Changes in Use of Prenatal Dental Care After Brazil's Incentive Policy.

In 2020, the Brazilian federal government launched the "Prevent Brazil" program to incentivize cities to improve their performance across 7 health care indicators, including prenatal dental care. Our study examines the impact of this policy on the use of oral health care among pregnant women in Brazil. We used a series of cross-sectional data from the Brazilian Public Health System from 2018 to 2023. We linked publicly available data from the Brazilian Ministry of Health and the Brazilian Institute of Geography and Statistics. Our outcome was the proportion of pregnant women receiving prenatal care who had at least 1 dental visit during the past year. Covariates included city-level socioeconomic (income and literacy), demographic (gender, race, and urban areas), and workforce variables (number of dentists working in the public health system per city/year). We estimated the impact of the policy on prenatal dental visits nationwide and stratified by geographic region using interrupted time-series analysis. Our analyses included 99.9% of all Brazilian cities (n = 5,562). The use of oral health care among pregnant women increased from 15% in 2018 to 69% in 2023. Adjusted estimates show that, after initiation of the Prevent Brazil, dental care use among pregnant women increased nationally at a rate of 4.6 percentage points per 4-mo period (95% confidence interval [CI] 4.5; 4.7). The policy's largest impact was in the North and Northeast regions, which have the lowest socioeconomic profiles (adjusted time-series rate 5.7 [95% CI 5.3; 6.1] and 5.2 [5.0; 5.4] percent points, respectively). Our findings support the positive impact of the Prevent Brazil policy on prenatal dental care in Brazil. The policy was associated with a countrywide improvement in prenatal dental care use, with a greater impact in socioeconomically disadvantaged regions.

A bibliometric analysis of Community Dentistry and Oral Epidemiology: Fifty years of publications.

OBJECTIVES: In celebration of the journal's 50th anniversary, the aim of the study was to review the whole collection of Community Dentistry and Oral Epidemiology (CDOE) publications from 1973 to 2022 and provide a complete overview of the main publication characteristics. METHODS: The study used bibliometric techniques such as performance and science mapping analysis of 3428 articles extracted from the Scopus database. The data were analysed using the 'Bibliometrix' package in R. The journal's scientific production was examined, along with the yearly citation count, the distribution of publications based on authors, the corresponding author's country and affiliation and citation count, citing source and keywords. Bibliometric network maps were constructed to determine the conceptual, intellectual and social collaborative structure over the past 50 years. The trending research topics and themes were identified. RESULTS: The total number of articles and average citations has increased over the years. D Locker, AJ Spencer, A Sheiham and WM Thomson were the most frequently published authors, and PE Petersen, GD Slade and AI Ismail published papers with the highest citations. The most published countries were the United States, United Kingdom, Brazil and Canada, frequently engaging in collaborative efforts. The most common keywords used were 'dental caries', 'oral epidemiology' and 'oral health'. The trending topics were healthcare and health disparities, social determinants of health, systematic review and health inequalities. Epidemiology, oral health and disparities were highly researched areas. CONCLUSION: This bibliometric study reviews CDOE's significant contribution to dental public health by identifying key research trends, themes, influential authors and collaborations. The findings provide insights into the need to increase publications from developing countries, improve gender diversity in authorship and broaden the scope of research themes.

Atraumatic Restorative Treatment (ART) as Public Policy: a Scoping Review / O Tratamento Restaurador Atraumático (ART) como Política Pública: uma Revisão de Escopo

This scoping review aimed to identify, describe, and analyze the use of Atraumatic Restorative Treatment (ART) as public policy. Inclusion criteria: studies on public oral health policies; dental caries; ART. Exclusion criteria: clinical studies; specific interventions; studies that report public policies that do not use ART as a strategy for caries treatment. The search was conducted in PubMed, BVS, Epistemonikos, Health Systems Evidence, and Rxforchange. The selection process and data extraction were performed by two authors independently according to the stages and categories of a conceptual framework. Of the 2253 eligible articles, 139 were duplicates, and 1680 were not included after reading the title and abstract. After assessing the full text, 414 articles were excluded. Twenty articles were included. Nineteen were conducted in nine countries (South Africa, Bolivia, Cambodia, Egypt, Mexico, Tanzania, East Timor, Tunisia, and Zimbabwe), and one in the Americas. The studies reported high prevalence of dental caries and lack of access to restorative procedures in health services as common problems. Policy developments followed a similar process, with the presence of governments, conceptual use of scientific evidence, and induction by the World Health Organization. Regarding implementation barriers, the included studies mentioned the lack of supplies and lack of induction by managers,while in relation to the facilitators, permanent education and professional practice were mentioned. Cohort studies have shown a survival rate greater than 80% after one year of follow up of the restorations performed. The findings of this review indicate that the use of ART in public policies is promising, however, its use is still in an early stage. (AU)

