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

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.

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

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.

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).

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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Odontologia baseada em evidência: etapas e métodos de uma revisão sistemática / Evidence-based dentistry: steps and methods of a systematic review

ciência baseada em evidência utiliza modelos de estudos epidemiológicos com a finalidade de aplicar o conhecimento científico nas decisões em saúde. O objetivo deste artigo foi descrever e discutir a OdontologiaBaseada em Evidência (OBE) e metodologia das revisões sistemáticas, destacando as etapas para a suarealização, como a formulação de estratégias de busca, definição de critérios de inclusão e exclusão, extração, análise e síntese dos dados, incluindo a meta-análise. A OBE é compreendida como uma abordagem para o serviço de saúde odontológico que requer integração da evidência científica com a experiência do profissional e as necessidades da população. Como contribuição, a OBE introduziu métodos que geram evidência de qualidade, ferramentas estatísticas utilizadas para sintetizar e analisar a evidência (revisões sistemáticas emeta-análise) e modos de acessar (bancos de dados eletrônicos) e aplicar a evidência (decisões em saúdebaseadas em evidências). Por fim, a abordagem baseada em evidência permite avaliar o conhecimento científicopor sua validade, impacto e aplicabilidade, eliminando a lacuna entre pesquisa e realidade dos serviços desaúde. É necessário que esforços continuem sendo empregados no sentido de estimular avanços qualitativosna pesquisa epidemiológica, fazendo com que a OBE alcance cada vez mais seu espaço concreto nos processosde planejamento e execução das ações em saúde.

Satisfação e percepção do usuário do SUS sobre o serviço público de saúde / Satisfaction and perception of SUS's users about public health care

A avaliação do grau de satisfação dos usuários do sistema de saúde é um importante indicador a ser considerado no planejamento das ações. O objetivo deste estudo foi avaliar o grau de satisfação de usuários dos serviços de saúde pública municipal quanto aos serviços utilizados. Este estudo tipo inquérito foi conduzido em cinco municípios do Estado de São Paulo. A amostra foi selecionada de forma estratificada e aleatória, sendo entrevistados 471 chefes de família ou respectivos cônjuges. Os dados qualitativos foram analisados pelo método de Análise de Conteúdo, e os dados quantitativos foram processados utilizando-se o software estatístico Epi Info. Dentre os usuários dos cinco municípios, 93,0 por cento utilizam o serviço municipal de saúde. Para 72,0 por cento, os serviços de saúde prestados estão resolvendo os problemas e necessidades da população. Com base no acesso ao atendimento, 57,6 por cento da população queixaram-se da presença de filas para o atendimento. Mais da metade (69,5 por cento) afirmou ter confiança na equipe de saúde; no entanto, muitos relatos demonstraram a carência de um atendimento humanizado. Em relação aos serviços de saúde, 61,7 por cento classificaram-os como ótimo ou bom. Conclui-se que a maior parte dos usuários mostrou-se satisfeita com os serviços de saúde municipais, apesar da grande quantidade de queixas quanto ao atendimento, falta de humanização e acolhimento, deficiência de recursos físicos e materiais. A percepção do usuário é de extrema importância ao se dimensionar o reflexo das ações que vem sendo desenvolvidas no setor saúde, e serve como vetor de direcionamento e planejamento do serviço.

The assessment of the degree of users' satisfaction with the health system is an important indicator to be considered in planning actions. The aim of this study was to evaluate the degree of satisfaction of users of health services and municipal services to be used. This survey was conducted in five municipalities of São Paulo. The sample was selected at random, stratified, and interviewed 471 heads of households or their spouses. Qualitative data were analyzed using content analysis and quantitative data were processed using the statistical software Epi Info. Among the users of the five municipalities, 93.0 percent attended the public health care. To 72.0 percent, health services are solving the problems and needs of the population. Based on access to care, 57.6 percent of the population complained about the presence of queues for care. More than half (69.5 percent) said they had confidence in the health team, however, many reports demonstrated the lack of a humanized care. In relation to health services, 61.7 percent rated them as excellent or good. We conclude that most users are satisfied with the municipal health services, despite the large amount of complaints regarding care, lack of humanization and welcoming, lack of facilities. The user's perception is of utmost importance when scaling the result of actions that have been developed in the health sector, and serves as a vector of direction and planning service.

