Theorization about the limits to the inclusion of oral health teams in the Family Health Strategy. / Teorização sobre os limites à inserção da saúde bucal na Estratégia Saúde da Família.

This study aimed to theorize, by means of social actors' conception, about the reasons for the non-inclusion of oral health in the Family Health Strategy (FHS) in the city of Juiz de Fora, Minas Gerais, Brazil. This is a qualitative, exploratory, descriptive, and analytical study based on the grounded theory methodology and the National Oral Health Policy. Eleven interviews were performed with public managers, delegates who participate in the municipal health council, and dental surgeons who belong to the public health service. The theorization of the study was created through the data analysis process, which resulted in "a consequence of the dominant disease-centered oral health care model" as the main category. Data were categorized according to a methodological framework. The health concept set forth by local social actors contributed to the non-inclusion of oral healthcare teams (OHTs) in the FHS. This theorization identified the origins of the studied phenomenon and can aid in future policy decision-making carried out by local social actors.

Este estudo objetivou construir teorização a partir da concepção de atores sociais acerca das razões da não inserção da atenção à saúde bucal na Estratégia de Saúde da Família (ESF) no município de Juiz de Fora, Minas Gerais. Trata-se de um estudo qualitativo, fundamentado no referencial teórico construído com base na Política Nacional de Saúde Bucal e metodológico na Teoria Fundamentada nos Dados (TFD). Foram realizadas 11 entrevistas intensivas com atores sociais da gestão, do controle social e cirurgiões-dentistas do serviço público do município. Os dados foram categorizados segundo a TFD e a partir do processo de análise dos dados, construiu-se a teorização do estudo e obteve-se como categoria central "Consequência de uma concepção hegemônica doença-centrada da saúde para o modelo de atenção à saúde bucal". A concepção de saúde dos atores sociais do município contribuiu para a não inserção da atenção à saúde bucal na ESF. A teorização permitiu a identificação da origem das condições do fenômeno estudado e poderá contribuir para tomada de decisões dos atores sociais em futuras ações políticas.

Teorização sobre os limites à inserção da saúde bucal na Estratégia Saúde da Família / Theorization about the limits to the inclusion of oral health teams in the Family Health Strategy

Resumo Este estudo objetivou construir teorização a partir da concepção de atores sociais acerca das razões da não inserção da atenção à saúde bucal na Estratégia de Saúde da Família (ESF) no município de Juiz de Fora, Minas Gerais. Trata-se de um estudo qualitativo, fundamentado no referencial teórico construído com base na Política Nacional de Saúde Bucal e metodológico na Teoria Fundamentada nos Dados (TFD). Foram realizadas 11 entrevistas intensivas com atores sociais da gestão, do controle social e cirurgiões-dentistas do serviço público do município. Os dados foram categorizados segundo a TFD e a partir do processo de análise dos dados, construiu-se a teorização do estudo e obteve-se como categoria central "Consequência de uma concepção hegemônica doença-centrada da saúde para o modelo de atenção à saúde bucal". A concepção de saúde dos atores sociais do município contribuiu para a não inserção da atenção à saúde bucal na ESF. A teorização permitiu a identificação da origem das condições do fenômeno estudado e poderá contribuir para tomada de decisões dos atores sociais em futuras ações políticas.

Abstract This study aimed to theorize, by means of social actors' conception, about the reasons for the non-inclusion of oral health in the Family Health Strategy (FHS) in the city of Juiz de Fora, Minas Gerais, Brazil. This is a qualitative, exploratory, descriptive, and analytical study based on the grounded theory methodology and the National Oral Health Policy. Eleven interviews were performed with public managers, delegates who participate in the municipal health council, and dental surgeons who belong to the public health service. The theorization of the study was created through the data analysis process, which resulted in "a consequence of the dominant disease-centered oral health care model" as the main category. Data were categorized according to a methodological framework. The health concept set forth by local social actors contributed to the non-inclusion of oral healthcare teams (OHTs) in the FHS. This theorization identified the origins of the studied phenomenon and can aid in future policy decision-making carried out by local social actors.

What we know about antibiotics prescribed by dentists in a Brazilian southeastern state.

