Association between shortened dental configurations and health outcomes: a scoping review.

This study mapped definitions of shortened dental configurations and health outcomes employed in association studies. A scoping review was conducted using the PubMed/Medline, Scopus, Web of Science, SciELO and Cochrane databases. Two trained researchers selected studies and extracted data. Studies that investigated the association between shortened dental configurations (exposure) and person-centered outcomes (general and oral health) related to health behavior (dietary patterns). Clinical outcomes were classified according to the International Classification of Functioning, Disability and Health and the International Classification of Diseases of the World Health Organization (WHO). Shortened dental configurations were defined as at least 20/21 teeth or the position of the teeth, including esthetics, dental occlusion and periodontal status (Eichner Index, Shortened Dental Arches, Functional Dentition Classification System, Posterior Occluding Pairs, Functional Tooth Units). The initial search resulted in 12,525 records in English, Portuguese and Spanish, 432 of which addressed the association of interest. General health (n = 203) and oral health (n = 201) were addressed in a similar number of studies. Most outcomes were related to general health (n = 184), the most frequent of which were endocrine, nutritional or metabolic diseases (n = 57) and mental functions (n = 26). Person-centered measures were addressed in 153 studies, most of which were about oral health and oral health-related quality of life (n = 62). Oral health outcomes were predominantly related to intake functions (n = 44) and diseases or disorders of the orofacial complex (n = 24). Dietary patterns (n = 43) and mortality (n = 38) were also studied. The cross-sectional design (n = 257) and non-probabilistic sampling (n = 218) were more frequent. The shortened dental configurations defined by the WHO were the most frequent in the studies (n = 206). The effects of shortened dental configurations have been investigated mainly in relation to endocrine, nutritional or metabolic diseases and measures of oral health-related quality of life. The findings point to a diversity of health outcomes assessed and substantial methodological variability.

Education and income-based inequality in tooth loss among Brazilian adults: does the place you live make a difference?

BACKGROUND: Socioeconomic inequalities in tooth loss might be minimized or potentialized by the characteristics of the context where people live. We examined whether there is contextual variation in socioeconomic inequalities in tooth loss across Brazilian municipalities. METHODS: Data from the 2010 National Oral Health Survey of 9633 adults living in 157 Brazilian municipalities were used. The individual socioeconomic indicators were education and household income. At the municipal level, we used the Municipal Human Development Index (HDI) as our contextual indicator of socioeconomic status (low:< 0.699 versus high: > 0.70). The Relative (RII) and Slope (SII) Indexes of Inequality, Relative (RCI), and Absolute (ACI) Concentration Indexes were calculated to compare the magnitude of education and income-based inequalities among municipalities with low versus high HDI. Multilevel Poisson regression models with random intercepts and slopes were developed. RESULTS: At the individual level, adults with lower education & income reported more tooth loss. The mean number of missing teeth was 9.52 (95% CI: 7.93-11.13) and 6.95 (95% CI: 6.43-7.49) in municipalities with low and high HDI, respectively. Municipalities with high HDI showed higher relative and absolute education-based inequality. For income-based inequalities, higher SII and RCI was observed in municipalities with lower HDI. A significant cross-level interaction indicated that high-education adults reported fewer missing teeth when they lived in municipalities with high HDI compared to adults with the same education level living in low HDI municipalities. For individuals with the lowest education level, there was no difference in the number of teeth between those from municipalities with high and low HDI. CONCLUSIONS: There was a social gradient in tooth loss by education and income. Living in disadvantaged municipalities cannot overcome the risk associated with low schooling. The protective effect of higher education can be reduced when people live in disadvantaged areas.

COVID-19 Morbidity Among Oral Health Professionals in Brazil.

