Comparative analysis of dental trauma in contact and non-contact sports: A systematic review.

Dental traumas in sports are common and have physical, social, psychological, and economic impacts. The aim of this study was to determine, through a systematic review, the prevalence of dental trauma in contact and non-contact sports. This review was submitted to PROSPERO (CRD42023421206). Included studies addressed the prevalence of dental trauma in young athletes and adults above 18 years, excluding reviews, editorials, symposiums, or those evaluating athletes under 18 years. A literature search was conducted using the databases PubMed, Web of Science, Scopus, Embase, LIVIVO, SPORTDiscus, Dentistry & Oral Sciences Source (via EBSCO), and Lilacs and BBO, as well as gray literature. Bias risk was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist. Data were synthesized considering study characteristics, population, sport, and outcomes. R Statistics software was used for all meta-analyses. A total of 1707 articles were identified. After applying eligibility criteria, eight were selected. Three studies, not previously observed, were later added after reading four systematic reviews on a similar topic. Fourteen contact sports and five non-contact sports were analyzed. The prevalence of dental trauma was 11.38% in contact sports and 5.24% in non-contact sports. Regardless of the type of sport, athletes face risks of dental trauma, with contact sports showing higher prevalence. The use of mouthguards is essential across all contact and non-contact sports as a preventive measure.

Psychometric Properties of Food Frequency Questionnaires Used in Dentistry: A Systematic Review.

The objective of this systematic review was to analyze the quality of the food frequency instruments/scales used in dentistry while considering their psychometric properties. The databases consulted were PubMed (August 7, 2020), Scopus (August 27, 2020), Web of Science (August 27, 2020), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Dentistry and Oral Sciences Source (via EBSCO) (August 28, 2020), LILACS and BBO (August 25, 2020), gray literature: Proquest (October 1, 2020), Capes Theses Bank (October 1, 2020), Brazilian Digital Library of Theses and Dissertations (October 1, 2020), Google Scholar (October 2, 2020), and proceedings of the International Association for Dental Research (IADR) (October 10, 2020). All databases were updated on December 12, 2022. Articles were initially selected by reading the 6,421 titles and 13 abstracts selected, followed by reading the 8 articles included for full text reading to confirm the eligibility criteria, with the aid of Rayyan software. Databases of the construction and/or validation of instruments/scales for assessing food consumption for use in dentistry (in clinical contexts and/or epidemiological studies), with or without assessment of their psychometric properties, were included. Review studies, letters to editors, and research protocols were excluded. Risk of bias assessment was performed according to the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. The extracted data were author, country, instrument language, sample, assessment instrument, instrument structure, type of food, instruments compared with the clinical condition, adaptation of an existing instrument, and psychometric properties evaluated. The selection, risk of bias analysis, and data extraction processes were performed by two independent evaluators. Seven studies were identified. The instruments available in the literature were in English, Japanese, Creole, and Malay. Only one study performed translation and cross-cultural validation of an instrument, whereas the others were construction studies. One study did not assess psychometric properties. Regarding the quality assessment and general classification of the studies by the COSMIN checklist, all were considered "inadequate," with reliability (test-retest) being the most validated psychometric property; only one study carried out the validation of all psychometric properties measured in COSMIN. Regarding the quality of the instruments presented, all the studies were classified as "inadequate" in the general assessment. Advances are needed in the validation process.

Cross-cultural adaptation of the Dental Neglect Scale for five-year-old children in Brazil.

The aim of this study was to perform a cross-cultural adaptation of the Brazilian version of the Dental Neglect Scale (DNS). The process included (i) Translation; ii) Synthesis; iii) Back translation; (iv) Critical analysis by a committee of experts; (v) Pilot studies (n1=30 + n2=30); and (6) Evaluation and refinement of the instrument. The validated DNS presented a Content Validity Index (CVI) equal to 1.0 for the total score, as well as for each item. In the pilot studies, a minimum agreement level of 80% in understanding was achieved. DNS was properly adapted for Brazilian Portuguese, and it needs further study in a representative sample for reliability and construct validity assessment.

Quality of biosafety guidelines for dental clinical practice throughout the world in the early COVID-19 pandemic: a systematic review.

OBJECTIVES: To conduct a systematic review of coronavirus disease 2019 (COVID-19)-related biosafety guidelines for dental clinical practice in the early stage of the pandemic, focusing on quality assessment. METHODS: Electronic (via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, and Cochrane Library) and gray literature searches were performed for documents published up to May 12, 2020. Guidelines updated until April 17, 2021 were identified. Documents were included as guidelines if they (1) consisted of a set of statements, directions, or principles presenting current or future rules or policy; (2) were developed by government agencies, institutions, organizations, or expert panels; and (3) were related to the general conduct of healthcare activities rather a particular condition. Two researchers, using the Appraisal of Guidelines for Research & Evaluation II, independently extracted the recommendations and evaluated the quality of the guidelines. RESULTS: Twenty-seven documents from 19 countries were included in the review. These documents presented 122 recommendations related to (1) professional biosafety; (2) patients'/companions' safety; (3) the organization and biosafety of the physical dental facility environment; and (4) the work process in dental care. Overall, the scientific quality of the guidelines was considered low. Some recommendations presented in these guidelines would require further research to establish their effectiveness. CONCLUSIONS: We found a wide variety of biosafety guidelines for dental practice regarding COVID-19 in the early months of the pandemic, but their quality was low. Biosafety recommendations should be frequently updated.