The objective of this study was to analyze possible associations between antibiotic dental prescriptions in the public health service, health service characteristics, and social characteristics of the municipalities. Using the register of dispensing in the public health service of a state in the Southeast region of Brazil, in 2017 we analyzed patterns of antibiotic prescriptions by dentists. Data were obtained from the Integrated Pharmaceutical Services Management System (SIGAF, in Portuguese). The outcome variable was the number of Daily Defined Doses (DDD) per 1,000 residents/year in each municipality. CART (Classification and Regression Tree) technique was used to determine the influence of the following variables: populational social characteristics (Human Development Index, Gini Index, the proportion of rural population and proportion of families benefiting from the Bolsa Família Program) and oral health services characteristics (access to individual dental care, number of dentists and oral health teams per 1,000 residents, and percentage of preventive and restorative individual dental procedures. Data analysis was performed using IBM SPSS Statistics 21.0. Antibiotics were the medications most prescribed by dentists in the public health service, with penicillin being the most frequently prescribed class. The average DDD/1,000 residents/year for the 421 municipalities surveyed was 96.54 (range 0.008 and 619.660). Select factors were associated with antibiotic prescriptions including access to individual dental care (Adjusted p-value ≤0.001), a number of oral health teams/1,000 inhabitants (Adjusted p-value=0.001), and Gini Index (Adjusted p-value = 0.046). Access to oral health services and inequality were associated with the use of antibiotics.

What we know about antibiotics prescribed by dentists in a Brazilian southeastern state

Abstract The objective of this study was to analyze possible associations between antibiotic dental prescriptions in the public health service, health service characteristics, and social characteristics of the municipalities. Using the register of dispensing in the public health service of a state in the Southeast region of Brazil, in 2017 we analyzed patterns of antibiotic prescriptions by dentists. Data were obtained from the Integrated Pharmaceutical Services Management System (SIGAF, in Portuguese). The outcome variable was the number of Daily Defined Doses (DDD) per 1,000 residents/year in each municipality. CART (Classification and Regression Tree) technique was used to determine the influence of the following variables: populational social characteristics (Human Development Index, Gini Index, the proportion of rural population and proportion of families benefiting from the Bolsa Família Program) and oral health services characteristics (access to individual dental care, number of dentists and oral health teams per 1,000 residents, and percentage of preventive and restorative individual dental procedures. Data analysis was performed using IBM SPSS Statistics 21.0. Antibiotics were the medications most prescribed by dentists in the public health service, with penicillin being the most frequently prescribed class. The average DDD/1,000 residents/year for the 421 municipalities surveyed was 96.54 (range 0.008 and 619.660). Select factors were associated with antibiotic prescriptions including access to individual dental care (Adjusted p-value ≤0.001), a number of oral health teams/1,000 inhabitants (Adjusted p-value=0.001), and Gini Index (Adjusted p-value = 0.046). Access to oral health services and inequality were associated with the use of antibiotics.

Perspectives on Social and Environmental Determinants of Oral Health.

Most oral conditions have a multifactorial etiology; that is, they are modulated by biological, social, economic, cultural, and environmental factors. A consistent body of evidence has demonstrated the great burden of dental caries and periodontal disease in individuals from low socioeconomic strata. Oral health habits and access to care are influenced by the social determinants of health. Hence, the delivery of health promotion strategies at the population level has shown a great impact on reducing the prevalence of oral diseases. More recently, a growing discussion about the relationship between the environment, climate change, and oral health has been set in place. Certainly, outlining plans to address oral health inequities is not an easy task. It will demand political will, comprehensive funding of health services, and initiatives to reduce inequalities. This paper sought to give a perspective about the role of social and physical environmental factors on oral health conditions while discussing how the manuscripts published in this Special Issue could increase our knowledge of the topic.

Top 100 most-cited papers in core dental public health journals: bibliometric analysis.