BACKGROUND: We evaluated and compared the cumulative incidence of confirmed COVID-19 cases between oral health professionals and the general population in Brazil. METHODS: Secondary data from notification of laboratory unconfirmed and confirmed cases of COVID-19 in the National data system for 41 epidemiological weeks were analysed and compared between oral health professionals (dentist + oral health technicians/assistants) and the general population. The cumulative incidences of COVID-19 were obtained by the ratio of the total number of confirmed cases to the total Brazilian population or the population of oral health professionals registered with the Federal Council of Dentistry and adjusted by age. The incidences were then compared. RESULTS: The age-standardised cumulative incidences were 18.70/1000 for oral health professionals and 17.71/1000 for the population, with a ratio of 1.05. The highest incidences were observed in the states of Roraima (67.05/1000), Tocantins (58.81/1000), and Amazonas (58.24/1000). In 14 states, the age-standardised cumulative incidences were higher among oral health professionals than in the general population. There was a decrease in the number of new cases between the 29th and 30th epidemiological weeks in both populations. CONCLUSIONS: COVID-19 infections among oral health professionals was similar to that of the general population. However, the cumulative incidence was 5% higher among oral health professionals, varying among Brazilian states. PRACTICAL IMPLICATIONS: Infection control practices might help lower the risk of contamination in dental settings.

Oral health assessment of older adults living in long-term care facilities by non-dental professionals: a systematic review protocol of instruments.

INTRODUCTION: Regular oral health assessment among older adults living in long-term care facilities (LTCF) can improve their oral health. Different instruments have been developed and used to evaluate the oral health of institutionalised older people by non-dental professionals. These instruments must demonstrate adequate measurement properties. This systematic review aims to examine the studies describing the instruments employed to assess the oral health of older adults living in LTCF by non-dental professionals. The study will also evaluate the measurement properties of such instruments using the checklist proposed by the Consensus-based Standards to select health Measurement Instruments (COSMIN). METHODS AND ANALYSIS: Studies describing the development of instruments for assessing oral health of institutionalised older adults by non-dental professionals will be included. Studies assessing at least one measurement property (validity, reliability or responsiveness) will be also considered. Electronic searches will be conducted on MEDLINE (PubMed, Ovid), Embase, Web of Science, Scopus and LILACS databases. Two independent reviewers will select the studies and will extract data concerning the characteristics of the research and the instrument. The measurement properties will be evaluated using the COSMIN checklist. The Grading of Recommendations, Assessment, Development and Evaluation approach will be used to grade the quality (or certainty) of evidence and strength of recommendations. ETHICS AND DISSEMINATION: No ethical approval is required. The results will be submitted for publication to a peer-review journal and presented at relevant conferences. PROSPERO REGISTRATION NUMBER: CRD42020191479.

Oral health work process: disparity between teams in Brazil, 2014. / Processo de trabalho em saúde bucal: disparidade entre as equipes no Brasil, 2014.

OBJECTIVE: To compare Modality I and Modality II Oral Health Teams (OHT) regarding work process performance and differences between Brazilian regions. METHODS: This was a cross-sectional study with OHTs that took part in the National Program for Primary Health Care Access and Quality Improvement (2013-2014). Latent Class Analysis identified OHT subgroups according to work process (action planning, health promotion actions and comprehensive health care) performance (consolidated, developing or incipient). OHT modalities were compared, resulting in an Index of Disparity. RESULTS: After evaluating 15,886 OHTs, Modality II OHTs were found to have a higher percentage of consolidated work processes in the Southeast (67.8%-94.6%) and Southern (54.8%-93.0%) regions. Disparity in the consolidated work process was greater among Modality II OHTs (6.3-26.5) compared to Modality I OHTs (3.9-18.4). CONCLUSION: Modality II OHTs have the potential for better performance regarding the work process, but with regional disparities.

The science of collective health in writing: contribution to studies in collective oral health. / A ciência da saúde coletiva por escrito: contribuição para estudos em saúde bucal coletiva.

Celebrating the 25 years of existence of the Journal Ciência & Saúde Coletiva (C&SC), this paper analyzed 375 documents published between 2000-2019 as an integral part of the editorial of collective oral health. The production analysis aimed to understand how oral health core appears in publications and how it could have contributed to knowledge on the population's health-disease, specific public policies, education, and management of oral health services in the SUS. The process employed bibliometric and documental analysis. We could show the authors' territorial distribution, their extensive collaboration network, and the dimension of citations in publications, including the international plan. The Brazilian states most present in the publications were São Paulo and Minas Gerais, followed by authors from Pernambuco, Rio Grande do Sul, and Santa Catarina. Citations were more frequent in Brazil (85.14%), followed by the United States (2.31%), Portugal (1.34%), and Australia (1.34%). We concluded that, despite the limitations, the C&SC showed unequivocally a powerful instrument for the dissemination of scientific production from the perspective of collective oral health, enabling the exchange of information and facilitating the integration between researchers and enabling a path to its consolidation.