Sexual harassment in Dentistry: prevalence in dental school

OBJECTIVE: Sexual harassment is unlawful in all work and educational environments in most nations of the world. The goals of this study were to describe the sexual harassment prevalence and to evaluate the experiences and attitudes of undergraduate students in one dental school in Brazil. MATERIAL AND METHODS: An 18-item questionnaire was administered to 254 dental students with a completion rate of 82 percent (208). Students were requested to respond to questions about their background and academic level in dental school, their personal experiences with sexual harassment and their observation of someone else being sexually harassed. Bivariate statistical analyses were performed. RESULTS: Fifteen percent of the students reported being sexually harassed by a patient, by a relative of a patient or by a professor. Male students had 3 times higher probability of being sexually harassed than female student [OR=2.910 (1.113-7.611)]. Additionally, 25.4 percent of the students reported witnessing sexual harassment at the school environment. The majority of students did not feel professionally prepared to respond to unwanted sexual behaviors. CONCLUSION: These findings demonstrate that sexual harassment can occur in a dental school setting. There is a need for ongoing sexual harassment education programs for students and university staff. Increased knowledge of sexual harassment during graduation can better prepare dental professionals to respond to sexual harassment during their practice.

Associação entre condição periodontal de gestantes e variáveis maternas e de assistência à saúde / Association between the periodontal condition of pregnant women and maternal variables and health assistance

Objetivo: Avaliar a condicao periodontal de gestantes e analisar a influencia de variaveis maternas socio-economico-demograficas, de saude, habitos deleterios e acesso ao servico odontologico e a existencia do Programa Saude da Familia (PSF) nos servicos publicos de atendimento a gestante. Metodo: Esta avaliacao faz parte de um estudo de coorte com gestantes e criancas desenvolvido em dois municipios do Estado de Sao Paulo, sendo um deles com PSF implantado. Foram realizados exames bucais utilizando os Indices Periodontal Comunitario e Perda de Insercao Periodontal e entrevistas semi-estruturadas com as gestantes em seus domicilios. As analises incluiram o Teste do Qui-quadrado e Teste Exato de Fisher, ao nivel de significancia de 5% (?=0.05). Resultados: Foram examinadas todas as gestantes (n=119) cadastradas no servico de saude de ambos municipios. A idade media foi 24,7 anos; 61,4% pertenciam a raca negra/parda, a maioria (65,5%) recebia entre 2-3 salarios minimos e somente 6,7% iniciaram o ensino superior. Apenas 8% das pacientes mostraram periodonto saudavel. Sangramento e calculo foram observados em 66% do total e bolsas periodontais rasas e profundas em 20%. Perda de insercao periodontal superior a 4mm foi verificada em 24% das gestantes. O grupo mostrou-se homogeneo quanto as caracteristicas maternas, sendo que a idade (p=0,0384) e habito de fumar (p=0,0102) foram os unicos fatores associados com a doenca periodontal. A existencia do PSF nao foi associada com uma menor prevalencia da doenca. Conclusao: Os achados deste estudo mostram uma alta prevalencia de alteracoes periodontais durante a gestacao, nao havendo influencia do PSF na condicao encontrada. Dentre as variaveis de risco, a idade e o fumo foram os fatores associados com a presenca da doenca periodontal. Ha necessidade de melhor planejamento e execucao das acoes em saude bucal durante o pre-natal.

Objective: To evaluate the periodontal condition of pregnant women and to analyze the influence of maternal variables - socioeconomic-demographic data, health, deleterious habits and access to dental service- and the existence of the Family Health Program (FHP) at the public assistance services to pregnant women. Method: This evaluation was part of a cohort study with pregnant women and children conducted in two cities of the Sao Paulo State, one of which with an implemented FHP. Oral examinations were done using the Community Periodontal and Periodontal Attachment Loss Indexes, and semi-structured interviews with the pregnant women at their homes. Data were analyzed statistically by the chi-square test and Fisher?s exact test at 5% significance level (?=0.05). Results: All pregnant women (n=119) registered at the public health service of each city were examined. The mean age was 24.7 years; 61.4% were black or black/white mixed-race women; most (65.5%) earned 2-3 minimum wages, and only 6.7% initiated higher education. Only 8% of the patients presented periodontal health. Bleeding and calculus were observed in 66% of them, and shallow and deep periodontal pockets in 20%. Periodontal attachment loss > 4 mm was observed in 24% of the pregnant women. The group was homogeneous as to the maternal characteristics, age (p=0.0384) and smoking (p=0.0102) being the only factors associated with periodontal disease. The existence of a FHP at the public assistance service was not associated with a lower prevalence of the disease. Conclusion: The findings of this study show a high prevalence of periodontal alterations during pregnancy, with no influence from the existence of a FHP on the observed conditions. Among the risk variables, age and smoking were the factors associated with the presence of periodontal disease. There is a need for a better planing and accomplishment of oral health actions during the prenatal period.