Educational approaches for assessing knowledge about and actions of educators in response to dental avulsion.

BACKGROUND: Dental trauma affects especially schoolchildren and adolescents. Educators, the responsible for the first appointment, have a fundamental role in the prognosis of dental avulsion that occurred in this environment. AIM: To evaluate the educational approaches for assessing knowledge and actions in response to dental avulsion among educators. SETTINGS AND DESIGN: This cross-sectional and quanti-qualitative study included 197 teachers and 24 pedagogical coordinators (PCs), from the public schools of Pato Branco, Paraná, Brazil. METHODS: A questionnaire was initially administered regarding the knowledge about avulsion to all participants. Teachers just read a manual and answered the questionnaire after 30 days. PCs were divided into (n = 12): G1 - manual + fictitious scenario of avulsion and G2 - active methodology + fictitious scenario. The questionnaire was re-administered to all. STATISTICAL ANALYSIS: Quantitative data were analyzed statistically. For the qualitative stage, two questions were proposed and the Bardin's analysis was performed. RESULTS: For teachers, knowledge about avulsion increased after the intervention (P < 0.001), except as related to cleaning the tooth (P = 0.21). Activities involving G1 and G2 also led to an increase in knowledge, but no difference occurred in this increase between the approaches (P = 0.14). Qualitative analysis highlighted the need for calm and for performing actions that could favor a good prognosis in cases of avulsion. CONCLUSIONS: The level of knowledge increased after interventions, but no significant differences between the educational approaches were found.

Perfil do usuário e tempo de espera para tratamento endodôntico público em um município brasileiro / User profile and waiting time for public endodontic treatment in a Brazilian municipality / Perfil del usuario y tiempo de espera para tratamiento endodóncico público en un municipio brasileño

RESUMO Objetivo Avaliar o perfil do usuário e o tempo de espera para tratamento endodôntico no Centro de Especialidade Odontológicas (CEO) Positivo, localizado na cidade de Curitiba, PR. Brasil. Métodos Este estudo transversal utilizou dados primários de 77 pacientes que aguardavam na fila de espera para a especialidade de Endodontia, de março a de julho de 2017. Os dados coletados foram: tempo de espera, gênero, idade, dentes referenciados e quantidade de encaminhamentos por Unidade de Saúde do serviço público. Resultados O tempo médio de espera foi de aproximadamente 11 meses. Do total, 56% eram do gênero feminino, com média de idade de 35,5 anos. Os dentes mais referenciados foram os póstero-inferiores. Conclusão O tempo na fila de espera é considerado longo, o que requer maior diálogo com a atenção básica para a formulação de estratégias voltadas à redução dos agravos bucais e à maior capacitação profissional para diagnóstico e condução dos casos.

ABSTRACT Objective To evaluate the user's profile and waiting time for endodontic treatment at the Center of Dental Specialties (CDS) Positivo, located in the city of Curitiba, PR. Brazil. Methods This is a cross-sectional study using primary data from 77 patients queue specialty of Endodontics, from March to July 2017. Data collected were: waiting time, sex, age, referenced teeth and number of referrals per Public Service Health Unit. Results The mean waiting time was approximately 11 months. Of the total, 56% were female, with a mean age of 35.5 years. The most referenced teeth were the lower posterior. Conclusion Waiting time in queue is considered long, which requires a greater dialogue with the primary attention for the formulation of strategies aimed at the reduction of the oral diseases and the greater professional capacity for the diagnosis and the conduction of the cases.

RESUMEN Objetivo Evaluar el perfil de usuario y el tiempo de espera para tratamiento endodóncico en el Centro de Especialidad Odontológica (CEO) Positivo, localizado en la ciudad de Curitiba, PR. Brasil. Métodos Este estudio transversal utilizó datos primarios de 77 pacientes en lista de espera para la especialidad de Endodoncia, de marzo a julio de 2017. Los datos recolectados fueron: tiempo de espera, género, edad, dientes referenciados y cantidad de encaminamientos por Unidad de Salud del Servicio Público. Resultados El tiempo promedio de espera fue de aproximadamente 11 meses. Del total, 56% eran del género femenino, con promedio de edad de 35,5 años. Los dientes más referenciados fueron los postero-inferiores. Conclusión El tiempo en la lista de espera es considerado largo, lo que requiere mayor diálogo con la atención básica para la formulación de estrategias dirigidas de reducción de las enfermedades bucales y la mayor capacitación profesional para diagnóstico y conducción de los casos.