Esta revisão de escopo teve como objetivo identificar, descrever e analisar o uso do Tratamento Restaurador Atraumático (ART) como política pública. Critérios de inclusão: estudos sobre políticas públicas de saúde bucal; cáries dentárias; ART. Critérios de exclusão: estudos clínicos; intervenções específicas; estudos que relatam políticas públicas que não utilizam o ART como estratégia para o tratamento de cárie. A pesquisa foi realizada no PubMed, BVS, Epistemonikos, Health Systems Evidence e Rxforchange. O processo de seleção e extração de dados foram realizados por dois autores, de forma independente, de acordo com as etapas e categorias de um quadro conceitual. Dos 2.253 artigos elegíveis, 139 eram duplicados e 1.680 não foram incluídos após a leitura do título e do resumo. Após avaliação do texto completo, foram excluídos 414 artigos. Vinte artigos foram incluídos. Dezenove foram realizados em nove países (África do Sul, Bolívia, Camboja, Egito, México, Tanzânia, Timor Leste, Tunísia e Zimbábue) e um nas Américas. Os estudos relataram alta prevalência de cárie dentária e falta de acesso a procedimentos restauradores nos serviços de saúde como problemas comuns. Os desenvolvimentos de políticas seguiram um processo semelhante, com a presença de governos, uso conceitual de evidências científicas e indução da Organização Mundial da Saúde. Quanto às barreiras de implementação, foram mencionadas a falta de insumos e a falta de indução por parte dos gestores. Quanto aos facilitadores, foram citados a educação permanente e a prática profissional. Estudos de coorte mostraram sobrevida superior a 80% após um ano de acompanhamento. Os achados desta revisão indicam que a utilização da ART nas políticas públicas é promissora, porém, sua utilização ainda é incipiente. (AU)

Satisfacción del usuario en la atención odontológica comunitaria en Reynosa, Tamaulipas / User ́s satisfaction of community dental care in Reynosa,Tamaulipas

Resumen Objetivo: Evaluar el nivel de satisfacción en la atención recibida por los usuarios de la Clínica Odontológica de la Universidad México Americana del Norte (CO-UMAN) Allende. Material y método: El estudio fue descriptivo, observacional, transversal y prospectivo; se aplicó una encuesta de opinión a 200 pacientes, seleccionados mediante muestreo por conveniencia en 2019, sobre la estructura, proceso y resultados de la atención; así como bio-demográficos de cada paciente. Resultados: Predominaron pacientes con edades entre 21 y 60 años (71%), mujeres (63%), casados(as) (45%), empleados(as)/amas de casa (57%) y baja frecuencia de enfermedades concomitantes (10%). A mayor edad hubo mayor frecuencia de enfermedades concomitantes (r=0.26; p<0.05) y satisfacción en el servicio (r=0.26; p<0.05); con otras enfermedades concomitantes la satisfacción del paciente fue menor (r=-0.39; p<0.05). Los pacientes indican que hay más satisfacción (de 2.6 a 5.4 veces) al recibir un servicio adecuado o mejor. La satisfacción del paciente y la calidad de la atención de la clínica se asoció positivamente (p<0.05) con los trámites sencillos, trato por parte del odontólogo; confianza en la calidad de los servicios recibidos; relación costo/beneficio; puntualidad en la atención y efectividad del tratamiento odontológico recibido. Los coeficientes canónicos estandarizados indicaron mayor contribución en la satisfacción del usuario: las instalaciones e infraestructura de la clínica (0.479); atención del personal y proceso administrativo (0.543); atención del odontólogo (0.700); confianza en la atención y percepción del servicio recibido (0.660) y pobre relación con edad (0.078), género (0.030), estado civil (-0.040) y ocupación del paciente (0.065). Conclusión: No obstante que la cantidad y calidad del servicio de la CO-UMAN se ha incrementado y mejorado sustantivamente, es necesario desarrollar un plan de mejora continua para alcanzar estándares de calidad total.