OBJECTIVE: This quali-quantitative study analysed the 100 most-cited papers in core dental public health (DPH) journals focusing on understanding international knowledge production. METHODS: The DPH journals were selected from titles and scopes at Web of Science Core Collection database up to March 2020. Further comparisons were performed at Scopus and Google Scholar databases. Some bibliometric parameters were extracted as follows: title, number of citations, citation density (number of citations per year), first author's country, year of publication, study design and subject. VOSviewer software was used to create graphical bibliometric maps. RESULTS: Papers were ranked by the total number of citations, which ranged from 104 to 1,019, and six papers were cited more than 400 times. Papers were published from 1974 to 2013, mainly in Community Dentistry and Oral Epidemiology. Most frequent study designs were cross-sectional (30%) and nonsystematic review (25%). Most papers were from Europe (54%) and North America (31%). First authors were predominantly from the United Kingdom (17%), United States of America (17%) and Canada (14%). VOSviewer map of co-authorship demonstrated the existence of clusters in the research collaboration. Although epidemiology was the most frequent subject (84%), health services research presented eight times higher citation density. CONCLUSIONS: Top 100 most-cited papers in core DPH journals were predominantly observational studies from Anglo-Saxon countries. Top 100 most-cited papers in core DPH journals tend to be cross-sectional studies carried out in the United States with highest citation in health services research. Locker D, Petersen PE and Sheiham A are a landmark for DPH field.

Early Childhood Caries Experience of Children from Poor Families Living Below and Above Poverty Line

ABSTRACT Objective: To evaluate the role of poverty and its related factors on early childhood caries (ECC) experience among deprived children. Material and Methods: This population-based cross-sectional study surveyed 418 children aged one to six years enrolled in Brazilian public preschools from an area of the country known for its high social deprivation. Intraoral examination of children evaluated dental caries experience (dmft). Parents/caregivers answered a questionnaire with sociodemographic indicators. Family income was dichotomized into below or above poverty line. Data analysis used Chi-square test, Mann-Whitney test, and Multivariate Logistic Regression analysis (p<0.05). Results: Predisposing variables for an increased chance of ECC were: age group 3-4 years (OR: 4.89; 95% CI: 2.32-10.31), age group 5-6-years (OR: 5.60; 95% CI: 2.60-12.04), being part of families living below poverty line (OR: 1.88; 95% CI: 1.04-3.38) and having mothers with less than nine years of schooling (OR: 2.86; 95% CI: 2.77-7.14). Children from families living below poverty line presented higher dmft (2.9 +3.8; p=0.001) and untreated dental caries (d component) (2.7 +3.7; p=0.002). Conclusion: ECC in a poor population was influenced by indicators of social deprivation. The poorest of poor children from mothers with less years of schooling were at higher risk.

Prescriptions of analgesics and anti-inflammatory drugs in municipalities from a Brazilian Southeast state.

The objective of this study was to describe dental prescriptions of non-steroidal anti-inflammatory drugs (NSAID), opioids, and analgesics dispensed by the Brazilian National Health System (BNHS, SUS in Portuguese) of a Southeastern state from January to December 2017, and to analyze their association with socioeconomic and oral health care services' characteristics at municipal level. Data were collected from the Brazilian Integrated Pharmaceutical Care Management System. Medicines were grouped according to the Anatomical Therapeutic Chemical Classification System. The total number of Defined Daily Doses (DDD) and DDD per 1,000 inhabitants (inhab.) per year were presented and compared between groups of municipalities. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25.0. The total number of NSAID, opioids, and analgesics prescriptions was 70,747 and accounted for 354,221.13 DDD. The most frequently prescribed medicine was ibuprofen (n = 24,676; 34.88%). The number of dental practitioners in the BNHS per 1,000 inhab. (p < 0.001), first dental appointment coverage (p = 0.010), oral health teams per 1,000 inhab. (p=0.022), and the proportion of rural population (p = 0.014) were variables positively associated with the number of DDD of NSAID per 1,000 inhab. per year. Bolsa Família program coverage per 1,000 inhab. (p = 0.022) was negatively associated with NSAID prescription. Regarding analgesics, first dental appointment coverage (p=0.002) and Bolsa Família program coverage per 1,000 inhab. (p = 0.012) were positively associated with DDD per 1,000 inhab. per year. In conclusion, dental prescriptions of analgesics and NSAID in the BNHS were associated with socioeconomic and oral health care services' characteristics.

Health promotion in Brazil: qualitative survey with primary school teachers.

School health promotion programs can reduce common health problems like obesity, diabetes and respiratory complications. This qualitative study aimed to investigate the perceptions of a group of teachers regarding issues related to the promotion of health in school. The 15 teachers sampled were from public primary schools in a city in southeastern Brazil. Interviews with teachers were conducted and data was analyzed employing content. Teacher practices regarding the promotion of health appeared to be aimed at their students and their daily habits and their practices. Teachers described approaching health promotion through their lesson content and suggested that the school should seek help from other institutions in their health promotion activities like prevention activities, monitoring of improvements in student and teacher health. Teachers mentioned a strong relationship between knowledge and the pursuit of good health. The need to identify major determinants of the disease/health process was highlighted and the connection between lifestyle, socio-economic status and the disease/health process was described. Awareness of the influence concerning both the environment and the school surroundings was demonstrated. It is important that the teachers are aware of the environment that surrounds them as well as the reality of the lives of all those involved with the school.