Comemorando os 25 anos da Revista Ciência & Saúde Coletiva (C&SC), o presente artigo analisou 375 documentos publicados entre 2000-2019 neste periódico, como parte integrante da editoria de saúde bucal coletiva. A análise da produção visou compreender como o núcleo de saúde bucal aparece nas publicações e como poderia ter contribuído com o conhecimento sobre a saúde-doença da população, as políticas públicas específicas, o ensino e a gestão dos serviços de saúde bucal no SUS. O processo privilegiou a análise bibliométrica e a de documentos. Foi possível explicitar a distribuição institucional dos autores, sua expressiva rede de colaboradores e a dimensão das citações das publicações inclusive no plano internacional. Os estados brasileiros mais presentes nas publicações foram São Paulo e Minas Gerais, seguidos por autores de Pernambuco, Rio Grande do Sul e Santa Catarina. As citações foram mais frequentemente do Brasil (85,14%), seguido por Estados Unidos (2,31%), Portugal (1,34%) e Austrália (1,34%). Conclui-se que, mesmo com limitações, C&SC se mostrou, inequivocamente, um potente instrumento de divulgação da produção científica na perspectiva da saúde bucal coletiva, possibilitando a divulgação e o intercâmbio de informações, facilitando a integração entre os pesquisadores e possibilitando um caminho da sua consolidação.

Public oral health services performance in Brazil: Influence of the work process and service structure.

The quality of oral health care might be evaluated based on Donabedian's structure-process-outcome model. This study assessed the association between the oral health public services structure and work process of oral health teams (OHT) and performance indicators (access and problem-solving capacity) in Brazil. Secondary data from a national program obtained through interviews and by observation in 2013/2014 were analyzed. The performance indicators were Coverage of First Scheduled Dental Appointment (FDA) (< or ≥ the mean) and Ratio between Completed Treatments and First Scheduled Dental Appointments (CT/FDA) (< 1 or ≥ 1). The structure was assessed by the sum of available instruments, equipment, and supplies. Latent class analyses were used to identify similar groups (consolidated, developing, and incipient) of OHT according to the work process (planning of actions, health promotion and intersectoral actions, and integral health care). Each OHT was also described regarding the number of the health team in which the OHT operates, whether the primary care unit receives students/teaches, frequency of care provided outside of OHT coverage, and participation in telehealth. Multiple logistic regression models were adjusted for each performance indicator. A total of 16189 (99,8%) and 16192 (99,9%) OHTs located in 4344 (78,0%) municipalities had complete data on the work process and structure. 91.92% of OHTs presenting CT/FDA ≥ 1 and 37.05% presenting FDA ≥ the mean. Consolidated planning of actions and better structural conditions were associated with better performance. A higher frequency of CT/FDA ≥ 1 was observed among OHTs with consolidated integral health care and those that performed telehealth. OHTs that served individuals outside of OHT coverage daily and that worked with two to nine Health Teams presented a higher frequency of FDA ≥ the mean. OHTs with better structural and work process conditions had better performance.

Covid-19 pandemic: training caregivers to oral health care in nursing homes / Pandemia da COVID-19: capacitação dos cuidadores e a provisão de cuidados bucais aos idosos que vivem em Instituições de Longa Permanência

Aim: To assess the associated factors with oral hygiene practices of functionally dependent older adults by professionals working in long-stay elderly care homes during the COVID-19 pandemic. Methods:This was an exploratory study with a sample of 179 elderly care home professionals recruited through social media groups, applying "snowball" method. Data collection was performed using a structured questionnaire. The outcome variable was the practice of oral hygiene provided by caregivers to functionally dependent elderly individuals, including oral and denture hygiene. The independent variables included sociodemographic characteristics (sex, age group, education, race/skin color), professional performance (professional function and years of experience), training (for caregiving and oral health), elderly care home structure (availability of Personal Protective Equipment), working process (oral health protocols/guidelines), and perception of professional practices (Concerns about transmitting COVID-19 and feelings of being able to deal with cases of COVID-19, as well as the capacity to perform oral hygiene in dependent older adults). The association between the independent variables and oral hygiene practices was analyzed using Logistic Regression (p < 0.05). Results: Of the 179 professionals, 76.0% performed oral hygiene on the functionally dependent older adults, and 42.5% reported difficulties, including a lack of cooperation from the elders, a lack of time during working hours, and a lack of material. Professionals who received caregiver training for older adults (OR = 3.27, 95% CI 1.53 ­ 6.98) and those who were trained to perform oral hygiene in this age group (OR = 2.19, 95% CI 1.01 ­ 4.79) showed higher odds of performing oral hygiene in functionally dependent older adults. Conclusion: Oral hygiene practices were conducted in long-stay elderly care homes during the COVID-19 pandemic. Training caregivers of dependent older adults can enhance the provision of oral health care.

