Exclusive breastfeeding intention among pregnant women and associated variables: a cross-sectional study in a Brazilian community / Intenção de amamentar entre gestantes e variáveis associadas: estudo transversal em uma comunidade brasileira

ABSTRACT Objective: To investigate exclusive breastfeeding (EBF) intention and associated variables among women in the third trimester of pregnancy. Methods: The data were collected with a questionnaire for the pregnant women (n=653), from December/2018 to November/2019. They answered the Infant Feeding Intentions (IFI) scale, translated and adapted to Brazilian Portuguese, and a questionnaire on sociodemographic, biological, family, pregnancy, breastfeeding, health care, and habits variables. Descriptive statistics and multiple logistic regression analyses were performed with a 5% significance level, following a multilevel hierarchical model that estimated the association between the dependent and independent variables. The outcome EBF intention measured by the IFI score was dichotomized by the median (<16 or =16). Results: Mean±standard deviation score for the IFI scale was 14.4±2.6 (score 0: very strong intention to not breastfeed at all; score 16: very strong EBF intention up to six months). The results from the regression analysis showed that pregnant women who had no intention to bottle feed (OR=4.33; 95%CI 2.79-6.72) or did not know (OR=1.85; 95%CI 1.21-2.82), those who planned the pregnancy (OR=1.52; 95%CI 1.09-2.12), those who believed they would have help to care for the baby (OR=3.60; 95%CI 1.51-8.56) or did not know (OR=3.97; 95%CI 1.26-12.51), and those who reported knowing the World Health Organization recommendations on breastfeeding (OR=1.73; 95%CI 1.13-2.64) were more likely to show a very strong EBF intention. Conclusions: Pregnant women in the third trimester of pregnancy presented a strong EBF intention. The higher EBF intention score was significantly associated with the structural, setting, and individual determinants.

RESUMO Objetivo: Investigar a intenção materna de amamentar exclusivamente (IMA) e variáveis associadas entre as mulheres no terceiro trimestre de gravidez. Métodos: A coleta de dados foi realizada por meio de entrevista e questionário semiestruturado e autoadministrado, entre dezembro/2018 e novembro/2019. As gestantes (n=653) responderam à escala Infant Feeding Intentions (IFI) testada, traduzida e adaptada para o português do Brasil e ao questionário contendo perguntas sobre variáveis sociodemográficas, biológicas e familiares, bem como relacionadas à gestação, ao aleitamento materno, à assistência à saúde e a hábitos. Foram realizadas análises estatísticas descritivas e de regressão logística múltipla hierarquizada, com nível de significância de 5%, para estimar a associação entre as variáveis independentes e o desfecho. A IMA, medida pela escala IFI, foi dicotomizada pela mediana (<16 ou =16). Resultados: A pontuação média±desvio padrão para a escala IFI foi de 14,4±2,6. Os resultados da análise de regressão mostraram que as gestantes que não tinham intenção de oferecer mamadeira (OR=4,33; IC95% 2,79-6,72) ou não sabiam (OR=1,85; IC95% 1,21-2,82), que planejaram a gestação (OR=1,52; IC95% 1,09-2,12), aquelas que acreditavam que teriam ajuda nos cuidados com o bebê (OR=3,60; IC95% 1,51-8,56) ou que não sabiam (OR=3,97; IC95% 1,26-12,51), bem como aquelas que relataram conhecer as recomendações da Organização Mundial de Saúde sobre amamentação (OR=1,73; IC95% 1.13-2.64) tinham mais chances de mostrar uma IMA muito forte. Conclusões: As gestantes no terceiro trimestre de gestação apresentaram forte IMA. A maior IMA esteve significativamente associada aos determinantes estruturais, contextuais e individuais.

Evidence-practice gap in treatment decisions about defective composite and amalgam restorations among Brazilian dentists

Better understanding of dentists' decision-making about defective restorations is needed to close the evidence-practice gap (EPG). This study aimed to quantify the EPG about defective restorations and identify dentist factors associated with this EPG. Methods: 216 dentists from São Paulo State, Brazil, completed a questionnaire about three clinical case scenarios involving defective composite restorations with cementum-dentin margins (case 1) and enamel margins (case 2), and an amalgam (case 3) restoration. Dentists were asked what treatment, if any, they would recommend, including preventive treatment, polishing, re-surfacing, or repairing the restoration, or replacing the entire restoration. Replacing the entire restoration in any of these three scenarios was classified as inconsistent with the evidence, comprising an EPG. Bivariate analyses using Chi-square, ANOVA, or multiple comparison tests were performed (p<.05). Results: for defective composite restorations, 49% and 55% of dentists chose to replace the entire restoration for cases 1 and 2, respectively. Twenty-nine percent of dentists chose to replace the entire amalgam restoration. Dentists were significantly more likely to choose to replace the defective amalgam restoration than the composite restoration with a defect at the cementum-dentin margins or the enamel margins (both at p < .001). Female dentists were more likely to choose a conservative treatment than male dentists for cases 1 (p=.034) and 2 (p=.009). Dentists with a higher percentage of patients interested in individualized caries prevention were also more conservative in case 1 (p=.045). Conclusion: a substantial EPG regarding treatment decisions for defective restorations exists, especially for composite restorations. This study adds to the international evidence that an EPG exists in this clinical area and that global strategies need to be developed to close the gap

Association between Pacifier Use, Bottle-Feeding, and Pre-Postnatal Variables: A Cohort Study