Methods for prevention of early childhood caries: Overview of systematic reviews.

Early childhood caries (ECC) is a global problem, disproportionately affecting disadvantaged populations. The aim of this study was to evaluate systematically the available scientific evidence on the effectiveness of methods for ECC prevention. Six electronic databases were searched. Two independent reviewers selected the publications and analysed the quality of the included systematic reviews. Thirteen studies were included. Overall, eight reviews were classified with methodological quality critically low using the AMSTAR 2, whereas five reviews achieved a high risk of bias using the ROBIS tool. The methods identified that were positively related to the prevention of ECC were as follows: preventive dental programmes for pregnant women; advice on diet and feeding; prenatal oral health care; integration of maternal and children's oral health promotion into nursing practice; maternal oral health programmes undertaken by non-dental health professionals; dental health education in combination with the use of fluoride for children; early preventive dental visits; and the use of fluoride varnish and toothpastes with more than 1000 ppm of fluoride. The currently available evidence supporting the effectiveness of methods for prevention of ECC, although suggesting some methods of greater potential, is still lacking due to the methodological quality of the systematic reviews and the included primary studies.

Cross-cultural adaptation of the Dental Neglect Scale for five-year-old children in Brazil

Abstract The aim of this study was to perform a cross-cultural adaptation of the Brazilian version of the Dental Neglect Scale (DNS). The process included (i) Translation; ii) Synthesis; iii) Back translation; (iv) Critical analysis by a committee of experts; (v) Pilot studies (n1=30 + n2=30); and (6) Evaluation and refinement of the instrument. The validated DNS presented a Content Validity Index (CVI) equal to 1.0 for the total score, as well as for each item. In the pilot studies, a minimum agreement level of 80% in understanding was achieved. DNS was properly adapted for Brazilian Portuguese, and it needs further study in a representative sample for reliability and construct validity assessment.

Association between Pulp Stones and Kidney Stones: A Systematic Review and Meta-analysis.

INTRODUCTION: A systematic review and meta-analysis were performed to evaluate the association between pulp stones and kidney stones. METHODS: A search for observational studies was performed in PubMed, Scopus, Web of Science, Biblioteca Virtual em Saúde, and the gray literature. The Newcastle-Ottawa Scale for Risk of Bias criteria were used to evaluate the internal quality of the included studies. A fixed-effects meta-analysis was performed to evaluate the association between the conditions. RESULTS: A total of 213 studies were identified after the removal of duplicates. Of these, 9 studies were selected after screening the titles and abstracts. Finally, after full-text reading for qualitative analysis, 7 studies were selected, and of these, 2 were used in the meta-analysis. A significant association was found between pulp stones and kidney stones (1.97 [95% confidence interval, 1.21-3.18]; P < .05). CONCLUSIONS: This study revealed an association between pulp stones and kidney stones. Further well-designed studies should be conducted in order to confirm whether pulp stones are predictive indicators of undiagnosed kidney stones.

Barriers and facilitators to dental care during pregnancy: a systematic review and meta-synthesis of qualitative studies.

Some barriers to dental treatment during pregnancy are poorly understood, especially those related to psychosocial factors, which are better explored in qualitative studies. The aim of this systematic review was to explore the barriers and facilitators to dental care during pregnancy through a thematic synthesis of qualitative studies. Qualitative or mixed-methods studies published in English, Portuguese, Spanish and French, from 2000 to 2016, were included. The search strategies were conducted in PubMed, Scopus, Web of Science, LILACS, BBO and CINAHL. To evaluate the quality of the studies, we used the Critical Appraisal Skills Programme tool. Thematic synthesis was performed in order to interpret and summarize the results. From 2,581 screened studies, ten were included in the synthesis. We found 14 analytical themes related to barriers and facilitators to dental care during pregnancy that interacted in complex ways: physiological conditions, low importance of oral health, negative stigma regarding dentistry, fear of/anxiety toward dental treatment, mobility and safety, financial barriers, employment, time constraints, social support, lack of information, health professionals' barriers, family and friends' advice, beliefs and myths about the safety of dental treatment. Myths and beliefs about oral health and dental treatment during pregnancy appear to be the most frequent barriers, both to pregnant women and to dentists or other health professionals. The findings of this review may support new studies, especially to test intervention protocols and to guide effective public policies for the promotion of oral health during pregnancy.