Objetivo: Avaliar os fatores associados às práticas de higiene bucal de idosos dependentes por profissionais que atuam em instituições de longa permanência para idosos (ILPI) durante a pandemia de COVID-19. Métodos: Estudo exploratório com amostra de 179 profissionais de ILPI recrutados por meio de grupos de mídia social e utilizando o método "bola de neve". Coleta de dados foi realizada empregando questionário estruturado. A variável resposta foi a prática de higiene bucal dos idosos dependentes por cuidadores, incluindo a realização de higiene bucal e de próteses. As variáveis independentes foram características sociodemográficas (sexo, faixa etária, escolaridade, raça/cor de pele), atuação (função da ILPI e tempo de atuação) e formação profissional (curso/treinamento para cuidador e em relação à saúde bucal), estrutura da instituição (disponibilidade de Equipamentos de Proteção Individual), processo de trabalho (protocolos/diretrizes de saúde bucal existentes na ILPI) e percepção sobre as práticas profissionais (Preocupações em transmitir e de ser capaz de lidar com casos de COVID-19, e de ser capaz de realizar higiene bucal dos idosos). A associação entre as variáveis independentes e as práticas de higiene bucal foi analisada por Regressão Logística (p < 0,05). Resultados: Dos 179 profissionais, 76,0% realizavam a higiene bucal dos idosos dependentes e 42,5% relataram dificuldades, como falta de cooperação do idoso, falta de tempo no turno de trabalho e falta de material. Os profissionais que possuíam formação para atuarem como cuidadores de idosos (OR = 3,27, IC 95% 1,53 ­ 6,98) e os que foram treinados para realizar higiene bucal nessa faixa etária (OR = 2,19, IC 95% 1,01 ­ 4,79) apresentaram maior chance de realização da higiene bucal em idosos dependentes. Conclusão: Práticas de higiene bucal foram realizadas em ILPI durante a pandemia de COVID-19. A formação de cuidadores de idosos dependentes pode potenciar a prestação de cuidados de saúde bucal.

Processo de trabalho em saúde bucal: disparidade entre as equipes no Brasil, 2014 / Proceso de trabajo de salud bucal: disparidad entre equipos en Brasil, 2014 / Oral health work process: disparity between teams in Brazil, 2014

Objetivo: Comparar o desempenho das equipes de saúde bucal (ESBs) das modalidades I e II no processo de trabalho e as diferenças entre regiões brasileiras. Métodos: Estudo transversal, com dados das ESBs que aderiram ao Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (2013-2014). A análise de classes latentes identificou subgrupos de ESBs segundo desempenho (consolidado, em desenvolvimento ou incipiente) no processo de trabalho (planejamento das ações; promoção da saúde; atenção integral). Comparadas as modalidades, obteve-se o índice de disparidade. Resultados: Avaliadas 15.886 ESBs, as da modalidade II apresentaram maior percentual de processo de trabalho consolidado nas regiões Sudeste (67,8 a 94,6%) e Sul (54,8 a 93,0%); observou-se maior disparidade no processo de trabalho consolidado entre ESBs da modalidade II (6,3 a 26,5), comparadas à modalidade I (3,9 a 18,4). Conclusão: ESBs da modalidade II guardam potencial para melhor desempenho no processo de trabalho, com disparidades regionais.

Objetivo: Comparar Equipos de Salud Bucal (ESB) modalidades I y II cuanto al desempeño en el proceso de trabajo y diferencias entre regiones brasileñas. Métodos: Estudio transversal con datos de la ESB adherida al Programa Nacional de Mejoramiento del Acceso y la Calidad en Atención Primaria (2013-2014). Análisis de Clases Latentes identificaron subgrupos de ESB según el desempeño (consolidado, en desarrollo o incipiente) en el proceso de trabajo (planificación de acciones, promoción de salud y atención integral). Se compararon las modalidades y se obtuvo el Índice de Disparidad. Resultados: Participaron 15.886 ESBs, las de modalidad II presentaron mayor porcentaje de proceso de trabajo consolidado en la región Sudeste (67,8% a 94,6%) y Sur (54,8% a 93,0%). La disparidad fue mayor entre la modalidad II (6,3 a 26,5) en comparación con la I (3,9 a 18,4). Conclusión: las ESBs modalidad II tienen potencial para obtener mejor desempeño en el proceso de trabajo, pero hubo disparidad regional.