ABSTRACT Objective: To determine the prevalence and analyze the variables associated with the use of pacifiers and/or bottles by infants up to 6 months of age. Material and Methods: Data on sociodemographic characteristics, intention to offer pacifier and bottle-feeding, pregnancy and breastfeeding (BF) variables were collected at baseline by interviews and a self-administered questionnaire among pregnant women in the 3rd trimester. After delivery, mother-baby binomials were followed by phone calls at the 1st, 3rd, and 6th months of the baby's life (n=467) to gather information on the type of delivery, baby's gender, BF in the first hour of the newborn's life, baby's weight, mother's return to work, and oral habits. Association analyses were performed using logistic regression models with a 5% significance level with the pacifier/bottle-feeding use as the outcome. Results: Most mothers (52.5%) reported their babies used bottle-feeding, 48.2% used pacifiers and 33.4% used both of them throughout the 6 months. Intention to offer pacifier and bottle-feeding was reported by 45.0% and 54.8% of the mothers at the 3rd trimester of the pregnancy, respectively. Not living in one's own residence (OR=1.53; 95%CI: 1.05-2.24) and having the prenatal intention of offering a pacifier (OR=2.50; 95%CI: 1.63-3.83) to the baby were significantly associated with pacifier use. Variables significantly associated with bottle-feeding were mother's return to work (OR=2.48; 95%CI: 1.54-3.97), baby's lower birth weight (OR=1.58; IC95%: 1.07-2.33), and prenatal intention to offer bottle-feeding (OR=2.51; 95%CI 1.56-4.04). Conclusion: About half of the babies used pacifiers or were bottle-fed, which were associated with the mother's prenatal intention to offer them to their babies and socioeconomic factors.

Evidence-practice gap in treatment recommendations for proximal caries among Brazilian dentists / Lacuna entre a evidência e a prática nas recomendações de tratamento para cárie proximal entre dentistas brasileiros

ABSTRACT Little is known about how Brazilian dentists' treatment decisions for proximal carious lesions are compared to current evidence-based recommendations, so better understanding is needed to close any potential evidence-practice gap. Objectives: This cross-sectional study aimed to quantify the evidence-practice gap about proximal carious lesions treatment and identify dentist factors associated with this evidence-practice gap. Methods: Brazilian dentists (n=214) from Araraquara, São Paulo State, "completed a questionnaire about their dentist and practice characteristics and a translated version of the "Assessment of Caries Diagnosis and Caries Treatment" from the U.S. National Dental Practice-Based Research Network. Five radiographic images of proximal carious lesions in low-risk and high-risk patient scenarios were used. Associations between treatment recommendations and lesion, dentist, and practice characteristics were tested for statistical significance (p<0.05). Results: Lesions confined to the enamel would be restored by 35% and 71% of dentists in the low-risk and high-risk patient scenarios, respectively, suggesting a substantial evidence-practice gap given that surgical intervention of enamel lesions is not consistent with current evidence. The lesion depth threshold to recommend a permanent restoration differed between the low-risk and high-risk patient scenarios (p<0.001). Specific dentist/practice characteristics (dentist gender, graduate of a public dental school, postgraduate training, use of caries risk assessment) were significantly associated with the evidence-practice gap, but the magnitude of these differences was not major Conclusion: A substantial evidence-practice gap in treatment of proximal carious lesions was found for the sample overall, even when clinical scenarios presented low-risk patients. Global strategies are needed to close this substantial evidence-practice gap.

RESUMO Pouco se sabe se as decisões de tratamento dos dentistas brasileiros para lesões cariosas proximais são comparadas às recomendações atuais baseadas em evidências, portanto, é necessário um melhor entendimento para fechar qualquer potencial lacuna entre a evidência e a prática. Purpose: Este estudo transversal teve como objetivo quantificar a lacuna entre a evidência e a prática na decisão de tratamento das lesões cariosas proximais e identificar os fatores associados a essa lacuna entre a evidência e a prática. Methods: Cirurgiões-dentistas brasileiros (n=214) de Araraquara, Estado de São Paulo, preencheram um questionário sobre suas características odontológicas e clínicas e uma versão traduzida do "Assessment of Caries Diagnosis and Caries Treatment" da U.S. National Dental Practice-Based Research Network. Cinco imagens radiográficas de lesões cariosas proximais em cenários de pacientes de baixo risco e alto risco foram usadas. Associações entre recomendações de tratamento e lesão, dentista e características da prática foram testadas (p<0,05). Results: As lesões confinadas ao esmalte seriam restauradas por 35% e 71% dos dentistas nos cenários de pacientes de baixo risco e alto risco, respectivamente, sugerindo uma lacuna entre a evidência e a prática substancial, dado que a intervenção cirúrgica das lesões do esmalte não é consistente com as evidências atuais. O limiar de profundidade da lesão para recomendar uma restauração permanente diferiu entre os cenários de pacientes de baixo risco e alto risco (p<0,001). Características específicas do dentista/prática (sexo do dentista, graduado em uma faculdade pública, pós-graduação, uso da avaliação de risco de cárie) foram significativamente associadas à lacuna entre a evidência e a prática, mas a magnitude dessas diferenças não foi importante. Conclusions: uma lacuna entre a evidência e a prática substancial na decisão de tratamento de lesões cariosas proximais foi encontrada para a amostra como um todo, mesmo quando os cenários clínicos apresentavam pacientes de baixo risco. Estratégias globais são necessárias para fechar essa lacuna entre a evidência e a prática.