Atenção à saúde da criança na estratégia em saúde da família / Children's health care in the family health strategy

Avaliação é uma ferramenta que se insere no processo de gestão interna de melhoria contínua das ações e práticas da atenção à saúde da criança, visando atingir níveis de qualidade em sintonia com as demandas sociais e os avanços técnicos científicos em saúde. Objetivo: avaliar o Programa de Atenção à Saúde da Criança de duas Unidades Saúde da Família de Colombo-PR, com base no Protocolo Municipal de Saúde da Criança: Nascer Colombo. Metodologia: trata-se de um estudo de caráter descritivo e analítico exploratório. Os dados foram coletados nas Unidades de Saúde Jardim das Graças e Fátima, com Estratégia em Saúde da Família. Para a coleta de dados foram analisadas as Fichas de Acompanhamento da Criança. Foram avaliados os seguintes critérios: adesão ao programa, monitoramento de crescimento e desenvolvimento, vacinação, suplementação de ferro, atendimento odontológico e sua conclusão e a avaliação de risco. Resultados: apenas 43% e 52% das crianças da Unidade Jardim das Graças e Fátima aderiram ao Programa de Atenção à Saúde da Criança, respectivamente. A taxa de imunização foi maior de 90% para as duas unidades. A proporção de suplementação de ferro ficou entre 17 e 24% nas duas unidades. 64,1% do total das crianças foram ao dentista, sendo que destas, mais de 90% concluíram o tratamento. Observou- se deficiência no registro das informações. Conclusão: alguns valores encontrados estavam abaixo do esperado. Para melhorar o programa haverá a necessidade de que as equipes trabalhem em conformidade com o Protocolo Municipal de Saúde da Criança.

Evaluation is a tool that fits into the internal management process for continuous improvement of the actions and practices of children's health care in order to reach quality levels in line with the social demands and the scientific technical advances in health. Objective: this study evaluated the Children's Health Care Program of two Family Health Units in Colombo, PR, based on the Municipal Children's Health Protocol: Nascer Colombo. Methodology: this is a descriptive and exploratory analytical study. Data were collected at the Jardim das Graças and Fátima Health Units, with the Family Health Strategy. For data collection, Child Health Monitoring Records were analyzed. The following criteria were evaluated: program adherence, growth and development monitoring, vaccination, iron supplementation, dental care, and risk assessment. Results: only 43% and 52% of the children of the Jardim das Graças and Fátima units participated in the Children's Health Care Program, respectively. The immunization rate was greater than 90% for both units. The proportion of iron supplementation was between 17 and 24% in both units. Fully 64.1% of the children went to the dentist, and of these, more than 90% completed the treatment. There was observable deficiency in the recording of information. Conclusion: some values found were lower than expected. To improve the program the teams will have to work in accordance with the Municipal Children's Health Protocol.

Determinants of Dental Care Attendance during Pregnancy: A Systematic Review.

Despite the fact that dental care attendance during pregnancy has been recommended by guidelines and institutions, the demand for dental services is still low among pregnant women. The aim of this study was to identify and analyze the determinants of dental care attendance during pregnancy. We performed a systematic literature search in the electronic databases PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature, Brazilian Library in Dentistry, Cumulative Index to Nursing and Allied Health Literature, and Medline using relevant keywords. Studies were filtered by publication year (2000-2016) and language (English, Portuguese, Spanish, and French). The included studies were assessed for quality. Their characteristics and statistically significant factors were reported. Fourteen papers were included in the review. The prevalence of dental service usage during pregnancy ranged from 16 to 83%. Demographic factors included women's age, marital status, parity, and nationality. The socioeconomic factors were income, educational level, and type of health insurance. Many psychological and behavioral factors played a role, including oral health practices, oral health and pregnancy beliefs, and health care maintenance. Referred symptoms of gingivitis, dental pain, or dental problems were perceived need. Demographic, socioeconomic, psychological, behavioral factors and perceived need were associated with the utilization of dental services during pregnancy. More well-designed studies with reliable outcomes are required to confirm the framework described in this review.

Barriers and facilitators to dental care during pregnancy: a systematic review and meta-synthesis of qualitative studies / Barreiras e facilitadores para os cuidados de saúde bucal durante a gravidez: uma revisão sistemática e meta-síntese de estudos qualitativos / Barreras y facilitadores para el cuidado dental durante el embarazo: una revisión sistemática y metasíntesis de estudios cualitativos

Some barriers to dental treatment during pregnancy are poorly understood, especially those related to psychosocial factors, which are better explored in qualitative studies. The aim of this systematic review was to explore the barriers and facilitators to dental care during pregnancy through a thematic synthesis of qualitative studies. Qualitative or mixed-methods studies published in English, Portuguese, Spanish and French, from 2000 to 2016, were included. The search strategies were conducted in PubMed, Scopus, Web of Science, LILACS, BBO and CINAHL. To evaluate the quality of the studies, we used the Critical Appraisal Skills Programme tool. Thematic synthesis was performed in order to interpret and summarize the results. From 2,581 screened studies, ten were included in the synthesis. We found 14 analytical themes related to barriers and facilitators to dental care during pregnancy that interacted in complex ways: physiological conditions, low importance of oral health, negative stigma regarding dentistry, fear of/anxiety toward dental treatment, mobility and safety, financial barriers, employment, time constraints, social support, lack of information, health professionals' barriers, family and friends' advice, beliefs and myths about the safety of dental treatment. Myths and beliefs about oral health and dental treatment during pregnancy appear to be the most frequent barriers, both to pregnant women and to dentists or other health professionals. The findings of this review may support new studies, especially to test intervention protocols and to guide effective public policies for the promotion of oral health during pregnancy.