Abstract Objective: To evaluate the level of satisfaction in the care received by the users of the Dental Clinic of the Universidad México Americana del Norte (DC-UMAN) Allende. Material and method: The study was descriptive, observational, cross-sectional, and prospective. In 2019, an opinion survey on the structure, proceedings, and results of the care, as well as bio-demographics of each patient was applied to 200 patients selected by convenience sampling. Results: Patients aged between 21 and 60 years (71%), women (63%), married (45%), employees/housewives (57%) and a low frequency of concomitant diseases (10%) predominated. At an older age, there was a higher frequency of concomitant diseases (r=0.26; p<0.05) and satisfaction in the service (r=0.26; p<0.05); with other concomitant diseases, patient satisfaction was lower (r=-0.39; p<0.05). Patients indicated that there is more satisfaction (from 2.6 to 5.4 times) when receiving an adequate or better service. Patient satisfaction and the quality of clinic care were positively associated (p<0.05) with simple procedures, treatment by the dentist, confidence in the quality of the services received, cost-benefit ratio, punctuality in the care and effectiveness of the dental treatment received. The standardized canonical coefficients indicated a greater contribution to user satisfaction from the facilities and infrastructure of the clinic (0.479), staff attention and administrative process (0.543), dental care (0.700), trust in care and perception of the service received (0.660) and poor relationship with age (0.078), gender (0.030), marital status (-0.040), and occupation (0.065) of the patient. Conclusion: Although the quantity and quality of the DC-UMAN service has increased and improved substantially, it is necessary to develop a continuous improvement plan to achieve total quality standards.

Factors related to the waiting time for scheduling an oral biopsy in Brazil: a multilevel analysis.

BACKGROUND: Timely diagnosis of oral cancers is critical, and performing biopsies of oral lesions with suspected malignancy is a crucial step in achieving this goal. The waiting time for the diagnosis may be related to the progression and prognosis of malignant neoplasms. OBJECTIVE: The aim of this observational, cross-sectional, national-level study was to identify the factors associated with the waiting time for scheduling an oral biopsy, based on the identification of its need. METHODS: We used secondary data from the Brazilian public health system, obtained from the 2nd cycle of the National Program to Improve Access and Quality of Dental Specialty Centers (PMAQ-CEO). The study outcome was the waiting time for scheduling an oral biopsy, starting from the identification of the need for the exam. We analyzed individual and contextual variables using multilevel statistical analysis. RESULTS: In 51.8% of DSC the waiting time for scheduling a biopsy was non-immediate; in 58.1% of CEOs, the sum of the weekly workload of dentists working in the Stomatology specialty is up to 20 h per week; in terms of coverage, 67.1% of the CEOs have only municipal coverage and 34.0% are references for up to 12 oral health teams in primary health care; only the coverage variable remained significant in the multivariate model (p < 0.05). Of the contextual variables, none of the variables remained significant (p > 0.05). When these were analyzed together, only the coverage remained significant (p < 0.05); CONCLUSION: Our analysis indicates that the waiting time for scheduling an oral biopsy is longer in CEOs that cover only one municipality and is not related to contextual factors.

Experiencia educativa de una estructura didáctica en la carrera de Estomatología para visitas domiciliarias / Educational experience of a didactic structure in the Dentistry career to visit the family