Methods for Caries Prevention in Children Reported by Dentists from a Brazilian Community

ABSTRACT Objective: To describe the dental practice patterns related to caries prevention in children aged 6-18 years and associated factors. Material and Methods: Dentists (n=162) from Araraquara, Brazil, completed two paper questionnaires: (1) one about characteristics of their practice and their patient population; and (2) a translated version of the "Assessment of Caries Diagnosis and Caries Treatment" Questionnaire from the National Dental Practice-Based Research Network. Regression analyses were used for data analysis (p<0.05). Results: Dentists reported using in-office fluoride (IOF) and dental sealants (DS) in 74.2% and 45.1% of their pediatric patients, respectively. Regression analysis showed that female dentists (p=0.035 for DS; p=0.044 for IOF; p=0.011 for non-prescription fluoride rinse), those with advanced degrees (p=0.032 for prescription of fluoride), those who graduated from a private dental school (p=0.018 for chlorhexidine rinse), those who provided caries prevention regimens (p<0.001 for DS; p=0.004 for IOF; p=0.013 for non-prescription fluoride rinse), those with a greater percentage of patients interested in a caries prevention regimen (p=0.007 for non-prescription fluoride rinse), those working in a private practice model (p=0.047 for prescription of fluoride) were more likely to recommend some type of preventive methods to their pediatric patients. Conclusion: Dentists reported recommending IOF to most of their pediatric patients. Certain dentists', practices', and patients' characteristics were associated to some caries prevention regimens recommended by dentists.

Caries risk assessment in dental practices by dentists from a Brazilian community

Abstract Data on dental practices related to caries risk assessment (CRA) are scarce among Brazilian dentists. This study aimed to determine the prevalence of CRA use by dentists and factors associated with its use, as well as to quantify dentists' ratings of the importance of specific factors when treatment planning. Dentists registered at the Regional Council of Dentistry of São Paulo State - Araraquara region were sent two paper questionnaires that comprised: a) characteristics of dentists themselves, their practices, and their patients; and b) the translated version of the "Assessment of Caries Diagnosis and Caries Treatment" Questionnaire from the U.S. National Dental Practice-Based Research Network. Participants were 206 dentists who currently practiced in Araraquara and treated dental caries. Descriptive statistics and multiple logistic regression analyses were used for data analysis. Thirty-six percent of the dentists reported they perform CRA and, among them, 36% indicated they record the assessment on a special form that is kept in the patient chart. More years since dental school graduation (OR = 1.1, p = 0.002) and holding an advanced academic degree (OR=2.6, p=0.005) were associated with a higher likelihood of performing CRA, whereas exclusively using a private practice model (OR = 0.5, p = 0.016) was associated with a lower likelihood of performing CRA. The current oral hygiene and commitment to return for follow-up were the most important risk factors for treatment planning. In conclusion, CRA was not a routine procedure in daily practice among the majority of participating dentists. Specific demographic, practice and academic education characteristics were associated with performing CRA.

Caries risk assessment in dental practices by dentists from a Brazilian community.

Data on dental practices related to caries risk assessment (CRA) are scarce among Brazilian dentists. This study aimed to determine the prevalence of CRA use by dentists and factors associated with its use, as well as to quantify dentists' ratings of the importance of specific factors when treatment planning. Dentists registered at the Regional Council of Dentistry of São Paulo State - Araraquara region were sent two paper questionnaires that comprised: a) characteristics of dentists themselves, their practices, and their patients; and b) the translated version of the "Assessment of Caries Diagnosis and Caries Treatment" Questionnaire from the U.S. National Dental Practice-Based Research Network. Participants were 206 dentists who currently practiced in Araraquara and treated dental caries. Descriptive statistics and multiple logistic regression analyses were used for data analysis. Thirty-six percent of the dentists reported they perform CRA and, among them, 36% indicated they record the assessment on a special form that is kept in the patient chart. More years since dental school graduation (OR = 1.1, p = 0.002) and holding an advanced academic degree (OR=2.6, p=0.005) were associated with a higher likelihood of performing CRA, whereas exclusively using a private practice model (OR = 0.5, p = 0.016) was associated with a lower likelihood of performing CRA. The current oral hygiene and commitment to return for follow-up were the most important risk factors for treatment planning. In conclusion, CRA was not a routine procedure in daily practice among the majority of participating dentists. Specific demographic, practice and academic education characteristics were associated with performing CRA.

Methods for caries prevention in adults among dentists from a brazilian community

Little is known about dental practice patterns of caries prevention in adults among Brazilian dentists. Aim: To quantify procedures used for caries prevention for adult patients among dentists from a Brazilian community. Methods: Dentists (n=197) who reported that at least 10% of their patients are more than 18 years old participated in the first Brazilian study that used a translated version of the "Assessment of Caries Diagnosis and Caries Treatment" from the U.S. National Dental Practice-Based Research Network. A questionnaire about characteristics of their practice and patient population were also completed by the dentists. Generalized linear regression models and a hierarchal clustering procedure were used (p<0.05). Results: In-office fluoride application was the preventive method most often reported. The main predictors for recommending some preventive agent were: female dentist (dental sealant; in-office fluoride; non-prescription fluoride) and percentage of patients interested in caries prevention (dental sealant; in-office fluoride; non-prescription fluoride). Other predictors included private practice (dental sealant), percentage of patients 65 years or older (in-office fluoride), graduation from a private dental school (non-prescription fluoride), years since dental school graduation (chlorhexidine rinse) and using a preventive method (recommending sealant/fluoride/chlorhexidine rinse/sugarless, xylitol gum). Cluster analysis showed that dentists in the largest subgroup seldom used any of the preventive agents. Conclusion: Dentists most often reported in-office fluoride as a method for caries prevention in adults. Some practitioner, practice and patients' characteristics were positively associated with more-frequent use of a preventive agent

Tradução e adaptação brasileira do questionário "Assessment of caries diagnosis and caries treatment" / Translation and Brazilian adaptation of the "Assessment of caries diagnosis and caries treatment questionnaire"