Algumas barreiras aos cuidados de saúde bucal durante a gravidez são mal compreendidas, principalmente aquelas relacionadas a fatores psicossociais, que são exploradas melhor com estudos qualitativos. Esta revisão sistemática teve como objetivo explorar as barreiras e facilitadores dos cuidados odontológicos durante a gravidez, através de uma síntese temática de estudos qualitativos. Foram incluídos estudos qualitativos ou de métodos mistos, publicados em inglês, português, espanhol ou francês entre 2000 e 2016. As buscas foram realizadas nas bases PubMed, Scopus, Web of Science, LILACS, BBO e CINAHL. Para avaliar a qualidade dos estudos, usamos a ferramenta Critical Appraisal Skills Programme. A síntese temática teve como objetivo interpretar e resumir os resultados. Entre os 2.581 estudos identificados, dez foram incluídos na síntese. Encontramos 14 temas analíticos relacionados a barreiras e facilitadores dos cuidados odontológicos na gravidez, e que interagiram de maneira complexa: condições fisiológicas, baixa importância atribuída à saúde oral, estigma negativo em relação à odontologia, medo ou ansiedade frente ao tratamento dentário, mobilidade e segurança, barreiras financeiras, emprego, limitações de tempo, apoio social, falta de informação, barreiras produzidas pelo profissional de saúde e conselhos de amigos e familiares, além de crenças e mitos sobre a segurança do tratamento dentário. Os mitos e crenças sobre a saúde oral e o tratamento dentário durante a gravidez parecem ser as barreiras mais importantes, tanto para as gestantes quanto para os odontólogos e outros profissionais de saúde. Os achados da revisão podem apoiar novos estudos, principalmente para testar protocolos de intervenção e orientar políticas públicas efetivas para a promoção da saúde oral durante a gravidez.

Algunas barreras al tratamiento dental durante el embarazo no se han entendido adecuadamente, especialmente aquellas relacionadas con factores psicosociales, que están mejor examinados en estudios cualitativos. El objetivo de esta revisión sistemática fue examinar las barreras y facilitadores para el cuidado dental durante el embarazo, a través de una síntesis temática de estudios cualitativos. Se incluyeron métodos cualitativos, o estudios de métodos mixtos, publicados en inglés, portugués, español y francés, desde el 2000 al 2016. La búsqueda de estrategias se realizó en PubMed, Scopus, Web of Science, LILACS, BBO y CINAHL. Con el fin de evaluar la calidad de los estudios, usamos la herramienta Critical Appraisal Skills Programme. Se realizó la síntesis temática para interpretar y resumir los resultados. De los 2.581 estudios seleccionados, diez fueron incluidos en la síntesis. Encontramos 14 temas analíticos, relacionados con barreras y facilitadores para la atención dental durante el embarazo, que interactuaron de forma compleja: condiciones fisiológicas, baja importancia de la salud oral, estigma negativo referente a la odontología, miedo/ ansiedad al tratamiento dental, movilidad y seguridad, barreras financieras, empleo, restricciones de tiempo, apoyo social, falta de información, barreras a la salud profesional, consejo de familia y amigos, creencias y mitos sobre la seguridad del tratamiento dental. Mitos y creencias sobre la salud oral y el tratamiento dental durante el embarazo parecen ser las barreras más frecuentes, tanto en el caso de las mujeres embarazadas, como en el caso de dentistas y otros profesionales de salud. Los hallazgos de esta revisión tal vez susciten nuevos estudios, especialmente para probar protocolos de intervención y guiar políticas públicas efectivas, orientadas a la promoción de la salud oral durante el embarazo.

Assessing the role of appropriate primary health care on the use of dental services by Brazilian low-income preschool children.

This cross-sectional study aimed to assess the association between the quality of primary health care (PHC) and the use of dental services by preschoolers served by the Family Health Strategy (FHS), controlling for socio-demographic determinants and perceived need. The sample encompassed 438 children aged 3-5 years, enrolled in 19 FHS facilities in Ponta Grossa, Paraná State, Brazil. Individual level variables were collected by interviewing parents or caregivers at home. They answered a questionnaire on socioeconomic conditions, oral hygiene habits and use of dental services. Parental perception of child's oral health related quality of life, as perceived need, was assessed by the Brazilian version of Early Childhood Oral Health Impact Scale (ECOHIS). Normative need was assessed by oral examinations, according to guidelines standardized by the World Health Organization. The contextual level factor was defined as the extent of implementation of PHC in the facilities. Managers responded to PCATool-Brazil, a validated questionnaire which measures the extent of PHC. Dentists answered to a version of PCATool, which was adapted and pretested for dental services. Multilevel analysis, based on Andersen's behavioral model, fitted the adjustment of "having ever consulted a dentist" to contextual and individual covariates. We observed high prevalence of dental caries. Almost half of the sample had had dental appointments in life. Social gradients were observed for the use of dental services. Although it was not able to eliminate the impact of adverse social conditions, higher levels of PHC attributes in dental services favored the effective use of such services by low-income children.