Objective: To compare Modality I and Modality II Oral Health Teams (OHT) regarding work process performance and differences between Brazilian regions. Methods: This was a cross-sectional study with OHTs that took part in the National Program for Primary Health Care Access and Quality Improvement (2013-2014). Latent Class Analysis identified OHT subgroups according to work process (action planning, health promotion actions and comprehensive health care) performance (consolidated, developing or incipient). OHT modalities were compared, resulting in an Index of Disparity. Results: After evaluating 15,886 OHTs, Modality II OHTs were found to have a higher percentage of consolidated work processes in the Southeast (67.8%-94.6%) and Southern (54.8%-93.0%) regions. Disparity in the consolidated work process was greater among Modality II OHTs (6.3-26.5) compared to Modality I OHTs (3.9-18.4). Conclusion: Modality II OHTs have the potential for better performance regarding the work process, but with regional disparities.

A ciência da saúde coletiva por escrito: contribuição para estudos em saúde bucal coletiva / The science of collective health in writing: contribution to studies in collective oral health

Resumo Comemorando os 25 anos da Revista Ciência & Saúde Coletiva (C&SC), o presente artigo analisou 375 documentos publicados entre 2000-2019 neste periódico, como parte integrante da editoria de saúde bucal coletiva. A análise da produção visou compreender como o núcleo de saúde bucal aparece nas publicações e como poderia ter contribuído com o conhecimento sobre a saúde-doença da população, as políticas públicas específicas, o ensino e a gestão dos serviços de saúde bucal no SUS. O processo privilegiou a análise bibliométrica e a de documentos. Foi possível explicitar a distribuição institucional dos autores, sua expressiva rede de colaboradores e a dimensão das citações das publicações inclusive no plano internacional. Os estados brasileiros mais presentes nas publicações foram São Paulo e Minas Gerais, seguidos por autores de Pernambuco, Rio Grande do Sul e Santa Catarina. As citações foram mais frequentemente do Brasil (85,14%), seguido por Estados Unidos (2,31%), Portugal (1,34%) e Austrália (1,34%). Conclui-se que, mesmo com limitações, C&SC se mostrou, inequivocamente, um potente instrumento de divulgação da produção científica na perspectiva da saúde bucal coletiva, possibilitando a divulgação e o intercâmbio de informações, facilitando a integração entre os pesquisadores e possibilitando um caminho da sua consolidação.

Abstract Celebrating the 25 years of existence of the Journal Ciência & Saúde Coletiva (C&SC), this paper analyzed 375 documents published between 2000-2019 as an integral part of the editorial of collective oral health. The production analysis aimed to understand how oral health core appears in publications and how it could have contributed to knowledge on the population's health-disease, specific public policies, education, and management of oral health services in the SUS. The process employed bibliometric and documental analysis. We could show the authors' territorial distribution, their extensive collaboration network, and the dimension of citations in publications, including the international plan. The Brazilian states most present in the publications were São Paulo and Minas Gerais, followed by authors from Pernambuco, Rio Grande do Sul, and Santa Catarina. Citations were more frequent in Brazil (85.14%), followed by the United States (2.31%), Portugal (1.34%), and Australia (1.34%). We concluded that, despite the limitations, the C&SC showed unequivocally a powerful instrument for the dissemination of scientific production from the perspective of collective oral health, enabling the exchange of information and facilitating the integration between researchers and enabling a path to its consolidation.