Sistema de Informação Pré-Natal: análise crítica de registros em um município paulista / Sistema de Información Prenatal: análisis critico de los registros en una ciudad del Estado de São Paulo / Prenatal Information System: critical analysis of register in a municipality of São Paulo State

A assistência pré-natal é um dos pilares nos cuidados em saúde. Este estudo objetivou realizar uma avaliação critica do SIS Pré-natal em um município paulista, comparar suas informações com a assistência local e verificar o cadastro das gestantes atendidas nos Estabelecimentos de Assistência à Saúde. Foram analisados os registros de gestantes por meio de consulta junto à Regional de Saúde e serviço de saúde municipal. Observaram-se incongruências entre o sistema e registro local. As falhas estavam relacionadas ao preenchimento inadequado das fichas de atendimento, além do controle escasso dos prontuários e agendamento nos estabelecimentos. Os resultados evidenciam a necessidade de um melhor planejamento das ações para a melhoria da qualidade do serviço pré-natal.

The prenatal assistance is one of the health care pillars. This study aimed to conduct a critical evaluation of the SIS Prenatal in a city of São Paulo State, to compare its data with the local assistance and to verify the registry of pregnant women attended at Health Care Centers. It was analyzed the pregnant women records through consultation at Health Regional Unit and municipal health service. There were inconsistencies between the system and local registry. The failures were related to the inadequate filling of attendance files, besides scarce control of pregnant women files and scheduling on health centers. The results suggest the need for better planning of actions for the improvement of prenatal service quality.

El cuidado prenatal es uno de los pilares del atención en salud. Este estudio tuvo como objetivo realizar una evaluación crítica del SIS prenatal en una ciudad paulista, comparar su información con asistencia local y comprobar la inscripción de mujeres embarazadas en los Establecimientos de Salud. Los registros del pacientes fueram analisados por consulta a Dirección Regional de Salud y servicios de salud locales. Se pudo notar inconsistencias entre sistema y registro local. Los fallos se referían a falta de llenado de las fichas de atención, además de la escasez de control del archivos de las pacientes y programación en los Establecimientos. Los resultados destacan la necesidad de una mejor planificación del acciones para mejorar la calidad delo servicio prenatal.

Práticas de ensino-aprendizagem com base em cenários reais / Teaching-learning practices based on real scenarios / Prácticas en la enseñanza-aprendizaje con base en escenarios reales

O processo ensino-pesquisa-extensão realizado com a imersão dos sujeitos em cenários reais possibilita a integração universidade-comunidade, ampliando a inserção social. O objetivo deste trabalho foi apresentar a experiência de um projeto conduzido em cinco municípios brasileiros, com a participação de docentes, pós-graduandos e acadêmicos, em parceria com prefeituras municipais e trabalhadores de saúde como cenário de ensino-pesquisa no SUS. Foram realizadas oficinas e cursos de capacitação com as equipes de saúde, gestores e conselheiros de saúde, visitas técnicas aos municípios para avaliação situacional e supervisão das atividades, avaliação da satisfação dos usuários e formação de lideranças populares. Observou-se a melhoria na organização dos serviços e estímulo ao fortalecimento do vínculo entre os usuários e prestadores de serviços. Essa experiência serviu como laboratório de aprendizagem e pesquisa, fazendo-se ciência a partir da vivência in loco da realidade do SUS e contribuindo para uma formação professional mais humanitária baseada em cenários reais.

