Salivary factors associated with noncarious cervical lesions: A systematic review.

OBJECTIVE: This study aimed to carry out a systematic review of observational studies searching the association between salivary factors (amount and quality of saliva) and noncarious cervical lesions (NCCL) in individuals with permanent dentition. DESIGN: Cross-sectional, case-control, and cohort studies performed in humans with permanent dentition (population) and considering noncarious cervical lesions (outcome) in association with salivary characteristics (exposure) were included. PubMed, Web of Science, Cochrane, LILACS/BBO, Scopus, Embase, IBCT, NICE, OpenGrey, and Google Scholar were searched, with no language or date restrictions. Of 6561 potentially eligible studies, 142 were selected for full-text analysis. Three reviewers independently selected the studies, performed data extraction, and quality analysis through the Newcastle-Ottawa Scale. RESULTS: Finally, ten references were included in the review, four case-control and six cross-sectional studies. Several salivary parameters were evaluated. Some parameters were considered associated with the presence of noncarious cervical lesions: salivary buffering capacity, salivary pH, citric acid, and calcium and potassium levels. The methodological quality varied across studies, with high heterogeneity among them. CONCLUSIONS: Some associations between saliva and NCCL suggesting protective factors and others risk factors were found. However, the evidence is sparse and comes from a few studies with great heterogeneity. New scientific evidence, with standardized methods, should be encouraged. Understanding salivary parameters that influence the occurrence of NCCL is important to guide dentists in relation to etiological factors that could potentially be neglected. The results may help in the development of new and early diagnostic methods and treatments for noncarious cervical lesions.

Compliance Analysis of the Dental Care Service Provided to Pregnant Women in Primary Health Care

ABSTRACT Objective: To analyze oral health services for pregnant women in the primary health care of a Brazilian metropolis, based on the performance of dentists who integrate these services. Material and Methods: Exploratory, descriptive and cross-sectional study was conducted through qualitative and quantitative approaches. A semi-structured questionnaire was used for data collection. This study was conducted in a Brazilian metropolis and included all dentists working in primary health care. The compliance analysis was performed considering access, adherence, group activity and individual dental care dimensions. Open questions were analyzed using the content analysis method and the closed questions were performed using frequency estimates. Bivariate statistics (Chi-square, Fisher's Exact Test, α<0.05) were analyzed through STATA. Results: 260 dentists agreed to participate in this study. Strategies to facilitate the scheduling of pregnant women to dental treatment occur in 93.9% of oral health teams, the main one being the scheduling and/or referral performed by the family health team. In terms of access and adherence to treatment, all variables in these dimensions showed relevant compliance results. The group activity dimension presented moderate compliance percentages, whereas individual care obtained high results, except for referral to radiography. Conclusion: The oral health service was compliant regarding access and adherence to treatment, but showed limitations in individual care and collective activities. Recommendations include improving oral health team coverage and permanent education programs.

A scoping review about LGBTQIAP+ people in oral health research.

Oral health personnel must acknowledge the health needs of sexual and gender minorities. They should consult scientific literature to deepen their knowledge about sexuality, gender identity, general and oral health status, and treatment disparities among LGBTQIA+ people. The aim of this scoping review was to portray the development and current stage of internationally indexed literature approaching the oral health of this population. In this study, the search strategy used consisted of combinations of subject descriptors (MeSH terms), in two concept blocks: LGBTQIAP+ people and oral health. Global literature was searched through Medline (PUBMED), Web of Science, Embase, Lilacs, and Scopus electronic databases, with no language or date restrictions. Records were selected and evaluated by two independent reviewers, under the supervision of three senior reviewers and the inclusion criteria resulted in 189 eligible papers. Since the first study was published in 1974, numbers increased over the decades, reaching 67 (35.4%) in 2010-2019. The most frequently studied populations were North American (42.9%) and European (19.0%) and the most frequent language of publication was English (99.0%). There were 38 open access papers (20.1%). Medical (57.7%) and dental journals (20.1%) predominated. Cross-sectional studies were found more frequently (65.1%), followed by the cohort type (11.1%). Oral manifestation of STI (58.7%) was the topic most frequently addressed. The search for literature approaching the oral health of LGBTQIAP+ people showed evidence of the need to encourage research reported in papers made easily available, with more robust scientific evidence, and on a broader scope of topics, including oral health needs and treatment, and planning of oral health services.