Guideline for oral care of dependent elders: mapping review and cross-cultural adaptation to Portuguese-Brazil

Abstract This study aimed to map evidence-based guidelines for oral care of the dependent elders and perform the cross-cultural adaptation to Brazilian Portuguese. Initially, a systematized review was conducted in Medline, Scielo, Scopus, Web of Science, and Google Scholar databases without restrictions in search period or type of study. Articles in English, Spanish, and Brazilian Portuguese describing evidence-based guidelines for oral care, including oral hygiene recommendations, of institutionalized dependent elders were included as long as they presented an evaluation of evident quality. The guideline that met inclusion criteria was submitted to cross-cultural adaptation after obtaining permission from the original authors. Two hundred and nineteen references were found. Three selected articles described evidence-based guidelines for oral care, but the Oral Health Care Guideline for Older People in Long-term Care Institutions (OGOLI), originally developed and implemented in the Netherlands, was selected. It was based on evidence level A2 and consensus of experts and met the quality requirements of the Appraisal of Guidelines for Research & Evaluation (AGREE). This guideline presents oral care recommendations for elders with different levels of dependence in activities of daily living to be performed by caregivers and nursing staff. The adaptation of the OGOLI was mainly on the attributions of care providers, given the differences in professional regulations between Brazil and the Netherlands. The cross-cultural equivalence between OGOLI and its Brazilian Portuguese version was verified.

Biossegurança em Odontologia: conduta dos estudantes antes e após uma ação educativa / Biosafety in Dentistry: conduct of students before and after an educational intervention

O objetivo do estudo foi avaliar o conhecimento e a adesão dos estudantes de graduação em Odontologia da Universidade Federal de Minas Gerais quanto às normas de biossegurança e controle da infecção. Trata-se de um estudo transversal descritivo realizado com alunos do 4° ao 10° período, matriculados no segundo semestre de 2017. Houve uma intervenção que buscou reforçar os conhecimentos de biossegurança por meio da distribuição de folhetos informativos aos estudantes e afixação de pôsteres em locais de maior circulação. Foram coletadas informações sociodemográficas e relativas à biossegurança antes e após a intervenção, por meio de um questionário validado. Foram realizadas análises descritivas e bivariada por meio do teste qui-quadrado. A amostra constituiu de 653 estudantes, a maioria do sexo feminino, cursando entre o 7° e o 10° períodos, com média de idade de 22,6 anos. Quanto à proteção mecânica dos instrumentos de trabalho, tanto antes quanto após a ação, mais de 80% responderam sempre utilizar barreiras. Houve redução das frequências de desinfecção do ambiente e uso de equipamentos de proteção individual. A frequência de lavagem dos instrumentais aumentou de 95,4% para 96,6% após a intervenção, enquanto a esterilização reduziu de 100% para 98,8%. Houve associação entre o uso de equipamentos de proteção individual com o sexo feminino e os períodos iniciais do curso (p<0,001). Conclui-se que os estudantes do sexo feminino e dos períodos iniciais aderem com maior frequência às normas de biossegurança. Os conhecimentos sobre biossegurança não foram satisfatórios para o controle da infecção, mesmo após a ação educativa (AU).

The objective of this study was to evaluate the knowledge of and adherence to biosafety and infection control norms of dental students. This was a cross-sectional descriptive study carried out with students from 4th to 10th semester, enrolled in the second half of 2017. Na educational intervention to reinforce biosafety knowledge was implemented through the distribution of information flyers to students and poster placement in areas of high pedestrian circulation. Sociodemographic and biosafety information was collected before and after the intervention using a validated questionnaire. Descriptive and bivariate analyses were performed with the chi-square test using SPSS software, version 19. The research was approved by the Research Ethics Committee. The sample consisted of 653 students, most of them female, between the 7th and 10th semesters, with a mean age of 22.6 years. Before and after the intervention, more than 80% always used physical protection barriers. The frequency of environment disinfection and use of personal protection equipment decreased after the intervention. Always performing instrument washing increased from 95.4% to 96.6% after the intervention, while sterilization decreased from 100% to 98.8%. There was an association between the use of personal protection equipment with being women and with semestre (p <0.001). We conclude that students in initial semesters more often adhere to biosafety standards. Knowledge about biosafety was not satisfactory for infection control even after the educational intervention (AU).