The teaching-research-extension process carried out with immersion of subjects in real scenarios enables university-community integration, thereby increasing social insertion. The aim of this study was to present the experience from a project conducted in five Brazilian municipalities, with participation of teachers and postgraduate and undergraduate students, in partnership with municipal authorities and healthcare workers as a scenario for teaching-research within the Brazilian health system. Workshops and training courses were conducted among healthcare teams, managers and health counselors, and technical visits were made to the municipalities for situational assessments, activity supervision, user satisfaction evaluations and formation of popular leaderships. Improvements in service organization and stimulation of strengthened links between users and service providers were observed. This experience served as a learning and research laboratory: science was conducted from in situ experience of health system realities, thereby contributing towards better humanitarian professional training based on real scenarios.

El proceso enseñanza-investigación-extensión realizado con la inmersión de los sujetos en escenarios reales posibilita la integración universidad-comunidad ampliando la inserción social. El objetivo de este trabajo ha sido de presentar la experiencia de un proyecto conducido en cinco municipios brasileños con la participación de docentes, pos-graduandos y académicos con la cooperación de alcaldías y trabajadores de salud como escenario de enseñanza-investigación del Sistema Único de Salud. Se han realizado talleres y cursos de capacitación con los equipos de salud, gestores y consejeros de salud, visitas técnicas a los municipios para evaluación de situación y supervisión de actividades, evaluación de la satisfacción de los usuarios y formación de jefaturas populares. Se observa mejoría en la organización de los servicios y estímulo al fortalecimiento del vínculo entre los usuarios y los prestadores de servicios. Esta experiencia ha servido como laboratorio para aprendizaje y investigación, haciéndose ciencia a partir de la vivencia in loco de la realidad del Sistema Único de Salud y contribuyendo para una formación profesional más humanitaria basada en escenarios reales.

Periodontite materna e nascimento de bebes pré-termo ou de baixo peso: existe associação? / Maternal periodontitis and preterm low birth weight: is there an association?

A doença periodontal (DP) durante a gestação, em conjunto com outras variáveis sócio-economico demográficas e de assistência à saúde, tem sido citada como um importante fator de risco para o parto prematuro (PP) e recém-nascido de baixo peso (BP). O objetivo deste estudo foi avaliar a doença periodontal de gestantes e verificar a associação desta condição e do Programa Saúde da Família (PSF) com a prevalência de PP e BP. Trata-se de estudo de coorte conduzido em dois municípios brasileiros, sendo um deles com PSF implantado. Foram realizados exames bucais durante a gestação e acompanhamento das pacientes até nascimento da criança. Os resultados foram verificados por meio de análises estatísticas bivariadas (α=0,05). Foram examinadas todas as gestantes (n=119) cadastradas no serviços públicos de saúde de ambos os municípios. Doença periodontal, representada pela presença de bolsas rasas e profundas, foi observada em 20% das gestantes, enquanto a perda de inserção periodontal superior a 4 mm foi verificada em 23,5%. Crianças prematuras e de baixo peso foram observadas em 15,8% e 10,5% da população, respectivamente. Não foi encontrada associação estatística entre DP materna e PP (p=1,000) e BP (p=1,000). A ausência do PSF não foi associada com uma maior prevalência do PP (p=1,000) nem BP (p=0,394). Desse modo, a doença periodontal materna não foi considerada um fator de risco para o nascimento de bebês prematuros e com baixo peso na população avaliada, assim como a ausência do PSF não influenciou na ocorrência da prematuridade.

The periodontal disease (PD) during pregnancy, together with other socio-economic-demographic and health assistance variables, has been cited as an important risk factor for preterm (PT) and low birth weight (LBW). The aim of this study was to evaluate the periodontal disease of pregnant women and to verity the association of this condition and the Family Health Program (FHP) with the prevalence of PT and LBW. This is a cohort study carried out in two Brazilian cities, one of them with FHP in operation. Oral exams were conducted during pregnancy and patients were followed up until offspring birth. Results were verified through bivariate statistical analysis (α=0.05). All pregnant women (n=119) registered in the public health services of both cities were evaluated. Periodontal disease, represented by the presence of shallow and deep pocket, was observed in 20% of pregnant women, while periodontal attachment loss superior to 4 mm was reported in 23.5%. Premature and low birth weight babies were observed in 15.8% and 10.5% of population, respectively. It was not found statistical association between maternal PD and PT (p=1.000) and LBW (p=1.000). The absence of FHP was not associated to a higher prevalence of PT (p=1.000) nor LBW (p=0.394). Hence, the maternal periodontal disease was not considered a risk factor for preterm low birth weight in this population, as well as the absence of FHP did not influence the occurrence of prematurity.