A scoping review about LGBTQIAP+ people in oral health research

Abstract Oral health personnel must acknowledge the health needs of sexual and gender minorities. They should consult scientific literature to deepen their knowledge about sexuality, gender identity, general and oral health status, and treatment disparities among LGBTQIA+ people. The aim of this scoping review was to portray the development and current stage of internationally indexed literature approaching the oral health of this population. In this study, the search strategy used consisted of combinations of subject descriptors (MeSH terms), in two concept blocks: LGBTQIAP+ people and oral health. Global literature was searched through Medline (PUBMED), Web of Science, Embase, Lilacs, and Scopus electronic databases, with no language or date restrictions. Records were selected and evaluated by two independent reviewers, under the supervision of three senior reviewers and the inclusion criteria resulted in 189 eligible papers. Since the first study was published in 1974, numbers increased over the decades, reaching 67 (35.4%) in 2010-2019. The most frequently studied populations were North American (42.9%) and European (19.0%) and the most frequent language of publication was English (99.0%). There were 38 open access papers (20.1%). Medical (57.7%) and dental journals (20.1%) predominated. Cross-sectional studies were found more frequently (65.1%), followed by the cohort type (11.1%). Oral manifestation of STI (58.7%) was the topic most frequently addressed. The search for literature approaching the oral health of LGBTQIAP+ people showed evidence of the need to encourage research reported in papers made easily available, with more robust scientific evidence, and on a broader scope of topics, including oral health needs and treatment, and planning of oral health services.

Mother's education and family relations protect children from dental caries experience: a salutogenic approach.

The objective of this study was to identify dental caries-protective factors among 5-year-old children using the salutogenic theory. A cross-sectional study was conducted in a small-sized municipality in the Southeast region of Brazil, with a representative sample of 247 children registered in preschool and their respective mothers. The data were collected through questionnaires administered to the mothers about the socioeconomic, behavioral, and biological aspects of the mother and children. Additionally, the collections included validated instruments concerning psychosocial aspects, such as a sense of coherence, resilience, family cohesion and religiosity, and intraoral examinations of the children through the decayed-missing-filled primary teeth (dmft) index. All examinations were performed by a trained and calibrated examiner. The non-adjusted and adjusted odds ratios (OR) and their respective confidence intervals (CI) were estimated using multiple logistic regression with a hierarchical model. Among the examined children, 41.7% were caries-free. In the final model, the chances of the absence of dental caries experience (dmft = 0) were greater in children with mothers who had higher education levels (> 8 years of study) (OR = 2.55 [95%CIi:1.42-4.59]) and those who lived in an environment of high family cohesion (OR = 3.66 [95%CI: 1.19-11.29]). The results indicated that mothers' level of education and family relationships are protective factors against dental caries in 5-year-old children, which overlapped with behavioral and biological factors.

Role of management and human resource factors on matrix support in secondary oral health care in Brazil.

OBJECTIVES: To investigate the association between health management and human resource factors on matrix support (MS) in a nationally representative sample of Dental Specialty Centres (DSCs) in Brazil. METHODS: This survey included 1042 DSCs (Response rate = 94.99%) in the second cycle of the National Program for the Improvement of the Quality and Access to the Dental Specialty Centres (PMAQ-CEO, in Portuguese) in 2018. Previously trained interviewers extracted information on MS, health management and human resources of the DSC by using a structured instrument. An MS score was created by adding the number of positive answers to the 10 MS questions. Negative binomial regression models were used to estimate the unadjusted and adjusted rate ratios (RR) and corresponding 95% confidence interval (CI). RESULTS: Of all the DSCs (n = 1042), 116 (11.1%) performed all 10 MS procedures. Those DSCs with a manager who had a higher education degree in the area of Public Health or Public Management (RR = 1.01, 95% CI, 1.01-1.02) and with human resources that received incentives, bonuses or financial awards for performance related to the PMAQ-CEO result (RR = 1.01 95% CI 1.01-1.02) are more likely to perform MS, when compared to the reference categories. The DSCs that are more likely to perform MS include those that developed actions as a result of periodic planning and evaluation with confirmatory documentation (RR = 1.06, 95% CI; 1.01-1.10); those that received support for planning and organizing the work scheme (RR = 1.03, 95% CI; 1.01-1.05); those that monitored and analysed the goals set for each specialty offered at the DSC, with (RR = 1.06, 95% CI; 1.01-1.10) or without confirmatory documentation (RR = 1.06, 95%CI; 1.02-1.11); those whose team periodically performed self-assessment processes, using the Ministry of Health's formal self-assessment (AMAQ in Portuguese) (RR = 1.04, 95% CI; 1.02-1.05); those who followed clinical guidelines (with confirmatory documentation) regarding the referral of patients from primary care to the DSC (RR = 1.02, 95% CI; 1.01-1.04). On the contrary, DSCs that did not use the results achieved in previous PMAQ cycles in the organization of the DSC's team work scheme proved to be less likely to perform MS (RR = 0.98, 95% CI; 0.96-0.99). CONCLUSIONS: Matrix support is associated with human resources and management factors in secondary oral health care in Brazil. Continuing professional development and some management characteristics are important for secondary dental care quality and could be considered in health policy initiatives.