[The use of metaphors to express toothache: a study in the field of the anthropology of health]. / Uso de metáforas para expressar a dor de dente: um estudo na área de antropologia da saúde.

This research was conducted with patients who sought emergency care at a Comprehensive Primary Care Clinic (CIAP IV) at the Dental School of Minas Gerais Federal University and at the Dental Center of a medium-sized city in the state of Minas Gerais. The scope of this article is to identify how the social representations of this issue are generated through the metaphors used by patients to express toothache. A total of 35 individuals of both genders who sought emergency care for toothache participated in the study. Content theme analysis was used. Social representations of toothache are generated as people resort to their life experiences to find words to express the problem. Prior sensations and feelings, and even imaginary situations, generate metaphors to attempt to explain the suffering. Toothache is often compared with the worst feelings ever experienced by individuals. Toothache represents great suffering for people seeking emergency dental care. This fact may help to develop further public oral health policies, bearing in mind that a socially deprived population is more often afflicted by toothache.

Uso de metáforas para expressar a dor de dente: um estudo na área de antropologia da saúde / The use of metaphors to express toothache: a study in the field of the anthropology of health

Trata-se de pesquisa desenvolvida com pacientes que procuraram o atendimento de urgência da disciplina Clínica Integrada de Atenção Primária IV da Faculdade de Odontologia da Universidade Federal de Minas Gerais e do centro odontológico de um município de médio porte. O objetivo deste artigo é analisar as representações sociais da dor de dentes por meio de metáforas utilizadas por pacientes. Participaram do estudo 35 adultos de ambos os sexos cujo motivo da procura pelo serviço odontológico de urgência era dor de dente. Utilizou-se a análise de conteúdo temática. As representações sociais da dor de dente são geradas à medida que as pessoas buscam na sua experiência de vida palavras para decodificar esse problema. Sensações e sentimentos já vivenciados, e até mesmo o imaginário, se tornam metáfora para tentar explicar o sofrimento. A dor de dente é comparada muitas vezes às piores sensações já experimentadas pelo indivíduo. A odontalgia representa muito sofrimento para a população que busca um serviço odontológico de urgência. Esse fato poderá orientar as políticas públicas de saúde bucal, tendo em vista que a população desfavorecida socialmente é mais acometida pela dor de dente.

This research was conducted with patients who sought emergency care at a Comprehensive Primary Care Clinic (CIAP IV) at the Dental School of Minas Gerais Federal University and at the Dental Center of a medium-sized city in the state of Minas Gerais. The scope of this article is to identify how the social representations of this issue are generated through the metaphors used by patients to express toothache. A total of 35 individuals of both genders who sought emergency care for toothache participated in the study. Content theme analysis was used. Social representations of toothache are generated as people resort to their life experiences to find words to express the problem. Prior sensations and feelings, and even imaginary situations, generate metaphors to attempt to explain the suffering. Toothache is often compared with the worst feelings ever experienced by individuals. Toothache represents great suffering for people seeking emergency dental care. This fact may help to develop further public oral health policies, bearing in mind that a socially deprived population is more often afflicted by toothache.

[Cross-cultural adaptation and reproducibility of a questionnaire to assess the knowledge and attitude of health professionals in cases of child physical abuse]. / Adaptação transcultural e reprodutibilidade de questionário para avaliação de conhecimento e atitude de profissionais de saúde frente a casos de abuso físico infantil.

The scope of this study was to conduct cross-cultural adaptation and evaluate the reproducibility of a questionnaire designed by a team from the University of London to assess knowledge and attitudes of health professionals during primary care when faced with cases of child physical abuse. The translation rigorously followed the criteria described by Herdman (1998), to maintain maximum functional equivalence. The adapted questionnaire was tested on 107 health care professionals from Belo Horizonte. Standard and Weighted Kappa tests were used to evaluate the reproducibility of the instrument. Most of the questions achieved Kappa test values above 80% (excellent). The Brazilian version of the questionnaire was, therefore, adapted and had proven reproducibility.