Pré-natal odontológico: assistência às gestantes na rede pública de atenção básica em saúde / Prenatal dental care: dental care for pregnant woman in the public primary healthcare network

Objetivo: avaliar como se dá a assistência odontológica a pacientes gestantes na rede pública de atenção básica em saúde, através das práticas descritas pelos cirurgiões-dentistas que compõe essa rede.Métodos: trata-se de um estudo transversal, em que os dados foram coletados por meio de questionário estruturado, entre maio e julho/2017 com cirurgiões-dentistas da rede pública de atenção básica em saúde do município de Belo Horizonte (MG). A análise foi por meio de cálculo de prevalência, utilizando o pacote estatístico STATA.Resultados: participaram deste estudo 260 cirurgiões-dentistas. Dentre eles, 98,5% atendiam gestantes, com média mensal de 1 a 4 atendimentos, havendo adesão ao tratamento em 54,5% dos casos. O acesso se deu, majoritariamente, através de encaminhamentos do médico e enfermeiro, ou livre demanda. Quase todos os dentistas (94,9%) sentem-se seguros para o atendimento da gestante. As principais dificuldades referiram-se à encaminhamento para tomadas radiográficas e falta de informação dos profissionais envolvidos no pré-natal e das gestantes sobre o atendimento odontológico.Conclusão: As gestantes estão recebendo assistência odontológica na rede pública de atenção básica e os cirurgiões-dentistas neste estudo não apresentaram receio em atende-as. O acesso facilitado aos serviços odontológicos disponíveis nos Centros de Saúde está sendo executada; pelas informações prestadas pelos cirurgiões-dentistas pôde-se ver que o encaminhamento das gestantes feito pelos profissionais de saúde envolvidos no pré-natal, seja ele médico, enfermeiro, Agente Comunitário de Saúde, está sendo realizado.

Aim: To evaluate the prenatal dental care provided for pregnant women in the public primary healthcare network, based on the perception of dentists who work in this service.Methods: This study was cross-sectional with a quantitative approach. The data were collected through a structured questionnaire between May and July 2017 with dentists who provide dental care in the public primary healthcare network in Belo Horizonte (MG). Data were analyzed using prevalence estimates calculated using the STATA statistics package. Results: Two hundred sixty dental surgeons participated in this study. Among them, 98.5% provided dental care for pregnant women in their healthcare center, with a monthly average of 1 to 4 visits and with treatment adherence in 54.5% of the cases. The access was mainly through referral given by the doctor or nurse or by free application. Almost all of the dentists (94.9%) considered themselves prepared to provide dental care to pregnant women. The main difficulties were related to the use of radiography and the lack of information of healthcare professionals involved in providing prenatal dental care and dental care for pregnant women during this period. Conclusion: The pregnant women are receiving dental care in the public primary healthcare network, and the dentists in this study were not afraid to attend to them. The facilitated access to the dental care services available at the Health Centers is being carried out; through the information provided by the dentists, it was possible to see that the referral of the pregnant women by the healthcare professionals involved in prenatal dental care, whether they are a doctor, a nurse, or a Community Healthcare Agent, is being carried out.

Cuidados bucais em instituições de longa permanência para idosos / Oral health care in long-term care facilities for elderly people