Contextual and local determinants associated with the achievement of goals in the endodontics specialty in Brazilian dental speciality centres: A multilevel analysis.

OBJECTIVES: To assess which factors were associated with the achievement of endodontic goals. METHODS: Cross-sectional study using secondary data from the second cycle of the Program for the Improvement of Access and Quality in the dental speciality centres-in Portuguese PMAQ-CEO. The independent variables extracted from this database were related to dental speciality centres (CEO in Portuguese). In addition, variables referring to the CEO host city were incorporated into the model. The outcome variable was the number of endodontic goals achieved calculated from the production of the CEO available in the Ambulatory Health Information System in 2018. Descriptive analyses and multilevel Poisson regression were performed with the software SPSS 23.0 and STATA 14.0. RESULTS: CEOs with more than 20% of patients' absenteeism were 26% less likely to reach the goals of the endodontics specialty; CEOs with availability of endodontists for more than 40 hours a week were two times more likely to reach the goals than those with less than 40 hours in endodontics specialty. CEOs with a waiting time for endodontic procedures greater than 45 days achieved a number of goals 31% lower than those with a waiting time up to 45 days. CEO type I and CEO type II showed 2.10 and 1.20 higher likelihood to reach the number of goals of the endodontics specialty than CEO type III. The number of endodontic instruments in sufficient number was positively associated with the achievement of goals. CEOs located in municipalities that reached more than 5% in the supervised brushing indicator had 2.26 greater likelihood to achieve the goals than those that did not reach this percentage. CONCLUSION: Contextual and local determinants are associated with the achievement of goals in the endodontic specialty in the dental speciality centres in Brazil.

Mother's education and family relations protect children from dental caries experience: a salutogenic approach

Abstract The objective of this study was to identify dental caries-protective factors among 5-year-old children using the salutogenic theory. A cross-sectional study was conducted in a small-sized municipality in the Southeast region of Brazil, with a representative sample of 247 children registered in preschool and their respective mothers. The data were collected through questionnaires administered to the mothers about the socioeconomic, behavioral, and biological aspects of the mother and children. Additionally, the collections included validated instruments concerning psychosocial aspects, such as a sense of coherence, resilience, family cohesion and religiosity, and intraoral examinations of the children through the decayed-missing-filled primary teeth (dmft) index. All examinations were performed by a trained and calibrated examiner. The non-adjusted and adjusted odds ratios (OR) and their respective confidence intervals (CI) were estimated using multiple logistic regression with a hierarchical model. Among the examined children, 41.7% were caries-free. In the final model, the chances of the absence of dental caries experience (dmft = 0) were greater in children with mothers who had higher education levels (> 8 years of study) (OR = 2.55 [95%CIi:1.42-4.59]) and those who lived in an environment of high family cohesion (OR = 3.66 [95%CI: 1.19-11.29]). The results indicated that mothers' level of education and family relationships are protective factors against dental caries in 5-year-old children, which overlapped with behavioral and biological factors.

Systematic Review on the Use of Homeopathy in Dentistry: Critical Analysis of Clinical Trials.