Assessing the role of appropriate primary health care on the use of dental services by Brazilian low-income preschool children / Avaliação do papel da atenção primária adequada no uso de serviços de saúde bucal por pré-escolares brasileiros de baixa renda / Evaluación del papel de la atención primaria apropiada en el uso de los servicios de salud bucal por parte de preescolares brasileños de baja renta

Abstract: This cross-sectional study aimed to assess the association between the quality of primary health care (PHC) and the use of dental services by preschoolers served by the Family Health Strategy (FHS), controlling for socio-demographic determinants and perceived need. The sample encompassed 438 children aged 3-5 years, enrolled in 19 FHS facilities in Ponta Grossa, Paraná State, Brazil. Individual level variables were collected by interviewing parents or caregivers at home. They answered a questionnaire on socioeconomic conditions, oral hygiene habits and use of dental services. Parental perception of child's oral health related quality of life, as perceived need, was assessed by the Brazilian version of Early Childhood Oral Health Impact Scale (ECOHIS). Normative need was assessed by oral examinations, according to guidelines standardized by the World Health Organization. The contextual level factor was defined as the extent of implementation of PHC in the facilities. Managers responded to PCATool-Brazil, a validated questionnaire which measures the extent of PHC. Dentists answered to a version of PCATool, which was adapted and pretested for dental services. Multilevel analysis, based on Andersen's behavioral model, fitted the adjustment of "having ever consulted a dentist" to contextual and individual covariates. We observed high prevalence of dental caries. Almost half of the sample had had dental appointments in life. Social gradients were observed for the use of dental services. Although it was not able to eliminate the impact of adverse social conditions, higher levels of PHC attributes in dental services favored the effective use of such services by low-income children.

Resumo: Este estudo transversal procurou avaliar a associação entre a qualidade da atenção primária em saúde e o uso de serviços de saúde bucal por pré-escolares atendidos pela Estratégia Saúde da Família (ESF), ajustada por determinantes sócio-demográficos e necessidade percebida. A amostra compreendia 438 crianças entre 3 e 5 anos de idade, cadastradas em 19 serviços da ESF em Ponta Grossa, Paraná, Brasil. As variáveis de nível individual foram coletadas através de entrevistas domiciliares com os pais ou responsáveis, que responderam um questionário sobre condições socioeconômicas, hábitos de higiene bucal e uso de serviços odontológicos. A percepção dos pais sobre a qualidade de vida do filho relacionada à saúde bucal, ou necessidade percebida, foi avaliada com a versão brasileira da Early Childhood Oral Health Impact Scale (ECOHIS). A necessidade normativa foi avaliada pelo exame bucal, de acordo com as diretrizes padronizadas pela Organização Mundial da Saúde. O fator de nível contextual foi definido como o grau de implementação da atenção primária em saúde pelas unidades de saúde. Os coordenadores responderam o PCATool-Brasil, um questionário validado que mede o grau de atenção primária em saúde. Os cirurgiões-dentistas responderam uma versão do PCATool, adaptada e pré-testada em serviços odontológicos. A análise multinível, baseada no modelo comportamental de Andersen, ajustou a variável de "ter consultado um dentista alguma vez na vida" às covariáveis contextuais e individuais. O estudo mostrou alta prevalência de cárie dentária. Quase a metade da amostra tinha história de consulta odontológica alguma vez na vida. Observamos gradientes sociais no uso de serviços de saúde bucal. Embora não tenha conseguido eliminar o impacto das condições sociais adversas, níveis maiores de atributos de atenção primária em saúde em serviços de saúde bucal favoreceram o uso efetivo desses serviços por crianças de famílias de baixa renda.

Resumen: Este estudio transversal tuvo como objetivo evaluar la asociación entre la calidad de la atención primaria en salud y el uso de servicios de salud bucal por parte de los preescolares, atendidos por el esquema Estrategia Salud de la Familia (ESF), ajustado por determinantes sociodemográficos y necesidad percibida. La muestra comprendía a 438 niños entre 3 y 5 años de edad, registrados en 19 servicios de la ESF en Ponta Grossa, Paraná, Brasil. Las variables de nivel individual se recogieron a través de entrevistas domiciliarias con los padres o responsables, que respondieron un cuestionario sobre condiciones socioeconómicas, hábitos de higiene bucal y uso de servicios odontológicos. La percepción de los padres sobre la calidad de vida del hijo, relacionada con la salud bucal, o necesidad percibida, fue evaluada con la versión brasileña de la Early Childhood Oral Health Impact Scale (ECOHIS). La necesidad normativa se evaluó mediante el examen bucal, de acuerdo con las directrices estandarizadas por la Organización Mundial de la Salud. El factor de nivel contextual se definió como el grado de implementación de la atención primaria en salud en las unidades de salud. Los gestores respondieron el PCATool-Brasil, un cuestionario validado que mide el grado de asistencia primaria a la salud. Los odontólogos respondieron una versión del PCATool, adaptada y pre-testeada en servicios odontológicos. El análisis multinivel, basado en el modelo comportamental de Andersen, ajustó la variable de "haber consultado a un dentista alguna vez en la vida" a las co-variables contextuales e individuales. El estudio mostró una alta prevalencia de caries dental. Casi la mitad de la muestra tenía un historial de consulta odontológica alguna vez en la vida. Observamos gradientes sociales en el uso de servicios de salud bucal. A pesar de que no se haya conseguido eliminar el impacto de las condiciones sociales adversas, unos mayores niveles de atribuciones a la atención primaria en salud en servicios de salud bucal favorecieron el uso efectivo de esos servicios por parte de hijos de familias de baja renta.