Adaptação transcultural e reprodutibilidade de questionário para avaliação de conhecimento e atitude de profissionais de saúde frente a casos de abuso físico infantil / Cross-cultural adaptation and reproducibility of a questionnaire to assess the knowledge and attitude of health professionals in cases of child physical abuse

O objetivo deste estudo foi adaptar transculturalmente e avaliar a reprodutibilidade de um questionário desenvolvido por uma equipe da Universidade de Londres, usado na avaliação do conhecimento e da atitude de profissionais da atenção primária frente a casos de abuso físico infantil. A tradução seguiu os critérios descritos por Herdman, 1998, de forma criteriosa, de modo a preservar ao máximo a equivalência funcional. O questionário adaptado foi aplicado em 107 profissionais de saúde de Belo Horizonte. Os testes Kappa Simples e Ponderado foram utilizados para avaliar a reprodutibilidade deste instrumento. A maioria das questões apresentou valores aos testes Kappa acima de 80% (excelente). A versão brasileira do questionário apresentou-se, portanto, adaptada e com boa reprodutibilidade.

The scope of this study was to conduct cross-cultural adaptation and evaluate the reproducibility of a questionnaire designed by a team from the University of London to assess knowledge and attitudes of health professionals during primary care when faced with cases of child physical abuse. The translation rigorously followed the criteria described by Herdman (1998), to maintain maximum functional equivalence. The adapted questionnaire was tested on 107 health care professionals from Belo Horizonte. Standard and Weighted Kappa tests were used to evaluate the reproducibility of the instrument. Most of the questions achieved Kappa test values above 80% (excellent). The Brazilian version of the questionnaire was, therefore, adapted and had proven reproducibility.

Representação social de adultos sobre tabagismo e suas implicações para a saúde: estudo realizado em comunidade rural - MG / The social representation of smoking among adults and its implications for health: study conducted in a rural community in the state of Minas Gerais

Objetivo: Apreender a representação social de adultos de uma comunidade rural sobre o tabagismo e suas implicações para a saúde e, por conseguinte, fornecer subsídios para planejamento das ações dos serviçosde saúde. Materiais e Métodos: Foram realizadas entrevistas semi-estruturadas com 15 adultos (fumantes, exfumantes e não-fumantes), entre 30 a 59 anos, moradores de uma região rural em Santa Bárbara-MG e usuários do serviço de saúde municipal, para uma análise utilizando a abordagem qualitativa dos dados. Resultados:Foi possível classificar e separar os discursos em três grandes temas: Iniciação do Tabagismo; Influência naQualidade de Vida e Cessação do Hábito. Os entrevistados consideraram importante que os profissionais desaúde tenham maior ação no apoio à cessação do tabagismo. Há concordância de que é necessário não apenasmanter as propagandas antitabaco nos maços e ampliar o número de áreas restritivas ao cigarro, bem comoa intensificação destas medidas. Conclusão: Deve-se aumentar as ações direcionadas aos jovens e à família,pois ambos interferem fundamentalmente na iniciação ao fumo. A criação de grupos de convivência podeauxiliar na cessação do hábito de fumar. Diminuir as formas de pressão social aos grupos em situação devulnerabilidade social pode ajudar na diminuição do número de fumantes.

O acesso aos serviços públicos de saúde em área limítrofe entre municípios / Access to public health services in a borderline area between two cities

Este artigo analisa o acesso aos serviços de saúde. O conceito de acessibilidade é descrito como uma característica dos serviços de saúde podendo ser abordado sob diferentes enfoques. Por isso o acesso aos serviços de saúde deve ser estabelecido em cada Unidade Básica de Saúde (UBS) com a participação efetiva, no processo, dos servidores de nível local e da comunidade. Foi empregada metodologia qualitativa, a pesquisa-ação e, para a coleta de dados, foram realizadas entrevistas e grupos focais. O trabalho foi desenvolvido junto às gerentes de duas UBS " Confisco, em Belo Horizonte, e Estrela Dalva, em Contagem " e moradores da área de abrangência das unidades. O acesso dos moradores aos serviços de saúde mostrou-se problemático por se tratar de uma área limítrofe entre dois municípios. Apesar de o trabalho ter sido desenvolvido durante dois anos, há dúvidas se ele contribuiu para a melhoria do acesso da população, em função das questões políticas que envolvem o tema. No entanto, toda a problemática detectada durante o desenvolvimento da pesquisa foi apresentada e debatida com os gestores de ambos os municípios.(AU)