Fundamento: en el entorno educativo las investigaciones relacionadas con los modos de actuación de los estudiantes adquieren especial significación. Los estudiantes de cuarto año de la carrera de Estomatología del escenario docente del policlínico "Docente de Playa" de la Facultad de Ciencias Médicas "Victoria de Girón" necesitan formarse del modo más cercano posible a los modos de actuación del futuro egresado, al tener en consideración problemas teóricos y metodológicos objetos de la profesión. Objetivo: describir una experiencia educativa sobre la aplicación de una estructura didáctica para el desarrollo de la visita a la familia como modalidad de la educación en el trabajo con estudiantes de cuarto año de Estomatología. Métodos: la investigación se desarrolló durante los cursos comprendidos entre el año 2014 al 2019. Se utilizaron métodos del nivel teórico, empírico y estadístico. La estructura didáctica centrada en el desarrollo de la visita a la familia consta de cuatro etapas con los correspondientes objetivos y acciones. Resultados: se reconoce la educación en el trabajo como forma fundamental de organización de la enseñanza para la carrera de Estomatología y la visita a la familia como una de las modalidades, lo cual constituye una pauta a seguir en la estructura didáctica propuesta. Conclusiones: el análisis y valoración de los resultados obtenidos luego de la aplicación, permitió constatar cambios significativos y transformaciones cualitativas a partir de la estructura didáctica, lo cual constituye una alternativa para el mejoramiento de los modos de actuación de los estudiantes de cuarto año de la carrera de Estomatología.

Background: in the educational environment, research related to students' modes of action acquire special meaning. The fourth-year students of the Dentistry degree in the teaching setting of the Victoria de Girón "teachin polyclinic of the ""Playa Faculty of Medical Sciences need to be trained as closely as possible to the modes of action of the future graduate, by taking into consideration theoretical and methodological problems objects of the profession. Objective: to describe an educational experience on the application of a didactic structure for the development of family visits as a modality of the in-service training with fourth-year dentistry students. Methods: the research was developed during the courses from 2014 to 2019. Theoretical, empirical and statistical methods were used. The didactic structure focused on the development of the visit to the family consists of four stages with the corresponding objectives and actions. Results: education at work is recognized as a fundamental way of organizing teaching for the Dentistry career and visiting the family as one of the modalities, which constitutes a guideline to follow in the proposed didactic structure. Conclusions: the analysis and assessment of the results obtained after the application allowed us to verify significant changes and qualitative transformations from the didactic structure, which constitutes an alternative for the improvement of the modes of action of the fourth year students of the Dentistry career.

[Health-illness and dental care in rural areas: Social representations of Argentine women]. / Salud-enfermedad y cuidados odontológicos en la ruralidad: representaciones sociales de mujeres argentinas.

The purpose of this study was to identify the social representations of the health/illness/care process from a dental dimension in rural dwellers in the north of the province of Cordoba, Argentina. Qualitative research was conducted based on the interpretivist paradigm. A purposive sampling was designed and selected to set up interviews with women who attend the hospital in Villa Candelaria Norte, and in-depth interviews with a subsample of dwellers from the area. The data were analyzed based on the grounded theory using Atlas Ti Software. The research was approved by the Ethics Committee (Res. 384/13). The people interviewed were separated into three groups: a) dwellers from the town center, b) dwellers from surrounding areas, and c) the health care team. The analysis dimension of the health/illness/care process is identified from a dental dimension in two sub-categories: perception of pain and loss of teeth. The results obtained serve to highlight the fact that "health" is associated with the demand for care when faced with an oral disease, which reproduces a biomedical model ­ repairing illness; pain and loss of teeth have become naturalized. It can be concluded that the results obtained reflect the lack of a positive conception of oral health which would lead to preventive care. Acknowledging these social representations related to health guides the construction of knowledge to plan actions pertaining to oral health care and disease.

El objetivo de este estudio fue identificar las representaciones sociales del proceso salud/enfermedad/atención desde una dimensión odontológica en pobladores rurales en el norte de Córdoba, Argentina. Se realizó una investigación de carácter cualitativo a partir del paradigma interpretativista. Se realizó observación, registrada en un cuaderno de bitácora. Se diseñó y seleccionó un muestreo intencional para la implementación de entrevistas a mujeres que asisten al hospital de Villa Candelaria Norte y efectores de salud, así como entrevistas en profundidad a una submuestra de mujeres. La información fue cargada en el Software Atlas Ti para su análisis a través de la teoría fundamentada. El proyecto fue aprobado por un Comité de Ética (Res. 384/13). Las personas entrevistadas se clasificaron en 3 grupos: a) pobladoras del centro de la localidad, b) pobladoras de parajes y c) equipo de salud. Se identifica la dimensión de análisis "proceso salud/enfermedad/atención desde una dimensión odontológica" en dos sub-categorías: a través de la percepción de dolor y la pérdida de elementos dentarios. Los resultados alcanzados ponen en evidencia que "salud" se asocia a la demanda de atención que surge ante una enfermedad bucal, reproduciendo un modelo biomédico - reparador de la enfermedad; existe una naturalización del dolor y de la pérdida de elementos dentarios. Se concluye que los resultados expuestos reflejan ausencia de una concepción de salud bucal positiva e integral que permita su cuidado desde una perspectiva preventiva. El reconocimiento de las representaciones sociales de la salud orienta la construcción de conocimientos sobre salud y enfermedad bucal.