Objetivo: O objetivo deste estudo foi traduzir e realizar a adaptação transcultural do questionário "Assessment of Caries Diagnosis and Caries Treatment", da Dental Practice Based Research Network (DPBRN), para a língua portuguesa do Brasil. Métodos: O questionário sobre a prática odontológica relacionada ao diagnóstico, prevenção, tratamento e avaliação de risco de cárie passou por tradução e adaptação cultural seguindo critérios pré-estabelecidos: tradução inicial, retrotradução e comitê de revisão. No pré-teste, o questionário foi preenchido por 21 cirurgiões-dentistas (CDs), cuja finalidade foi identificar erros, desvios das traduções e compreensão das perguntas. Após uma semana, 17 CDs preencheram o questionário novamente para avaliar a reprodutibilidade pelo teste de correlação intra-classe. Resultados: A etapa de tradução mostrou que os termos/sentenças traduzidos de forma destoante pelos diferentes pesquisadores eram, na verdade, sinônimos, e indicaram que o processo de tradução foi facilmente realizado. Em relação à compreensão do questionário, 95% (n=20) dos CDs não mostraram dúvida/dificuldade ao preenchê-lo. Os dados de reprodutibilidade mostraram que 42% (n=22) das questões apresentaram correlação satisfatória e 58% (n=31) correlação excelente. Conclusão: Conclui-se que o processo de tradução e adaptação cultural do questionário foi realizado de forma satisfatória e que a versão brasileira do questionário foi facilmente compreendida pela população estudada.(AU)

Aim: The aim of this study was to translate and cross-culturally adapt the "Assessment of Caries Diagnosis and Caries Treatment" questionnaire from the Dental Practice Based Research Network (DPBRN) into Brazilian Portuguese. Methods: The questionnaire on dental practices related to diagnosis, prevention, treatment, and caries risk assessment underwent translation and cross-cultural adaptation following pre-established criteria: initial translation, back-translation, and committee review. During the pre-test, the questionnaire was filled out by 21 dentists in order to evaluate mistakes, to find deviations in the translations, and to identify the comprehension of the questions. After one week, 17 dentists filled out the questionnaires again to evaluate their reliability by means of the intra-class correlation test. Results: The translation process showed that the term/sentences translated differently by distinct researchers were synonyms and indicated that the process was easily performed. Regarding the comprehension of the questionnaire, 95% (n=20) of the dentists showed no doubts / difficulty when filling it out. Reliability data showed that 42% (n=22) of the questions showed a satisfactory correlation, while 58% (n=31) showed an excellent correlation. Conclusion: In conclusion, the translation and cross-cultural adaptation process of the questionnaire was performed satisfactorily, and the Brazilian version of the questionnaire was easily understood by the studied population.(AU)

Impacto dos problemas de saúde bucal na qualidade de vida de gestantes / Impact of oral health problems on the quality of life of pregnant women

Objetivos: 1) Avaliar o impacto dos problemas de saúde bucal na qualidade de vida de gestantes por meio do questionário OHIP-14, bem como a presença de cárie dentária, doença periodontal e uso e necessidades de próteses em gestantes; 2) associar as variáveis sociodemográficas e condições de saúde bucal encontradas no exame clínico com o OHIP-14. Métodos: Além da aplicação do questionário OHIP-14, realizou-se uma avaliação clínica das condições bucais (índices: IPC, CPO-D e avaliação protética) em 51 gestantes que procuraram atendimento odontológico junto à Clínica de Odontologia Preventiva, no período de abril de 2008 a agosto de 2010. Realizaram-se análises descritivas para caracterização da amostra, análise bivariada (teste de Qui-Quadrado ou Exato de Fisher) e regressão logística múltipla em nível de significância de 5% para analisar a associação entre o impacto da saúde bucal na qualidade de vida de gestantes e as variáveis sociodemográficas e clínicas. Resultados: Os dados do OHIP-14 mostraram menor impacto da saúde bucal na qualidade de vida. O CPOD médio foi 12,8; 70,6% das gestantes apresentavam cálculo dental e 58,8% necessitavam de prótese. A associação entre OHIP-14 e última visita ao dentista e CPOD permaneceram no modelo final de regressão (p<0,05). Conclusão: A experiência de cárie das gestantes examinadas foi considerada alta, a maioria apresentava necessidade de prótese e presença de cálculo dental. O OHIP apresentou baixo impacto no grupo estudado e foi significativamente influenciado pela última visita ao dentista e pelo índice CPOD...

Objectives: 1) to evaluate the impact of oral health problems on the quality of life of pregnant women by the simplified Oral Health Impact Profile (OHIP-14) questionnaire as well by the presence of dental caries, periodontal disease and denture use/need; 2) to correlate the sociodemographic variables and the oral health conditions revealed in the clinical examinations with the OHIP-14. Method: In addition to the application of the OHIP-14 questionnaire, clinical examination of the oral conditions (CPI - community periodontal index, DMFT and prosthetic evaluation) was performed on 51 pregnant women, who sought dental treatment between April 2008 and August 2010 at the Preventive Dentistry Clinic. Descriptive analyses were made for sample characterization, bivariate analysis (chi-square or FisherÆs exact tests) and multiple logistic regressions at a 5% significance level to assess the correlation between the impact of oral health on the quality of life of pregnant women and the socio-demographic and clinical variables. Results: The OHIP-14 data showed a lesser impact of oral health on the womenÆs quality of life. The mean DMFT was 12.8; 70.6% of the pregnant women presented dental calculus and 58.8% needed prostheses. The association between OHIP-14 data and last dental visit and DMFT remained in the final regression model (p<0.05). Conclusion: Caries experience of the pregnant women was considered high. Most of them needed prostheses and presented dental calculus. The OHIP-14 presented a low impact on this population and was significantly influenced by the last dental visit and the DMFT index...