Objectives: The objective of this research was to systematically map the literature on homeopathy and dentistry studies and to evaluate the effectiveness of using homeopathy in dental practice through the critical analysis of clinical studies. Design: The search for scientific articles in any language, year, and place of publication was made in the databases of Public Medline (PUBMED), Web of Science, Cochrane, and Virtual Health Library; the articles selected were later classified according to the type of study. Gray literature was accessed through Google Scholar. Clinical trials were analyzed for methodological quality. Two previously trained reviewers accomplished the entire process independently. Results: Of the 281 studies retrieved by means of the search, 44 met the eligibility criteria, with prevalence of literature reviews (56.8%), followed by clinical trials (34.1%), cross-sectional studies (6.8%), laboratory research (6.8%), and longitudinal observational studies (4.5%). The clinical trials identified were published from 1965 to 2019, using homeopathy in several dental specialties: in Endodontics, Periodontics, Orofacial Pain, Surgery, Pediatric Dentistry, and Stomatology, as well as in cases of dental anxiety. Qualitative failures, in all criteria investigated, and positive influences of the individual prescriptions on the results of treatments reported were observed. Conclusions: There is still a scarcity of studies about homeopathy and dentistry. The clinical trials selected showed positive effects on oral health; however, when they were critically evaluated, it was possible to recognize qualitative failures, mainly relative to double-blinding. It is necessary to encourage research on the subject, using standardized methodological procedures, to obtain better evaluation of the clinical applicability.

Revisões integrativas: conceitos, planejamento e execução / Integrative reviews: concepts, planning, and execution

Objetivo: Fornecer um guia no formato de checklist para auxiliar pesquisadores na condução de revisões integrativas em Odontologia. Métodos:O guiapara revisões integrativas em Odontologiafoi construído a partir do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (The PRISMA Statement). Resultados:Para o delineamento de revisões integrativas em Odontologia é preciso percorrer etapas distintas: 1. Identificação do tema (elaboração da pergunta de pesquisa); 2. Estabelecimento dos critérios de elegibilidade de estudos; 3. Busca sistematizada em diversas fontes de informação; 4. Coleta de dados; 5. Análise dos dados; 6. Discussão; 7. Apresentação da revisão/síntese do conhecimento. Os erros mais comuns ao realizar uma revisão integrativa estão relacionados à descrição incompleta ou não realização de etapas importantes, tais como: 1. Processo de seleção das evidências; 2. Estratégia de busca reprodutível; 3. Detalhes relacionados à busca, seleção e inclusão de estudos; 4. Aplicação dos critérios de elegibilidade; 5. Processo de extração dos dados (definição clara dos dados a serem extraídos, número de revisores envolvidos); 6. Apresentação do processo de seleção de estudos no formato de fluxograma; 7. Avaliação da qualidade dos estudos; 8. Síntese dos resultados. Conclusão:O guia para revisões integrativas em Odontologia apresenta utilidade na redução de equívocos metodológicos frequentemente observados nesse desenho de estudo, bem como estimula a condução de trabalhos com delineamentos robustos.

Aim: To provide a checklist to assist researchers in conducting integrative reviews in Dentistry. Methods: This guideline for integrative reviews in Dentistry was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (The PRISMA Statement). Results: Planning integrative reviews in Dentistry involves different stages: 1. Identification of the theme (elaboration of the research question); 2. Establishment of eligibility criteria; 3. Systematized search in several databases and other data sources; 4. Data collection; 5. Data analysis; 6. Discussion; 7. Report on the review/summary of findings. The most common errors when conducting an integrative review are related to incomplete description or failure to perform important steps, such as: 1. Evidence synthesis; 2. A reproducible search strategy; 3. Details related to studies' search, screening, selection; 4. Clear state eligibility criteria; 5. Data extraction process (clear definition of the data to be extracted, number of reviewers involved); 6. Presentation studies' screening and selection process in a flowchart format; 7. Evaluation of the quality of the studies; 8. Summary of the findings. Conclusion:A guideline for integrative reviews in Dentistry intends to reduce methodological issues frequently observed in this study design, as well as to encourage researchers to conduct studies with a robust design.

The effect of caries increment on oral health-related quality of life among adolescents in Brazil: a 3-year longitudinal study.