Digital Form for Assessing Dentists' Knowledge about Oral Care of People Living with HIV.

Oral lesions are usually the first sign of HIV infection. The present study aimed to determine the level of the knowledge of dentists on the dental care needs of People Living with HIV (PLWH). This cross-sectional study was conducted between February and May 2021, in the Brazilian state of Pará, during which a total of 51 dentists received an anonymous digital form (Google® Forms Platform) composed of four blocks of discursive, dichotomous, and multiple-choice questions. The questions referred to various aspects of the dental care needs of PLWH, together with data on the professional activities of the dentists. After signing the term of informed consent, the dentists were divided into six subgroups according to the time (in years) since completing their bachelor's degree in dentistry. The data were presented as descriptive statistics and percentages, and then analyzed using the Kappa test. Most (70.6%; 36 of 51) of the dentists were female, the mean age of the dentists was 32.5 years, and a majority (80.2%) were based in the city of Belem; the mean time since graduation was 8.5 years, with 22 (43.1%) having more than 5 years of professional experience, and 31 (60.8%) having graduated from a private dental college. Just over half (51%) of the 51 dentists had completed graduate courses, and the most common dental specialty was orthodontics (19.6%). Most (74.5%) of the dentists work in the private sector, 38 (74.5%) claimed to have already provided oral care to PLWH, and 43 (84.3%) had access to specialist content on the oral care needs of PLWH. In terms of the knowledge of the dentists with regard to the oral care needs of PLWH, four of the ten diagnostic questions obtained more inadequate answers than expected, whereas the final two questions (11-45.1% and 12-31.4%) demonstrated that many of the dentists adopt unnecessary modifications in their oral care protocol for PLWH, due to a fear of contamination. Overall, our results demonstrate a frequent lack of knowledge, especially with regard to the oral healthcare needs of PLWH, which may account for many of the stigmas that persist in the dental care of this vulnerable group.

Trajectories of Sugar Consumption and Dental Caries in Early Childhood.

This study verifies the association between the trajectory of sugar consumption and dental caries in the 2015 Pelotas Birth Cohort in Pelotas, Brazil. It was conducted with data from the follow-ups at 3, 12, 24, and 48 mo from the 2015 Birth Cohort, which included 4,275 children born alive in hospitals in Pelotas. Data collection included standardized questionnaires for first caregivers applied by trained interviewers at all follow-ups. Exposure was the trajectory of sugar consumption from 3 to 48 mo (always low, always intermediate, increasing, and always high), obtained by group-based trajectory modeling. The outcome of this study was dental caries, obtained through clinical examination performed by calibrated dentists at 48 mo of age. Socioeconomic conditions and oral health instruction from a health professional during the first 4 y of life were included in the analysis as potential confounders. Prevalence ratios and their 95% confidence intervals were provided from generalized estimating equations with a log-Poisson with robust variance specification. In total, 3,654 (91.1%) children participated in the survey at 48 mo, and 2,806 children had complete data for the analyzes performed. Of these, 1,012 (36.1%; 95% confidence interval [CI], 34.3-37.8) experienced caries, and 723 (25.8%; 95% CI, 24.2-27.4) had cavitated caries. Regarding cavitated caries, the prevalence was 1.48 times higher in the group with increasing sugar consumption than children with always low consumption. There is an association between the trajectory of sugar consumption and dental caries at 48 mo. Children with increasing and always high sugar consumption have the highest prevalence of caries.