Organização da atenção na saúde bucal em um município da região metropolitana de Curitiba: percepção do usuário / Organization of oral health care in a city in the Curitiba metropolitan area: user perception

Objetivo: O objetivo deste estudo foi avaliar a organização da atenção em saúde bucal nas Unidades de Saúde da Família (USF) com Equipes de Saúde Bucal (ESB), em relação ao acesso e à resolubilidade no município de Colombo-PR, na percepção do usuário. Material e Métodos: Estudo de abordagem quantitativa, aplicou-se em forma de entrevista um questionário semiestruturado e adaptado aos 136 usuários das USF com ESB. A análise estatística foi descritiva, com o auxílio do programa Excel e BioEstat 5.3, realizando o teste do Qui-quadrado (p<0,05). Resultados: Entre os entrevistados, 51,5% nunca foram ao cirurgião-dentista na USF, sendo que a maioria destes procura o atendimento privado. Já entre aqueles que procuraram atendimento no serviço público, 74,7% frequentaram há menos de um ano a USF, destes 27,3% conseguiram atendimento por agendamento semanal e 37,9% pelo agendamento mensal. Dos usuários que procuraram o atendimento, 56,1% foram atendidos no mesmo dia. Somente 27,3% necessitaram de encaminhamento ao serviço especializado e 50% dos usuários concluíram seu tratamento. Não houve relação estatisticamente significante entre a opinião sobre o acesso em relação ao sexo, renda ou escolaridade. Conclusão: A dificuldade no acesso e a própria limitação dos serviços ofertados no setor público faz com que muitos usuários procurem atendimento privado. A porta de entrada na USF continua a demanda espontânea. Apesar da resolubilidade da atenção primária, houve apenas conclusão parcial dos casos atendidos. Ainda persistem entraves na organização do serviço no município.

Objective: The aim of this study was to evaluate, from a user perspective, the organization of oral health care in Family Health Units (FHUs) with Oral Health Teams (OHTs), regarding access and resolution capacity, in the city of Colombo, PR. Methods: This quantitative study, in interview form, applied a semi-structured questionnaire adapted to the 136 users at the FHUs with OHTs. The statistical analysis was descriptive, with the help of the Excel program and BioEstat 5.3, performing the chisquare test (p <0.05). Results: Among the respondents, 51.5% had never gone to the dentist at the FHU, with most having opted for private care. While among those who sought care at the public service, 74.7% were attended at the FHU within the past year, and of these 27.3% received care on a weekly schedule and 37.9% on a monthly schedule. Among the users who sought care, 56.1% were attended on the same day. Only 27.3% required referral to specialized services and 50% of the users completed their treatment. There was no statistically significant relationship between the opinion about access and gender, income, or education. Conclusion: The difficulty of access and the actual limited services offered in the public sector makes many users search for a substitute for public services. The gateway to the FHU continues to be spontaneous demand. Despite the resolution capacity of primary care, there was only partial completion of the cases treated. Barriers in the organization of the service persist in this city.

O uso da aprendizagem baseada em problemas na Odontologia: uma revisão crítica da literatura / Problem-Based Learning in Dentistry: a critical literature review

A sociedade contemporânea impõe desafios constantes aos setores da saúde e da educação, alicerçada em revisões e reformulações permanentes para formação de recursos humanos. Este artigo promove uma revisão crítica da literatura a respeito da aprendizagem baseada em problemas (Problem Based Learnig - PBL) direcionada ao ensino da Odontologia. As bases de dados consultadas foram Medline (via EBSCO), SCIELO, BBO e LILACS (via BVS). As palavras-chave foram definidas baseadas em artigos previamente selecionados. Esta metodologia se apresenta como uma alternativa para formação e educação em Odontologia. É considerada uma ferramenta de trabalho para professores que buscam desenvolver em seus alunos capacidades cognitivas promotoras do desenvolvimento do raciocínio clínico integrado, com perfil direcionado à educação permanente (AU).