Muito além dos muros / Beyond the walls

A arte de lidar com o semelhante vai além do simples contato de um prestador de serviços para o recebedor do serviço, afinal a boca é apenas uma parte do indivíduo. O projeto do PET- SAÚDE proporciona ao acadêmico a experiência de desbravar o mundo além dos muros da faculdade, o que é simplesmente sensacional. Essa é a melhor maneira de formar o profissional de odontologia, com uma visão humanista, crítica e reflexiva. Propiciando ao aluno a oportunidade de deparar-se com a realidade dos postos públicos e desenvolver as competências gerais do cirurgião-dentista, como a comunicação com outros profissionais, vivenciando a multiprofissionalidade, interdisciplinaridade e transdisciplinaridade, importantes na promoção da saúde. Durante as visitas aos municípios foram executadas as atividades de atenção à saúde com ações de prevenção e de reabilitação. Mesmo diante de um cenário de carência de recursos, a falta de determinados materiais, comuns na clínica diária, não impossibilitou a realização dos procedimentos e do cuidar. Esta experiência é imprescindível, pois auxilia na tomada de decisões e estabelecimento da relação custo- efetividade na carreira profissional, baseada não só em evidências científicas, mas também nas necessidades de uma determinada população. Portanto, a experiência de participar do PET, permite a formação completa do acadêmico, pautada também nas Ciências Humanas e Sociais. Dessa forma, ir além dos muros da faculdade proporciona uma visão completa e humana do paciente, que não se restringe mais a apenas uma "parte" doente, por poder ter seu contexto compreendido e integrado na visão de cada petiano (AU).

The art of dealing with the similar goes beyond simply contact a service provider to the recipient of the service , after the mouth is only part of the individual. The design PET - Saúde provides the academic experience of exploring the world beyond the walls of the college, which is simply phenomenal. This is the best way to form the dental professional with a humanist , critical and reflective view . Providing students the opportunity to encounter the reality of payphones and develop the general skills of the dentist , as communication with other professionals , experiencing multiprofessionality and transdisciplinarity , important in health promotion . During visits to municipalities were executed activities of health care with prevention and rehabilitation. Even against a background of lack of resources , lack of certain materials, common clinical presentation not prevented the carrying out of procedures and care . This experience is essential because it helps in decision making and establishment of costeffectiveness in their professional careers, based not only on scientific evidence , but also the needs of a given population. Therefore , the experience of participating in the PET allows the complete formation of the academic , also marked the Humanities and Social Sciences . Therefore, going beyond the walls of the college provides a comprehensive and humane view of the patient , which is no longer restricted to just one sick " part " , because it may have its context understood and integrated into the vision of each petiano (AU).

Acogimiento en el proceso de formación de los odontólogos en Brasil: un análisis en el contexto del Sistema Único de Salud (SUS) / Welcoming reception in the dentists training process in Brazil: an analysis in context of the Single Health System

Definir el perfil de los académicos en Odontología, cuanto al acogimiento de los pacientes/usuarios atendidos en la Institución, en el ámbito de las directrices del SUS. Métodos: Fue aplicado un cuestionario Se aplicó un cuestionario estructurado a 163 estudiantes, con cuestiones que englobaban cinco variables (recepción, diálogo y escucha, actuación y cuidado, primer contacto e identidad profesional). Fue realizado una entrevista para verificar la coherencia de respuestas obtenidas durante la primera fase. Los datos cuantitativos fueron tabulados y analizados por estadística descriptiva en el programa Epi-Info (versión 6.0) y los datos cualitativos analizados por medio del discurso del sujeto colectivo. Resultados: Fue verificado que, intelectualmente, la mayoría de los académicos (70,7%) entienden el concepto y la repercusión del proceso de acogimiento en salud y muchos poseen características de cuidadores. El sistema pedagógico formativo, centrado en el tecnicismo, puede dificultar o sistematizar una acción acogedora espontánea e integral. Conclusión: Los académicos poseen perfil acogedor, pero existe una necesidad de mayor motivación de humanización en la educación universitaria.

To define the profile of Dentistry's academics, on the welcoming reception of patients/users attended in the Public Institution, under the guidelines of the SUS. Methods: A structured questionnaire was applied to 163 students, which contained questions that covered five variables (reception, dialogue and listening, action and care first contact, professional identity) and conducted an interview to associate to responses obtained during the first phase. Quantitative data were tabulated and analyzed by descriptive statistics in SPSS 16.0 and qualitative data analyzed through discourse of the collective subject. Results: It was observed that, intellectually, the most of student (70.7%) understand the concept and the repercussion of the welcoming reception process in health and many have caring characteristics. However, the pedagogic system formation makes it difficult or systemizes an integral and spontaneous welcoming action. Conclusions: The academics have the embracement profile but it is need more motivation in the humanization of the university teaching.

Retardo na procura do tratamento odontológico e percepção da saúde bucal em mulheres grávidas / Delay in seeking dental treatment and perception of oral health in pregnant women

Este trabalho teve como objetivo verificar em mulheres com crianças até 5 anos de idade o que ocorreu no seu período gestacional em relação a tratamentos odontológicos, associado a uma provável correlação entre o nível de seu conhecimento sobre a saúde bucal e possíveis razões que a levariam ou a levaram a uma busca tardia a esse tratamento. As entrevistas foram realizadas em ambientes do Posto de Saúde Central do município e na Faculdade de Odontologia de Araraquara. Dentre as mães entrevistadas, 57% recusaram o tratamento odontológico durante a gestação. Verificou-se que as mães têm receio de realizarem um tratamento odontológico durante o período gestacional. A desinformação sobre essa questão, muitas vezes, está associada à crença na área médica de que o atendimento odontológico durante os primeiros três meses de gestação é prejudicial ao bebê. Tal informação transmitida às mães acarreta uma hesitação ao tratamento odontológico nesse período. O nível educacional das mães não interferiu nessa busca, sendo que 24,5% delas evitam o tratamento durante a gestação. O diferencial, entretanto, é que as mães de alto nível de escolaridade realizam prevenção bucal antes da gravidez.