Projeto Rede de Cuidados Territoriais em Saúde: cuidado integral e multiprofissional como prática de aprendizagem / Territorial Health Care Network Project: comprehensive and multiprofessional care as a learning practice

Na formação do profissional de saúde é essencial o conhecimento sobre o Sistema Único de Saúde (SUS) além da teoria, sendo importante a vivência prática da interdisciplinaridade e interprofissionalidade no cuidado integral dos indivíduos. O presente relato de experiência descreve, sob a visão de um aluno do curso de odontologia, as principais ações, como as visitas domiciliares, que tinham o enfoque na atenção primária à saúde, a busca ativa de demandas urgentes dos usuários e a importância delas no cuidado em saúde de uma comunidade incluída no Projeto Rede de Cuidados Territoriais, realizado pela Universidade de Passo Fundo, Brasil. O relato de experiência traz os aprendizados e reflexões gerados durante os encontros em equipe, como consequências das visitas domiciliares multidisciplinares, que ocorreram semanalmente, propiciando ao aluno o acompanhamento de famílias e a criação de vínculos, visando o cuidado e a atenção integral. As ações do projeto contribuíram para a formação acadêmica dos alunos de diversos cursos da área da saúde de uma Instituição de Ensino Superior (IES), permitindo a prática no território, na comunidade, sem simulações. A partir da realidade da população, o grupo acadêmico foi estimulado a conhecer o SUS, pela vivência das suas diretrizes e princípios, a realidade do sistema, incluindo suas fortalezas e fraquezas. Identifiquei, a partir dessa experiência, que ações voltadas as comunidades mais vulneráveis em seus territórios são desafiadoras, principalmente em relação a tomada de decisões na atenção integral à saúde dos indivíduos (AU).

In the education of health professionals, in addition to theory, knowledge about the Unified Health System (SUS) is essential, as this system providessignificant practical experience of interdisciplinarity and interprofessionality in the integral care of individualsto health professionals. Thisexperience report describes, fromthe viewpointof dentistry students,the main actionsincluded in the health care of a community in the Territorial Care Network Project, conducted by the University of Passo Fundo, Brazil; these actions includedhome visits, which focused on primary health care, and the active search for urgent demands of users. The experience report presents the learning and reflections generated during team meetingsheld to discussmultidisciplinary home visits, which occurred weekly,these provided the students with the information collected after monitoring the families in the target community; they alsoenabled the student to witness the creation of bonds among health care professionals and community members; thus, the students learned the significance of primary care and comprehensive care. The actions of the project contributed to the academic training of students from various courses in the health field of a Higher Education Institution (HEI), facilitatingtheirpractice in the territory, that is, in this case, the community, without simulation. Thus, the academic group was encouraged to learnthe roleof SUSin a community, by practically implementingits guidelines and principles, and the reality of the system, including its strengths and weaknesses. From this experience, weidentifythat actions aimed at the most vulnerable communities in their territories are challenging, especially in relation to decision-making in comprehensive health care of individuals (AU).

Estágio Comunitário Interprofissional na formação do estudante de Odontologia: relato de experiência da Universidade Federal de Goiás / Interprofessional Community Internship in Dental Student Education: experience report of the Federal University of Goiás

O Sistema Único de Saúde configura-se como um potente cenário de atuação e campo de formação interprofissional, principalmente,no que se refere aos estágios supervisionados. Esse relato de experiência (RE) tem como objetivo descrever o processo de construção do Estágio Comunitário Interprofissional (ECI) da Universidade Federal de Goiás na perspectiva da formação do cirurgião-dentista. A construção parte das experiências vivenciadas e refletidas pelas autoras/sujeitos do RE: as professoras do estágio em cada curso (enfermagem, nutrição, medicinae odontologia) e a coordenadora da integração ensino-serviço-comunidade do campus do município onde ocorre o estágio. Foram ainda consultados os planos de ensino e projetos pedagógicos dos cursos envolvidos, as memórias das oficinas avaliativas realizadas ao longo do estágioe o Manual do Estágio Comunitário. O contexto do ECI, o processo ensino-aprendizagem na formação interprofissional do estudante de odontologia, a busca da sustentabilidade do estágio e a potencialidade da aprendizagem informal são apresentados e discutidos. Considera-se os avanços históricos alcançados no percurso do ECI e os dispositivos que favorecem tais mudanças na perspectiva da educação e prática interprofissional, além dos potenciais pontos de evolução do estágio para garantir a formação integral do cirurgião-dentista, no que tange às competências colaborativas (AU).