Contemporary society imposes constant challenges in the areas of health and education, founded on permanent revisions and redesigns for training. This article promotes a critical review of the literature on problem-based learning (PBL) directed to the teaching of Dentistry. Data bases consulted were Medline (via EBSCO), SCIELO, BBO and LILACS (BVS). The keywords have been defined based on previously selected articles. The PBL is presented as an alternative methodology for training and education in Dentistry. It isconsidered a working tool for teachers seeking to develop in their students cognitive skills promoting the development of integrated clinical reasoning with the continuing education directed profile (AU).

Impact of prenatal protein-calorie malnutrition on the odontogenesis of wistar rats / Impacto da desnutrição protéico-calórica pré-natal sobre a odontogênese de ratos wistar

Objetivo: Este trabalho teve por objetivo determinar alterações na odontogênese decorrentes da desnutrição protéico-calórica pré e pós-natal. Foram selecionados 12 ratos Wistar adultos, 8 fêmeas e 4 machos. As fêmeas foram divididas em dois grupos, sendo que um deles recebeu dieta normoprotéica (G1) e o outro recebeu dieta hipoprotéica (G2). Material e Métodos: Após o nascimento das ninhadas, foram separados aleatoriamente 24 filhotes de cada grupo. Os animais foram sacrificados, 12 aos 5 dias de vida e 12 aos 8, e suas mandíbulas submetidas à preparação histológica para a obtenção de cortes dos germes dentários. Foram selecionadas 48 lâminas que apresentavam os germes adequadamente cortados (24 de cada grupo), as quais foram analisadas em microscópio e medidas por um examinador calibrado utilizando-se o software Image Pro Plus for Windows, versão 6.0. As diferenças entre as médias foram verificadas mediante o teste não paramétrico de Mann Whitney. Resultados: Os resultados obtidos demonstram que, aos 5 dias, as diferenças de espessura de esmalte e dentina foram estatisticamente significantes entre G1 (84,08 ± 28,9 e 141,51 ± 33,2; p = 0,026) e G2 (47,26 ± 43,8 e 91,19 ± 54,7; p = 0,006). Aos 8 dias de vida não foram identificadas diferenças significativas entre os grupos. Conclusão: Os resultados demonstraram indícios de impacto da desnutrição sobre a espessura dos tecidos dentários. Sugere-se o aprofundamento desta linha de investigação com delineamentos mais complexos.

Objective: This study aimed to determine changes in odontogenesis arising from prenatal and postnatal protein-calorie malnutrition. Material and Methods: Twelve adult Wistar rats were selected; 8 females and 4 males. The females were divided into two groups, one of which received a normoproteic diet (NG) and the other received a hypoproteic diet (HG). After the birth of the litters, 24 pups were randomly separated from each group. The animals were sacrificed, 12 at five-days old and 12 at eight-days old, and their jaws were subjected to histological preparation to obtain cuts of tooth germs. Forty-eight slides were selected that presented the germs properly cut (24 from each group), which were analyzed by microscopy and measured by a calibrated examiner. The differences between means were verified by the nonparametric Mann-Whitney test. Results: The results showed that at 5 days the differences in thickness of enamel and dentin were statistically significant between NG (84.08 ± 28.9 and 141.51 ± 33.2; p = 0.026) and HG (47.26 ± 43.8 and 91.19 ± 54.7; p = 0.006). At 8 days of life there were no significant differences between the groups. Conclusion: The results showed evidence of the impact of malnutrition on the thickness of dental tissues. It is suggested that further work should be carried out in this line of research with more complex designs.

A ética em pesquisa com seres humanos pelas lentes do cinema / Ethics in clinical research through movies

O avanço científico que vem ocorrendo no Brasil elevou a necessitada de discussão sobre ética em pesquisa envolvendo seres humanos dentro das instituições de ensino superior. Para isso, a associação entre a arte persuasiva do cinema e a ética em pesquisa tem sido uma metodologia eficaz no que diz respeito ao processo de ensino-aprendizagem de alunos de graduação e pós-graduação. Assim, o objetivo deste projeto de extensão foi promover a discussão e o conhecimento sobre a ética em pesquisa envolvendo seres humanos com graduandos, pós-graduandos, professores e servidores públicos da Universidade Estadual de Ponta Grossa. Os resultados mostraram a efetividade do método, concluindo que os filmes contribuíram satisfatoriamente para o aprendizado e posicionamento ético de todos os participantes (AU).

The scientific advance that has occurred in Brazil increases the need to discuss ethics in human research within universities and research institutes. With this in mind, the association between the persuasive art of cinema and ethics research has been an effective methodology regarding the teaching and learning of undergraduate and graduate students. The aim of this extramural education project was to promote the discussion and understanding of ethics in human clinical research among undergraduate and graduate students, professors and public servants at Ponta Grossa State University. The results showed the effectiveness of this method. In conclusion, movies can contribute satisfactorily to the ethical learning and positioning of all participants (AU).