Quality of life and adherence to dental treatment in adolescents: a longitudinal analytical study

The study aimed to analyze the quality of life, oral health impact on daily activities and its association with adherence to dental treatment, and other factors, among vulnerable adolescents. It is a longitudinal analytical study performed with 15- to 19-year-old adolescents in the city of Piracicaba, São Paulo, from 2014 to 2015. The sample consisted of 476 adolescents referred for the treatment of caries and/or periodontal disease in family health units (initial phase). After 18 months, 325 individuals were assessed to investigate the dental treatment provided (final phase). The response variables considered in the final phase were the Quality of Life (WHOQOL-bref) and the Oral Impacts on Daily Performances (OIDP) questionnaires. The independent variables analyzed were sex, age, treatment adherence, and family cohesion and adaptability. A multiple regression model was used. The data on the physical (p<0.0001), social (p=0.0003), environmental (p<0.0001), and psychological (p<0.0001) domains of the WHOQOL collected in the initial phase had a positive relationship with the same domains assessed in the final phase. The WHOQOL data of the initial phase were associated with the WHOQOL data of the final phase (p=0.0341). The OIDP data of the initial phase were associated with the OIDP data of the final phase (p<0.0001). The OIDP of volunteers who did not adhere to dental treatment showed a higher impact (p=0.0234). The quality of life and impacts on daily performances of adolescents improved between the evaluation periods.

Caries experience in children under 5 years old in the Xingu indigenous park in Brazil

Aim: The present study sought to investigate dental caries experience and its association with sociodemographic, postnatal and breastfeeding variables in children in the agerange from 6 to 71 months of age, in the Xingu Indigenous Park, Mato Grosso, Brazil. Methods: This was an analytical cross-sectional study that used secondary data pertaining to 402 indigenous children of the Low, Middle and Eastern Xingu regions, who participated in the Oral Health Epidemiological Survey in 2013. The dependent variable was dental caries, dichotomized by the median (dmf-t≤1 and dmf-t>1). The data of independent variables were obtained by means of instruments of the Local Health Information System of the Xingu Indigenous Special Sanitary District (DSEI). Raw analyses were performed to test the association of the independent variables with the dependent variable. The variables were tested in the multiple logistic regression model. Results: The mean value of the dmf-t index was 2.60 and the prevalence of affected children was 51%. In the multiple analysis, only children older than 36 months (OR: 6.64; CI95%: 4.11 to 10.73) and those that were breastfed for a longer period of time (OR: 1.88; CI95%: 1.16 to 3.02) showed significant association with the dmf-t>1 index. Conclusion: Childhood dental caries among indigenous children was associated with age and breastfeeding prolonged for over 26 months, therefore, pointing out the need to offer dental follow-up care at earlier ages

[Strategies for tackling absenteeism in dental appointments in the Family Health Units of a large municipality: action research]. / Estratégias para o enfrentamento do absenteísmo em consultas odontológicas nas Unidades de Saúde da Família de um município de grande porte: uma pesquisa-ação.

The aim of this study was to analyze the reasons for missed appointments in dental Family Health Units (FHU) and implement strategies to reduce same through action research. This is a study conducted in 12 FHUs in Piracicaba in the State of São Paulo from January, 1 to December, 31 2010. The sample was composed of 385 users of these health units who were interviewed over the phone and asked about the reasons for missing dental appointments, as well as 12 dentists and 12 nurses. Two workshops were staged with professionals: the first to assess the data collected in interviews and develop strategy, and the second for evaluation after 4 months. The primary cause for missed appointments was the opening hours of the units coinciding with the work schedule of the users. Among the strategies suggested were lectures on oral health, ongoing education in team meetings, training of Community Health Agents, participation in therapeutic groups and partnerships between Oral Health Teams and the social infrastructure of the community. The adoption of the single medical record was the strategy proposed by professionals. The strategies implemented led to a 66.6% reduction in missed appointments by the units and the motivating nature of the workshops elicited critical reflection to redirect health practices.

Qualitative study on adolescents' reasons to non-adherence to dental treatment.

The study aimed to reflect on adolescents' speeches regarding their justifications for non-adherence to dental treatment. This is a qualitative research derived from a quantitative research aimed at adolescents from 15 to 19 years of public schools belonging to the area of 34 Primary Health Units - Family Health, in Piracicaba, SP, in 2012. The adolescents were evaluated, diagnosed and referred for dental treatment. One year after this intervention and with non-adherence to treatment, we used a qualitative method to deeply understand this phenomenon. We conducted 25 interviews with a semi-structured script, divided into three blocks: adopted or did not adopt actions recommended; arguments justifying the non-adherence of recommended actions; dimensions related to oral health importance. We adopted the thematic analysis and non-adherence was related to some aspects and grouped in: no priority; priority and change of priority. We concluded that the main reasons for non-adherence are related to different priorities, and orthodontic brace was a potent stimulator of interest and establishment of priorities in oral health care among adolescents.

[Referencing and counter-referencing in specialized dental health procedures in Campinas in the state of São Paulo, Brazil]. / Referência e Contrarreferência na atenção Secundária em odontologia em Campinas, SP, Brasil.

This article aims to evaluate the referencing of the demand for specialized care in oral health in Campinas in relation to the distribution of treatment and the influence of socio-economic variables in addition to the perception and information available to users in relation to counter-referencing. It is an observational exploratory study, selecting two Health Administrative Regions: one with a Center for Dental Specialties and one without, divided into two phases: 1) all referrals to secondary care were collected from all Oral Health teams as well as population and socio-economic data and distribution of referrals; 2) interview with 331 users, checking the counter-referencing, quality of service and reasons for absences or withdrawals. Regarding the counter-referencing, the majority of users who received the specialized treatments were well attended, and waited less than one month for appointment scheduling. The management model did not statistically influence access to secondary care in oral health. It was found that in a given Health Administrative Region the discrepancies were less evident and there was a correlation coefficient of demand attended with socio-economic variables, in addition to a lower percentage of non-attendance, demonstrating a greater commitment to integrity and fairness.