O acesso aos serviços públicos de saúde em área limítrofe entre municípios / Access to public health services in a borderline area between two cities

Este artigo analisa o acesso aos serviços de saúde. O conceito de acessibilidade é descrito como uma característica dos serviços de saúde podendo ser abordado sob diferentes enfoques. Por isso o acesso aos serviços de saúde deve ser estabelecido em cada Unidade Básica de Saúde (UBS) com a participação efetiva, no processo, dos servidores de nível local e da comunidade. Foi empregada metodologia qualitativa, a pesquisa-ação e, para a coleta de dados, foram realizadas entrevistas e grupos focais. O trabalho foi desenvolvido junto às gerentes de duas UBS " Confisco, em Belo Horizonte, e Estrela Dalva, em Contagem " e moradores da área de abrangência das unidades. O acesso dos moradores aos serviços de saúde mostrou-se problemático por se tratar de uma área limítrofe entre dois municípios. Apesar de o trabalho ter sido desenvolvido durante dois anos, há dúvidas se ele contribuiu para a melhoria do acesso da população, em função das questões políticas que envolvem o tema. No entanto, toda a problemática detectada durante o desenvolvimento da pesquisa foi apresentada e debatida com os gestores de ambos os municípios.

Ansiedade odontológica em um serviço de saúde bucal de atenção Primária / Dental anxiety in a primary attention oral health service

Objetivo: Identificar a ansiedade odontológica e determinar os fatores a ela associados. Método: Trezentos e quinze indivíduos sob tratamento nas clínicas da Faculdade de Odontologia da Universidade Federal de Minas Gerais participaram do estudo. A Escala de Ansiedade Odontológica Modificada foi utilizada para identificar ansiedade e fobia. A Escala Modificada de Ansiedade Odontológica (MDAS) consiste de cinco itens com cinco alternativas cada, especialmente desenvolvidos para medir a ansiedade odontológica com escores de 5 a 25. Pacientes considerados ansiosos quando apresentam escores maiores do que 16. Escores a partir de 19 indicam fobia odontológica. Foram coletadas informações sobre idade, sexo, nível educacional, renda, estórias de tratamentos odontológicos evitados e também de consultas perdidas. O nível de significância adotado foi de p<0,05. Resultados: Ansiedade odontológica e fobia foram identificadas em 20% e 8,6% dos indivíduos, respectivamente. As mulheres apresentaram níveis de ansiedade mais elevados do que os homens. O nível educacional mais baixo esteve associado a escores mais elevados de ansiedade. Os pacientes com escores mais elevados de ansiedade tenderam mais a faltar às consultas odontológicas. Conclusão: A ansiedade odontológica foi freqüente no serviço de saúde bucal estudado. Há múltiplos determinantes desta condição, especialmente os relatos de tratamentos odontológicos evitados e consultas odontológicas perdidas. Se o serviço de saúde bucal não favorece a redução da ansiedade, pode criar uma barreira ao acesso ao tratamento.

Objective: To identify dental anxiety and determine the factors associated with its occurrence. Methods: Three hundred and fifteen individuals under treatment at the clinics of the Dental School of the Federal University of Minas Gerais participated in the study. The Modified Dental Anxiety Scale (MDAS) was used to identify dental anxiety and phobia. The MDAS is an instrument composed of 5 items with 5 alternatives each, especially developed to measure dental anxiety with scores from 5 to 25. Patients are considered anxious when present scores higher than 16, while scores above 19 indicate dental phobia. Information was collected about age, gender, educational level, income, history of avoided dental treatments and missed dental appointments. The significance level was set at p<0.05. Results: Dental anxiety and phobia were identified in 20% and 8.6% of the individuals, respectively. Women presented higher levels of anxiety than men. Lower educational level was associated with higher anxiety scores. Patients with higher anxiety scores tended to miss more dental appointments. Conclusion: Dental anxiety was frequent in the oral health service evaluated. There are multiple determinants for this condition, especially reports of postponed dental treatments and missed dental appointments. If the oral health service cannot reduce dental anxiety, it may create a barrier to patients' access to the treatment.