This study aimed to assess the effect of caries increment on Oral Health-related Quality of Life (OHRQoL) of Brazilian adolescents and to evaluate the responsiveness of the Child Perceptions Questionnaire (CPQ11-14) in this group. A population-based sample of 515 Brazilian 12-year-olds from a large city located in the southeast of Brazil was evaluated according to a random multistage sampling design at baseline and 291 at three years follow-up, using the DMFT index and the CPQ11-14 instrument. To evaluate the responsiveness to change, the measures of effect size and longitudinal construct validity were used. It was verified that OHRQoL among adolescents with DMFT increment across the three years worsened significantly (p<0.05) in relation to their counterparts. The effect size varied from small to moderate. The longitudinal construct validity of CPQ11-14 was satisfactory. Caries increment impacted on OHRQoL of adolescents in Brazil. The CPQ11-14 instrument demonstrated acceptable responsiveness properties.

The effect of caries increment on oral health-related quality of life among adolescents in Brazil: a 3-year longitudinal study

Abstract This study aimed to assess the effect of caries increment on Oral Health-related Quality of Life (OHRQoL) of Brazilian adolescents and to evaluate the responsiveness of the Child Perceptions Questionnaire (CPQ11-14) in this group. A population-based sample of 515 Brazilian 12-year-olds from a large city located in the southeast of Brazil was evaluated according to a random multistage sampling design at baseline and 291 at three years follow-up, using the DMFT index and the CPQ11-14 instrument. To evaluate the responsiveness to change, the measures of effect size and longitudinal construct validity were used. It was verified that OHRQoL among adolescents with DMFT increment across the three years worsened significantly (p<0.05) in relation to their counterparts. The effect size varied from small to moderate. The longitudinal construct validity of CPQ11-14 was satisfactory. Caries increment impacted on OHRQoL of adolescents in Brazil. The CPQ11-14 instrument demonstrated acceptable responsiveness properties.

Factors associated with the inclusion of oral health technicians into the public health service in Brazil.

BACKGROUND: The number of oral health technicians (OHT) in the public health service in Brazil is lower than the number of training school graduates. Thus, the objective of this study was to investigate possible factors associated with the inclusion of OHT in the public health service in Minas Gerais, Brazil, and its implications on oral health indicators. METHODS: This cross-sectional ecological study used a database (Excel) composed of 122 municipalities that participated in an OHT training course that took place between 2012 and 2013. Municipal contextual variables, including oral health indicators and sociodemographic indicators, related to the organization of health services were incorporated before and after the course. The dependent variable was the entry of graduates into the public health service according to a self-report survey conducted in 2015. A descriptive analysis of the variables was carried out, followed by bivariate analyses between the independent variables and the dependent variable using Pearson's chi-square test. The independent variables selected for multivariate logistic regression were statistically significant at p <  0.20. In the final model, significant effects were identified for variables with p <  0.05. The statistical software SPSS 18.0 for Windows was used. RESULTS: After the course, the variable of the public service organization and the two variables of oral health indicators were associated with the outcome. The organization services variable "presence of oral health team modality II" and the variable "indicator of coverage of first dental programmatic consultation" presented an association tendency with the entry of OHT in the multivariate logistic regression model, but these associations were not statistically significant because they had significance levels of p = 0.075 and p = 0.191, respectively. The variable "collective action indicator supervised dental brushing" was associated with the entry of egress (p = 0.045) remaining in the final model. CONCLUSION: The model of organization of the oral health service formed through the implementation of modality II oral health teams positively influenced the inclusion of OHT in the public health service in Minas Gerais, with improvement in the oral health indicators of the municipalities.

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).

Viability of Bovine Teeth as a Substrate in Bond Strength Tests: A Systematic Review and Meta-analysis.