The objective was to assess in women with children under 5 years old what happened to your pregnancy in relation to dental care, coupled with a probable correlation between the level of their knowledge on dental health and possible reasons which lead or have led to a late seeking such treatment. The interviews were conducted in an environment of health center in the city center and the Odontoly Faculty in Araraquara. Among the interviews mothers, 57% refused the dental treatment during pregnancy. It appears on mothers that are afraid to perform a dental treatment during pregnancy. The misinformation on this issue often associated with this belief in the medical field that dental care during the first three months of pregnancy is harmful to the baby. Such information passed on to mothers leads to a hesitancy with dental treatment during this period. The educational level of mothers did not interfere in this pursuit, and 24.5% of them avoid treatment during pregnancy. The difference, however, is between those mothers of high educational level, performing oral prevention before pregnancy.

Avaliação do perfil de risco de cárie dentária em gestantes de Araraquara, Brasil / Evaluación de factores de riesgo de padecer caries dental en gestantes de Araraquara, Brasil / Evaluation of risk factors suffering dental caries in pregnants from Araraquara, Brazil

O conhecimento do risco de cárie na gravidez é essencial para um correto plano de tratamento com ações educativas e preventivas às mães para que possam cuidar adequadamente de sua saúde bucal e de seus filhos. Este estudo retrospectivo teve como objetivo identificar o risco de cárie de gestantes (15-44 anos; média= 25 anos) que frequentaram a clínica de odontologia preventiva da Faculdade de Odontologia de Araraquara, Universidade Estadual Paulista de 1999 a 2007. Um total de 166 prontuários, preenchidos por alunos do 3º ano do Curso de Graduação, seguindo orientações pré-estabelecidas, foram utilizados. Coletou-se informação sobre: classificação do diagnóstico de risco de cárie, trimestre gestacional, consumo de carboidratos (entre ou durante as refeições), placa corada (registro de controle de placa de O'Leary), número e grupo de dentes com experiência de cárie. Para análise estatística foram utilizados o teste de qui-quadrado e ANOVA. A maioria das gestantes (92,1 por cento) apresentou 25 por cento ou mais das superfícies dentárias com placa dental. A média (desvio-padrão) de dentes obturados e cariados foi 7,9 (5,1) e 4,0 (3,4), respectiva emente. Os dentes posteriores foram os mais acometidos por cárie/restaurações. Quanto ao diagnóstico de risco à cárie, a classificação alta foi observada em 38,5 por cento das gestantes, moderada em 47,6 por cento e baixa em 13,9 por cento. Houve associação estatisticamente significativa (p= 0,001) entre o consumo de carboidratos e o diagnóstico de risco de cárie. O índice de placa foi semelhante nos diferentes trimestres gestacionais (f= 0,223; p= 0,803). Portanto pode-se concluir que o risco de cárie da grande maioria das gestantes foi alto ou moderado e esteve estatisticamente associado ao consumo de carboidratos(AU)

The knowledge of risk of carried during pregnant is essential for an appropriate treatment using educational and preventives actions to mother for a good care of their oral health and that of children. The main objective of present retrospective study was to identify the risk of caries of pregnants (aged 15-44, mean= 25 years) came to clinic of Preventive Odontology of Araraquara-UNSEP from 1999 to 2007, using 166 medical records obtained by the third pregraduate year students, following the pre-established guidelines. The information collected includes: classification of caries risk diagnosis, pregnancy trimester, carbohydrates ingestion (between or during foods), dental plaques (O'Leary's plaque control registry) and the number of teeth with caries. The statistical analysis used the Chi² and ANOVA tests. Most of patients showed a 25 percent or more of teeth surfaces with dental plaques (92.1 percent) and carbohydrates consumption among foods (89.2 percent). The mean (SD) of carried and restores teeth was of 7.9 (5.1) and 4.0 (3.4), respectively and the posterior teeth were the more involved by caries/restorations. As regards the diagnosis of caries risk, classification of high risk was observed in the 38.5 percent of pregnants, moderate in the 47.6 percent) and low in the 13.9 percent. There was a statistically significant association (p= 0.001) between the carbohydrates consumption and the diagnosis of caries risk. The plaque's rate was similar in the different trimesters of pregnancy (f= 0.223; p= 0.803). The caries risk of most pregnant women was high or moderate and it was associated with the consumption of carbohydrates(AU)

El conocimiento del riesgo de padecer de caries dental durante el periodo de embarazo es esencial para un correcto plan de tratamiento con las acciones educativas y preventivas necesarias para que las madres puedan cuidar adecuadamente de su salud bucal y la de sus hijos. Este estudio retrospectivo tuvo como objetivo identificar el riesgo de caries dental en las mujeres en periodo de gestación con edades comprendidas entre 15 y 44 años, con una media de 25 años, que acudieron a la clínica de odontología preventiva de la Facultad de Odontología de Araraquara, Universidad Estadual Paulista, del año 1999 al 2007. Se utilizaron 166 historias clínicas hechas por los estudiantes de tercer año de pregrado, según las directrices preestablecidas. La información recogida fue: clasificación del diagnóstico de riesgo de caries, trimestre de embarazo, la ingesta de hidratos de carbono entre o durante las comidas, placa dental (registro de control de placa de O'Leary) y el número de grupo de dientes con caries. El análisis estadístico utilizó el Chi cuadrado y ANOVA. La mayoría de los pacientes mostraron el 25 por ciento o más de las superficies de los dientes con la placa dental con un valor de 92,1 por ciento e hidratos de carbono consumidos entre comidas con un valor de 89,2 por ciento. La media (desviación estándar) de los dientes cariados y restaurados fue de 7,9 (5,1) y 4,0 (3,4) respectivamente; los dientes posteriores se vieron más afectados por la caries o restauraciones. En cuanto al diagnóstico de riesgo de caries, la clasificación de alto riesgo se observó en 38,5 por ciento de las mujeres embarazadas, moderado en 47,6 por ciento y bajo en 13,9 por ciento. Existió una asociación estadísticamente significativa (p= 0,001) entre el consumo de hidratos de carbono y el riesgo de caries. El índice de placa fue similar en los diferentes trimestres del embarazo (f= 0,223 y p= 0,803). El riesgo de padecer caries dental en la gran mayoría de las mujeres embarazadas fue alto o moderado y se asoció significativamente con el consumo de hidratos de carbono(AU)