The Unified Health System (SUS) in Brazil is a powerful scenario for action and a field of interprofessional education, particularly with regard to supervised internships. This experiencereport (ER) describes the structure of the interprofessional community internship (ICI) at the Federal Universityof Goiás from the perspective of dental education. The articleis based on the experiences and reflectionsofthe authorsand subjectsof the ER: the faculty of each study program (Dentistry, Medicine, Nursing, and Nutrition) and the coordinator for the integration of teaching, service, and community on the campus where the internshiptakes place. The pedagogical projects and teaching plans of the participating programs, the evaluation workshops during the internship, and the community internship manualwere also consulted.The ICI context, the learning process in interprofessional dental student education, the sustainability of the internship, and the potential of informal learning are presented and discussed. The historical advances made during the ICIand the means by which such changes in the perspective of education and interprofessional practice are fostered, as well as the potential points of development of the internshipto ensure the holistic education of dental studentsin terms of collaborativeskills, are considered (AU).

Professional Factors Associated with Case Resolution without Referrals of Orofacial Pain Cases to Secondary Dental Care by Telehealth in Brazil: A Cross-Sectional Study in 2019 and 2020.

This study aimed to identify professional factors associated with case resolution without a referral of orofacial pain to secondary health care by Brazilian Primary Health Care (PHC) practitioners who demanded asynchronous teleconsulting, stratified by year, in 2019 and 2020 (the COVID-19 Pandemic burst). A cross-sectional study employed secondary databases from asynchronous teleconsulting Telehealth Brazil Networks from January 2019 to December 2020. The outcome was the dichotomous variable "If referral to secondary care was avoided." As covariates: sex, healthcare professions, and category of orofacial pain doubts. A negative binomial regression model estimated each covariate's unadjusted and adjusted PR (95%CI) and p values, stratified for 2019 and 2020. There was a difference in descriptive factors associated with case resolution without a referral from 2019 to 2020. Females prevailed in both years, and the total demand decreased to a third from 2019 to 2020. The rate of resoluteness decreased by 19.1%. In 2019, nurses (PR = 0.69 CI 95% 0.57-0.83) and other professionals (PR = 0.84 CI 95% 0.73-0.97) showed less frequency of case resolution without a referral than did general dentists. In 2020, oral-cavity-related doubts (PR = 1.18 CI 95% 1.06-1.32) and temporomandibular disorders (PR = 1.33 95% 1.15-1.54) surpassed other causes of orofacial pain in case resolution without a referral, and female professionals avoided referrals more frequently than men (PR = 1.24 CI 95% 1.21-1.38). In conclusion, in 2019, oral cavity doubts and the PHC profession influenced the case resolution. Female professionals and oral cavity doubts scored the higher case resolution without a referral for the service in 2020.

Factors Associated With Self-Perception in Oral Health of Pregnant Women.

BACKGROUND: Health perception is a subjective predictor of long-term morbidity and mortality. Few studies address the perception that pregnant women have of their oral health. OBJECTIVE: The objective of this study was to explore the relationship between socioeconomic factors and self-assessment of oral health in pregnant women from Cali, Colombia. METHOD: A cross-sectional study was carried out with a sample of 998 pregnant women, calculated using the formula to estimate a proportion in finite populations, with a confidence level of 95%. A questionnaire was applied for sociodemographic characterization, as well as to enquire about oral health perception, knowledge, and practices of oral health. RESULTS: The mean age of the surveyed mothers was 24.7, with a standard deviation of 6.1, of which 23.6% were adolescents. The perception they had about their oral health status was considered good by 60.8%. Of the 82.9% who reported having attended dentistry, more than half perceived good oral health. Pregnant women with no history of oral problems, with a perception of medium or high income, and with good oral hygiene practices tend to have a good perception of their oral health. CONCLUSION: Pregnant women with no history of oral problems, with a perception of medium or high income, and with good oral hygiene practices tend to have a good perception of their oral health.