PURPOSE: To assess whether bovine teeth can be used as viable alternatives for human teeth in tensile and shear bond strength testing. MATERIALS AND METHODS: Articles were selected from Web of Science, PubMed, Scopus, LILACS-Bireme, and BBO electronic databases using keywords obtained from Medical Subject Headings (MeSH). Of 1540 potentially eligible studies, 157 were selected for full text analysis. Five independent reviewers (Kappa = 0.89) selected the studies, abstracted information, and assessed quality based on standardized scales. After the analysis, 78 studies comparing bovine teeth to human teeth were found. Only 18 studies comparing bovine and human substrates in bond strength tests were included in the systematic review and 13 in the meta-analysis. Two authors independently selected the studies, extracted the data and assessed the risk of bias. Mean differences were obtained by comparing tensile and shear bond strengths between human and bovine teeth (permanent and deciduous) and considering enamel and dentin separately (subgroup analysis). Statistical analysis was performed using RevMan5.1, with a random-effect model, at a 5% significance level. RESULTS: No significant difference was found between human and bovine teeth in tensile tests (p = 0.41) for dentin (p = 0.86), but there was a difference for enamel (p = 0.01). Regarding shear bond strength, no significant difference was found between human and bovine teeth (p = 0.16) either for enamel (p = 0.07) or dentin (p = 0.68). Regarding shear bond strength on deciduous teeth, no significant difference was found between human and bovine substrates (p = 0.54), either for enamel (p = 0.42) or dentin (p = 0.05). Most studies were at high (low or unclear) risk of bias. CONCLUSIONS: In shear bond strength testing, bovine teeth can be a suitable alternative for permanent and deciduous human teeth, for both enamel and dentin substrates. However, they may not be suitable for enamel tensile bond strength testing. The findings are based on low quality studies (considerable heterogeneity) and should be interpreted with caution.

Tratamento odontológico durante a gestação: conhecimentos e percepções de estudantes de Odontologia / Dental care during pregnancy: knowledge and perceptions among Dentistry students

O tratamento odontológico durante a gestação envolve mitos e incertezas, perpetuados pelo medo dos profissionais em atender gestantes. Poucos cursos de odontologia no Brasil possuem algum tipo de disciplina, projeto, programa ou ação que proporcione a capacitação do graduando para o cuidado dessa paciente. O objetivo deste trabalho foi avaliar o conhecimento dos acadêmicos de um curso de graduação em Odontologia sobre o atendimento odontológico à gestante e conhecer as necessidades desse grupo quanto ao aprendizado desse tema. Foi aplicado um questionário semiestruturado a todos os alunos matriculados no segundo semestre de 2016 na Faculdade de Odontologia da Universidade Federal de Minas Gerais. O questionário abordou questões como conhecimentos e expectativas sobre o atendimento odontológico à gestante. Os resultados foram analisados pela técnica de Análise de Conteúdo, e calculadas estimativas de prevalência. Dentre os 303 alunos que responderam ao questionário, apenas 14% atenderam gestantes durante a graduação. Somente 43% dos estudantes consideraram-se preparados para atender gestante, e 62% relataram ter recebido alguma orientação sobre o pré-natal odontológico durante a graduação, não existindo um conteúdo formal associado a alguma disciplina. Quanto à técnica, os principais problemas encontrados referiram-se ao desconhecimento sobre o uso de medicamentos, anestésicos e procedimentos permitidos. Em conclusão, os estudantes apresentaram deficiências no conhecimento sobre o atendimento odontológico à gestante, e demonstraram interesse em melhorar seu aprendizado nessa área. O ensino da graduação não está preparando adequadamente os alunos para o pré-natal odontológico, reforçando o ciclo de medos e adágios que envolvem esse cuidado (AU).

Dental treatment during pregnancy is surrounded by myths and uncertainties, perpetuated by the fear of treating pregnant women. Few dental schools in Brazil include some disciplines, projects, programs, or actions that prepare undergraduate students for providing dental care to pregnant women. The aim of this study was to assess the knowledge of undergraduate dental students about the dental care of pregnant women and the needs of these students to learn about this topic. A semistructured questionnaire was applied to all students enrolled for the second semester of 2016 at the Dental School of Universidade Federal de Minas Gerais. The questionnaire contained questions about knowledge and expectations of dental treatment of pregnant women. The results were evaluated by content analysis and prevalence estimates were calculated. Among the 303 students who answered the questionnaire, only 14% attended to pregnant women during their undergraduate course. Only 43% of the students thought they were prepared to treat pregnant women and 62% reported having been given some guidelines on prenatal dental care during their undergraduate studies, with no formal syllabus dealt with in any discipline. Regarding technical qualification, the major problems were lack of knowledge about the use of medications, anesthetics, and procedures. In conclusion, students lacked knowledge about dental treatment of pregnant women, but they showed interest in improving their learning in this field. Undergraduate courses do not properly qualify students for prenatal dental care, strengthening the fears and aphorisms surrounding this healthcare service (AU).