Esta dissertação apresenta três artigos na temática de saúde bucal dos idosos institucionalizados que buscam avaliar os cuidados bucais prestados por profissionais de Instituições de Longa Permanência para Idosos e qualificar instrumentos que propõem tal avaliação quanto às suas propriedades de mensuração. Com o objetivo de mapear os instrumentos de avaliação da saúde bucal de pessoas idosas que vive em Instituições de Longa Permanência para Idosos (ILPI) por profissionais não dentistas e avaliar suas propriedades de mensuração foram desenvolvidos um protocolo de revisão sistemática e uma revisão sistemática. Foram incluídos estudos que descrevem o desenvolvimento de instrumentos de avaliação da saúde bucal de idosos institucionalizados por profissionais não dentistas. Estudos avaliando pelo menos uma propriedade de mensuração (validade, confiabilidade ou responsividade) foram considerados. Pesquisas eletrônicas foram realizadas e as propriedades foram avaliadas usando os parâmetros para avaliação do risco de viés de acordo com Consensus-based Standards for the selection of health Measurement INstruments (COSMIN). O Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) foi usado para classificar a qualidade da evidência e recomendar o instrumento mais adequado. 15 estudos relataram propriedades de mensuração de sete instrumentos, sendo o ohr-interRAI o instrumento com maior potencial para ser recomendado. Além dele, OHAT, DHI, OAS, OHSTNP tem potencial para uso. Considerando o nível de evidência disponível, recomenda-se o uso do ohr-inteRAI para fins avaliativos até que novas evidências de alta qualidade demonstrem propriedades de mensuração superiores para outros instrumentos com potencial para uso. Assim, há a necessidade de aprimorar os aspectos metodológicos dos estudos e realizar mais estudos consistentes para avaliação das propriedades de mensuração dos instrumentos já existentes que possuem potencial de serem indicados para uso. O terceiro estudo buscou descrever as práticas de higiene bucal de idosos institucionalizados dependentes de cuidados no contexto da pandemia de COVID-19 e analisar os fatores associados à realização desses procedimentos por profissionais que atuam em ILPI. Trata-se de um estudo transversal, de caráter exploratório, com uma amostra não probabilística de profissionais de ILPI. Dados sobre as práticas de higiene bucal, perfil sociodemográfico, atuação e capacitação profissional, estrutura da ILPI, processo de trabalho e percepção dos profissionais foram coletados por meio de um questionário online, previamente validado por Comitê de Especialistas, entre junho e dezembro de 2020. As associações foram investigadas por meio de Regressão Logística simples e múltipla. Dos 179 profissionais que responderam ao questionário da pesquisa original, 76,0% realizavam higiene bucal de idosos dependentes e, 42,5% relataram dificuldades, incluindo barreiras como a falta de cooperação do idoso (93,20%), falta de conhecimento (35,60%), falta de tempo (29,30%) e, falta de materiais necessários (27,6%). Possuir curso de capacitação para cuidador de idosos (OR = 3,27, IC 1,53 - 6,98) e para higiene bucal (OR = 2,19, IC 1,01 - 4,79) foram associados à maior frequência de realização de higiene bucal. As práticas de higiene bucal são realizadas nas ILPI do Brasil durante o contexto da pandemia de COVID-19 e a capacitação para cuidador de idosos e para os cuidados bucais podem favorecer a provisão desses cuidados.

This dissertation presents three articles on the topic of oral health of institutionalized elderly people that seek to evaluate the oral care provided by professionals of Long-Term Care Facilities (LTCF) for the elderly people and qualify instruments that propose such an assessment regarding their measurement properties. In order to map the instruments for assessing the oral health of elderly people living in LTCF by non-dentist professionals and to assess their measurement properties, a systematic review protocol and a systematic review were developed. Studies describing the development of instruments to assess the oral health of institutionalized old people by nondentist professionals were included. Studies evaluating at least one measurement property (validity, reliability or responsiveness) were considered. Electronic surveys were performed and properties were assessed using the parameters for risk of bias assessment according to the Consensusbased Standards for the selection of health Measurement INnstruments (COSMIN). The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to rank the quality of evidence and recommend the most appropriate instrument. 15 studies reported measurement properties of seven instruments, with the ohr-interRAI being the instrument with the greatest potential to be recommended. In addition to it, OHAT, DHI, OAS, OHSTNP has potential for use. Considering the level of evidence available, the use of the ohr-interRAI for evaluative purposes is recommended until new high-quality evidence demonstrates superior measurement properties for other instruments with potential for use. Thus, there is a need to improve the methodological aspects of the studies and carry out more consistent studies to assess the measurement properties of existing instruments that have the potential to be indicated for use. The third study sought to describe the oral hygiene practices of institutionalized elderly people dependent on care in the context of the COVID-19 pandemic and to analyze the factors associated with the performance of these procedures by professionals working in LTCF. This is a cross-sectional, exploratory study with a non-probabilistic sample of LTCF professionals. Data on oral hygiene practices, sociodemographic profile, professional performance and training, structure of the LTCF, work process and perception of professionals were collected through an online questionnaire, previously validated by the Expert Committee, between June and December 2020. Associations were investigated using simple and multiple logistic regression. Of the 179 professionals who answered the original survey questionnaire, 76.0% performed oral hygiene for dependent elderly people and 42.5% reported difficulties, including barriers such as the elderly's lack of cooperation (93.20%), lack of knowledge (35.60%), lack of time (29.30%) and lack of necessary materials (27.6%). Having a training course for elderly caregivers (OR = 3.27, CI 1.53 - 6.98) and for oral hygiene (OR = 2.19, CI 1.01 - 4.79) were associated with a higher frequency of performing oral hygiene. Oral hygiene practices are carried out in LTCF in Brazil during the context of the COVID-19 pandemic and training for caregivers of the elderly and for oral care can favor the provision of such care.