Effects of oral environment stabilization procedures on Streptococcus mutans counts in pregnant women.

The aim of this study was to determine the effect of oral environment stabilization (OES) on the counting of Streptococcus mutans in high-caries-risk pregnant women participants of a prevention program in a public teaching institution. The sample was composed of 30 pregnant women aged 18 to 43 years, who looked for treatment at the Preventive Dentistry Clinic of the Araraquara Dental School, UNESP. Saliva samples were collected before and after the OES procedures and were forwarded to the pathology for observation and quantification of S. mutans CFU. There was a decrease in the number of S. mutans CFU, which was significantly different (p<0.0001) between samples. Considering the age group, 70.0% were between 18 to 30 years old and 30.0% belonged to the 31-43-year-old age group. Data related to the pregnancy period showed that 73.4% were in the second trimester, 13.3% in the first and 13.3% in third trimester. OES showed to be an effective clinical procedure in diminishing the number of S. mutans CFU in the saliva of high-caries-risk pregnant women. This management is simple and effective, corresponding to the basic treatment needs of pregnant women that search dental care in this public service.

Conhecimento de mães sobre promoção de saúde bucal em bebês / Mother’s knowledge on oral health promotion for babies

Objetivo: O objetivo deste estudo foi avaliar o nível de conhecimento sobre promoção de saúde bucal em bebês de todas as mães (n=60), com idade de 18-42 anos, que frequentaram a Clínica de Prevenção da Faculdade de Odontologia de Araraquara, da Universidade Estadual Paulista (FOA-Unesp), durante o período 2005-2008. Métodos - Realizou-se uma entrevista utilizando questionário contendo 18 questões abertas e cinco fechadas sobre o conhecimento e práticas em saúde bucal de bebês relacionadas à cárie e sua prevenção, bem como sobre informações sociodemográficas. Resultados - A maioria das mães acreditava que o leite materno não causa cárie (73,3%), que esta não é uma doença transmissível (51,6%) e que o antibiótico provoca cárie (63,3%). Quase todas as mães (93,3%) responderam que a doença poderia ser evitada escovando os dentes, ação que deveria ser iniciada desde o nascimento do primeiro “dente de leite” (75%). Para 73,3% das entrevistadas,o uso do fio dental deveria ser iniciado somente após o irrompimento de todos os “dentes de leite”. A maior porcentagem das mães (83,3%) sabia o que era o flúor, mas 33,3% desconheciam a época ideal para iniciar sua utilização. A orientação do cirurgião-dentista em relação à saúde bucal deseus bebês foi considerada importante por 96,7% das mães. Conclusões - As mães entrevistadas demonstraram conhecimento em relação à escovação dental em bebês, porém, não sabiam sobre outras variáveis importantes na promoção de saúde bucal dos bebês, como os fatores etiológicos da doença, uso de compostos fluoretados e visitas ao cirurgião-dentista.

Objective: The aim of this study was to assess the knowledge level on oral health promotion for babies of all mothers (n=60), aged 18-42 years, assisted in the Preventive Dentistry Clinic of the Faculty of Dentistry of Araraquara, at Universidade Estadual Paulista (UNESP), during the period 2005-2008. Methods -An interview was performed using a questionnaire with 18 open and five closed questions about knowledge and practices related to caries prevention as well as demographic information. Methods -The majority believed that breast milk does not cause caries (73.3%), that caries is not a transmissible disease (51.6%) and that antibiotics cause caries (63.3%). Almost all mothers (93.3%) responded that brushing teeth could prevent the disease, action that should be initiated since first tooth erupts (75%). For 73.3% of the respondents, the use of dental floss should be initiated only after all deciduous teeth erupt. Results - The majority (83.3%) knew what was fluoride, but a third of them (33.3%) did not know the best time to start using it. The dentist counseling related to oral health of babies was considered important by 96.7% of mothers. Conclusion - The mothers presented good knowledge about baby’s oral hygiene, however, they did not know about other important variables for oral health promotion of babies.

Effects of oral environment stabilization procedures on Streptococcus mutans counts in pregnant women

The aim of this study was to determine the effect of oral environment stabilization (OES) on the counting of Streptococcus mutans in high-caries-risk pregnant women participants of a prevention program in a public teaching institution. The sample was composed of 30 pregnant women aged 18 to 43 years, who looked for treatment at the Preventive Dentistry Clinic of the Araraquara Dental School, UNESP. Saliva samples were collected before and after the OES procedures and were forwarded to the pathology for observation and quantification of S. mutans CFU. There was a decrease in the number of S. mutans CFU, which was significantly different (p<0.0001) between samples. Considering the age group, 70.0 percent were between 18 to 30 years old and 30.0 percent belonged to the 31-43-year-old age group. Data related to the pregnancy period showed that 73.4 percent were in the second trimester, 13.3 percent in the first and 13.3 percent in third trimester. OES showed to be an effective clinical procedure in diminishing the number of S. mutans CFU in the saliva of high-caries-risk pregnant women. This management is simple and effective, corresponding to the basic treatment needs of pregnant women that search dental care in this public service.