Clinical Analysis of Management Aspects of Centers for Dental Specialties

Objective: To evaluate the different management aspects of Centers for Dental Specialties (CEO) in Brazil. Material and Methods: Quantitative study with analysis of secondary data. The results of external evaluation of the first PMAQ-CEO cycle were considered, especially those related to planning and self-assessment, demand organization, work process, human resources as well as the availability of supplies/materials/dental equipment. The selected data were analyzed based on the calculation of proportions using the Microsoft Office Excel and Statistical Package for the Social Sciences (SPSS) programs. Results: The planning of actions in CEOs is conducted in nearly 80% of units, with the participation of dental surgeons, receiving support, mainly, from the local dental health or state public manager. The access to CEO is given, mostly, in a referenced or mixed (referenced and spontaneous) form. Only 49% of CEOs offer permanent education actions for workers. The work management process has been guided by quality standards of PMAQ-CEO for 77% of managers. Conclusion: The study allowed perceiving the presence of an often shared management, on the CEO organization, on self-evaluation process, planning, demand organization and work process, as well as human resources and infrastructure, showing conformity with the Oral Health National Policy guidelines. However, the results show that some problems with regard to the evaluation as work routine and management of access to CEOs still persist, pointing to the need for further studies and effort of managers to overcome them.

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.

Avaliação do impacto da informação de técnicos em saúde bucal na rede pública de saúde no Estado de Minas Gerais / Evaluation of the impact of training oral health technicians in the public health network in the state of Minas Gerais

O objetivo deste projeto foi avaliar o impacto da formação de técnicos em saúde bucal (TSB) na rede pública de atenção à saúde em Minas Gerais/MG. Participaram deste estudo 194 egressos (taxa de resposta=81%). O curso de TSB é ofertado pela escola formadora do SUS do Estado de MG, que compõem a Rede de Escolas Técnicas do Sistema Único de Saúde (RetSUS), está organizado em módulos, na perspectiva do currículo integrado, e contempla todas as regiões ampliadas de saúde do Estado. De forma geral, a sua avaliação foi satisfatória, fazendo-se uma ressalva para as atividades práticas, que precisam ser revistas. Após a conclusão do curso, a inserção do egresso no mercado profissional, como TSB, foi muito pequena. Apenas 11% atuam como TSB, sendo que a maioria continua trabalhando como ASB (68%). Dentre as dificuldades encontradas para a sua inserção está a ausência de criação de cargos de TSB pelas prefeituras municipais. Apesar disso, os poucos egressos que ocupam o cargo de TSB estão inseridos nas equipes de saúde bucal da Estratégia Saúde da Família, conseguindo exercer as suas atribuições, em sua maioria, e consideram-se fundamentais para a melhoria dos serviços de saúde bucal.

Recurrent aphthous stomatitis and Helicobacter pylori

BACKGROUND: Recurrent aphthous stomatitis (RAS) is a recurrent painful ulcerative disorder that commonly affects the oral mucosa. Local and systemic factors such as trauma, food sensitivity, nutritional deficiencies, systemic conditions, immunological disorders and genetic polymorphisms are associated with the development of the disease. Helicobacter pylori (H. pylori) is a gram-negative, microaerophile bacteria, that colonizes the gastric mucosa and it was previously suggested to be involved in RAS development. In the present paper we reviewed all previous studies that investigated the association between RAS and H. pylori. MATERIAL AND METHODS: A search in Pubmed (MEDLINE) databases was made of articles published up until July 2015 using the following keywords: Helicobacter Pylori or H. pylori and RAS or Recurrent aphthous stomatitis. RESULTS: Fifteen experimental studies that addressed the relationship between infection with H. pylori and the presence of RAS and three reviews, including a systematic review and a meta-analysis were included in this review. The studies reviewed used different methods to assess this relationship, including PCR, nested PCR, culture, ELISA and urea breath test. A large variation in the number of patients included in each study, as well as inclusion criteria and laboratorial methods was observed. H. pylori can be detected in the oral mucosa or ulcerated lesion of some patients with RAS. The quality of the all studies included in this review was assessed using levels of evidence based on the University of Oxford's Center for Evidence Based Medicine Criteria. CONCLUSIONS: Although the eradication of the infection may affect the clinical course of the oral lesions by undetermined mechanisms, RAS ulcers are not associated with the presence of the bacteria in the oral cavity and there is no evidence that H. pylori infection drives RAS development

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