Conhecimentos e práticas sobre as principais doenças bucais da população adulta que demanda centro de saúde / Oral diseases related knowledge and practices of a population seeking care in a public health unit

Realizar educação em saúde, supondo os indivíduos "vazios" de conteúdo e ignorantes de saber, fez considerálos como meros "objetos" da prática educativa. Este trabalho tem por objetivo verificar o conhecimento da população sobre as principais doenças bucais e as práticas cotidianas dos usuários do serviço público municipalde saúde de Congonhas, Minas Gerais. Foram entrevistados 96 usuários que compareceram à primeira consulta odontológica da Policlínica do município. Para a coleta dos dados foi utilizado um questionário estruturado. O grupo entrevistado foi constituído principalmente por mulheres, da faixa etária entre 18 e 35 anos, que não possuem o 1o grau completo, assalariadas e com renda familiar mensal média na faixa de um atrês salários mínimos. Os problemas bucais mais conhecidos pela população estudada foram: cárie, doença periodontal e lesões de mucosa, respectivamente. Dentre os entrevistados 75,0% relataram ter cárie, cuja característica principal para 36,79% é a cavitação e para 43,40% alterações de cor na superfície dental. Além disso, a maioria cita o autocuidado como principal forma de se evitar a cárie e 58,33% dos entrevistados nãoa considera como uma doença infecto-contagiosa. Em relação à doença periodontal, 40,63% informaram que possuem sangramento gengival e a causa principal relatada é o traumatismo causado pela escovação, sendo que 15,69% diz fazer bochecho com água morna para paralisar o sangramento. Conclui-se que os usuários do serviço de odontologia da policlínica de Congonhas podem ser melhor informados sobre as características,progressão, transmissão e prevenção da cárie e doença periodontal.

The promotion of health education ignoring people´s knowledge makes them simple objects of the practice.This work aimed at identifying oral diseases related knowledge and practices among users of the public health system of the city of Congonhas, Minas Gerais. A total of 96 users were interviewed at the moment oftheir first appointment in the city's dental practice. Data collection was undertaken by means of a structured questionnaire. The study population was mainly composed by women, between 18 and 35 years of age, oflow educational level, with an income between 1 and 3 minimum wages. The oral health problems mostcommonly known by them were: dental caries, periodontal disease and oral mucosal lesions, respectively. Some 75% of those interviewed, reported having caries, which were described by 36.79% as cavities and by 43.4%as alterations in the color of dental surfaces. Most of the sample mentioned self-care as a way of avoiding thedisease and 58.33% did not mention dental caries as contagious. As for periodontal disease, 40.63% informed having gingival bleeding, mainly caused by toothbrushing, and 15.69% reported washing their mouth withwarm water to stop the bleeding. It was concluded that the users of the oral health service in the city of Congonhas should be better informed about the characteristics, progression, transmission and prevention of dental caries and periodontal disease.

A influência dos agentes mirins num programa de escola saudável / The influence of young agents on a healthy school program

Objetivo: Planejar, implementar e avaliar a estratégia de Escolas Promotoras de Saúde, com envolvimento de adolescentes em uma escola pública de Belo Horizonte. Material e Métodos: Participaram do projeto no ano de 2003, de 15 a 20 alunos de 12 a 14 anos (agentes mirins). Em oficinas semanais foram abordados os temas alimentação e higiene, com aporte teórico e atividades lúdicas, iniciando com o diagnóstico do conhecimento dos alunos sobre a correlação entre alimentação e saúde. As atividades planejadas nas oficinas consistiram de: implementação da horta escolar com o plantio de plantas medicinais, confecção de cartazes para as palestras realizadas pelos voluntários para a escola e comunidade, experimentação de verduras e outras. Resultados: Apesar das barreiras iniciais de aceitação do projeto no cotidiano da escola, foram obtidos resultados positivos: participação dos jovens nas etapas de planejamento do projeto até a efetivação das atividades, articulação entre os alunos mais velhos (agentes mirins) e os mais jovens, compreensão e absorção pelos jovens da estratégia da escola promotora de saúde e despertar gradual dos professores. Conclusão: Este estudo demonstrou ser possível a aplicação da estratégia das EPS em uma escola pública de Belo Horizonte que alcançou o envolvimento da comunidade escolar através da adoção da participação dos agentes mirins