O objetivo desta pesquisa foi determinar o efeito da adequação do meio bucal sobre a contagem de Streptococcus mutans em gestantes de alto risco à cárie, participantes de um programa de prevenção em uma instituição de ensino público, antes e após adequação do meio bucal. Amostras de saliva de 30 gestantes (18 a 43 anos) que procuraram atendimento na Clínica de Odontologia Preventiva da FOAr-UNESP foram coletadas antes e após procedimentos de adequação do meio bucal, e examinadas para observação e contagem das UFCs de S. mutans. Foi demonstrado que houve diminuição na quantidade das UFCs (p<0,0001) entre as amostras. Em relação à faixa etária, 70,0 por cento das gestantes tinham entre 18 e 30 anos de idade e 30,0 por cento pertenciam à faixa etária de 31 a 43 anos. Dados relativos ao período da gestação revelaram que 73,4 por cento estavam no 2º trimestre e 13,3 por cento estavam igualitariamente no 1º e 3º trimestres. A adequação do meio bucal se mostrou eficaz na diminuição das UFCs de S. mutans presentes na saliva de gestantes de alto risco de cárie. Este procedimento é simples e extremamente efetivo, atendendo às necessidades de tratamento básico de gestantes que procuram atendimento odontológico no serviço público de saúde.

Infra-oclusão em molares decíduos: tratamento ao alcance de clínico geral / Infraocclusion of the deciduous molars: treatment by generality clinical dentist

A infra-oclusão de molares decíduos é uma anomalia de erupção que pode comprometer a oclusão dos dentes decíduos e de seus sucessores, o que exige acompanhamentos clínico e radiográfico, dependendo o tratamento da característica de cada caso. Neste trabalho será apresentado um caso clínico de infra-oclusão de primeiros e segundos molares decíduos inferiores, lados direito e esquerdo, que foram tratados e acompanhados clínico e radiograficamente, realizando-se exodontia dos primeiros molares decíduos e restauração nos segundos, para aumento de coroa clínica, colocando-os em oclusão. A preservação mostrou tratar-se de um procedimento seguro, eficaz e simples na resolução do caso, estando ao alcance de qualquer profissional da área odontológica, até mesmo para serviços públicos de saúde.

The deciduous molars infraocclusion is an eruption anomaly that can affect the occlusion development. Patients with infraocclusion molars need to be follow up and x ray examination is recommended each six months. The treatment is based on infraocclusion characteristics. The tooth was restoreded to establish the occlusion and to stimulate the most resorption on tooth exfoliation.

Estudo epidemiológico da ansiedade dos pacientes ao tratamento odontológico / Epidemiological study of dental anxiety among patients undergoing dental care

O objetivo deste estudo foi estimar a prevalência de ansiedade ao tratamento odontológico entre pacientes da Clínica Integrada da Faculdade de Odontologia de Araraquara, UNESP. Material e Método: A amostra era composta por 60 pacientes tomados deforma não-probabilística. Como instrumento de medida, utilizou-se um formulário com questões para avaliação da ansiedade segundo a escala proposta por Corah e traduzida para o português por Pereira et al. Os dados foram descritos em forma de distribuição de freqüências, e as associações entre nível de ansiedade e sexo, idade, renda e educação foram analisadas pelo teste de qui-quadrado (χ2). Resultado: A prevalência de ansiedade foi observada em 95 porcento dos pacients, tendo a maioria (53,3 porcento) apresentado nível moderado, 25,0% ansiedade baixa e 16,7% exacerbada; verificou-se associação significativa entre ansiedade e sexo (p = 0,001) e não-significativa para idade (p = 0,754), renda (p = 0,307) e nível de instrução (p = 0,711). O período de retorno ao tratamento odontológico a cada 6 meses foi observado em apenas 2 pacientes (3,3%), enquanto 40 % dos pacientes procuraram por atendimento apenas em situações de "dor". Entre os procedimentos que mais incomodaram os pacientes estão os que envolvem "motor de alta rotação" e "cirurgia", correspondendo a 21,7% em cada situação. Vinte por cento da amostra não se sentiram incomodados com qualquer procedimento odontológico, enquanto 10% se referiram a desconforto diante de qualquer procedimento a ser realizado. Conclusão: Concluiu-se que a prevalência de ansiedade ao tratamento odontológico foi de 95 % com predomínio do gênero feminino e que, entre pacientes ansiosos, o retorno ao consultório ocorreu por motivo de dor

Objective: The aim of this study was to estimate the prevalence of dental anxiety among patients undergoing dental treatment at Araraquara Dental School ­ UNESP. Material and Methods: It was performed a transversal study using a sample of convenience given by 60 patients. Dental anxiety was analysed using Corah's Dental Anxiety Scale (DAS)11. It was applied descriptive statistics and chi-squared test (χ2) was used to determine the relationship between level of anxiety and sex, age (<35 age and 35 year and above), income and educational level. Results: The results showed that 53.3% presented a moderate level of anxiety, 25% low level and 16.7% were fobic, leading to a prevalence of 95%. The association between level of anxiety according to sex was significant (p = 0.001) and it was non-significant in relation to age (p = 0.754), income (p = 0.307) and educational level (p = 0.711). Only two patients returned to visit the dentist within a 6-month period, while 40% looked for dental care when they had pain. The dental situations that produced anxiety were high-speed turbine (21.7%) and surgery (21.7%). Twenty percent of the sample didn't feel uncomfortable about any kind of dental treatment, while 10% felt uncomfortable about any one of the proceedings. Conclusion: The prevalence of dental anxiety was 95%, with predominance in the female sex and anxious patients looked for dental treatment only when they had pain