Dental care during the COVID-19 pandemic: an integrative review / Cuidados odontológicos durante a pandemia do COVID-19: uma revisão integrativa

ABSTRACT Objective: The study and enactment of dental preventive measures, in response to the COVID-19 pandemic, are necessary to prevent cross-infections between professionals and patients. The objective of this integrative review was to identify the COVID-19 preventive practices in dentistry. Methods: The electronic search was conducted on these databases: Pubmed / Medline, Web of Science, Cochrane Library, Scopus, LILACS and Scielo, using the following descriptors and / or words: "Coronavirus disease 2019"; "Coronavirus 2019"; "Covid-19"; "2019-ncov"; "Sars-cov2"; "Dental practice"; "Dental care"; "Dentistry"; "Dental medicine" and "Oral medicine". PRISMA was used as a reference for designing it. Results: A total of 11 articles were included and the preventive measures against COVID-19 were based on guidelines from health agencies and consisted of: perform only emergency treatments; reschedule patients with suspected disease; hand washing; disinfection of surfaces with 70% alcohol; testing dental professionals for the disease; use the N95 mask; disposable lab coats, and face shields. Children, in addition to the measures mentioned above, should routinely drink a lot of water and be provided with healthy diets. No study has evaluated the efficacy and effectiveness of these measures. There is a lack of scientific evidence on the preventive protocols adopted against COVID-19 in dentistry since preventive measures are recommended by health agencies. Conclusion: Consequently, professionals are recommended to follow the guidelines by these organizations until effective and efficient preventive protocols tailored to dentistry are established.

RESUMO Objetivo: O estudo e a adoção de medidas preventivas odontológicas, em resposta à pandemia do COVID-19, são necessárias para evitar infecções cruzadas entre profissionais e pacientes. O objetivo desta revisão integrativa foi identificar as práticas preventivas do COVID-19 em odontologia. Métodos: A busca eletrônica foi realizada nas seguintes bases de dados: Pubmed / Medline, Web of Science, Cochrane Library, Scopus, LILACS e Scielo, utilizando os seguintes descritores e / ou palavras: "Coronavirus disease 2019"; "Coronavirus 2019"; "Covid-19"; "2019-ncov"; "Sars-cov2"; "Dental practice"; "Dental care"; "Dentistry"; "Dental medicine" and "Oral medicine". O PRISMA foi utilizado como referência para sua realização. Resultados: Um total de 11 estudos foram incluídos e as medidas preventivas contra COVID-19 foram baseadas em diretrizes dos órgãos de saúde e consistiram em: realizar apenas tratamentos de emergência; reagendar pacientes com suspeita de doença; lavar as mãos; desinfetar superfícies com álcool a 70%; testar profissionais de odontologia para a doença; usar a máscara N95; jalecos descartáveis e protetores faciais. As crianças, além das medidas mencionadas acima, devem rotineiramente beber muita água e receber dietas saudáveis. Nenhum estudo avaliou a eficácia e a efetividade dessas medidas preventivas. Faltam evidências científicas sobre os protocolos preventivos adotados contra o COVID-19 em odontologia, uma vez que medidas preventivas são recomendadas pelos órgãos de saúde. Conclusão: Consequentemente, recomenda-se aos profissionais que sigam essas organizações até que sejam estabelecidos protocolos preventivos eficazes e eficientes, adaptados à odontologia.

Indicators for dental appointment scheduling in primary health care: a national cross-sectional study.

BACKGROUND: Integrated dental services within the Health System, particularly at primary health care, are crucial to reverse the current impact of oral diseases, which are among the most prevalent diseases worldwide. However, the use of dental services is determined by complex phenomena related to the individual, the environment and practices in which care is offered. Therefore, factors associated with dental appointments scheduling can affect positively or negatively the use of dental services. The aim of the present study was to evaluate the indicators for dental appointment scheduling in Primary Health Care (PHC). METHODS: The present is a cross-sectional analytical study that used data from the external assessment of the third cycle of the National Program for Improving Access and Quality in Primary Care (PMAQ-AB), carried out between 2017 and 2018, in Brazil. The final sample consisted of 85,231 patients and 22,475 Oral Health teams (OHTs). The outcome variable was the fact that the user sought for a dental appointment at the Primary Health Care Unit. A multilevel analysis was carried out to verify the association between individual variables (related to users) and contextual variables (related to the OHTs) in relation to the outcome. RESULTS: Only 58.1% of the users interviewed at these Primary Health Care Units seek the available dental care. The variables with the greatest effect on the outcome were the patient's age up to 42 years old (OR = 2.03, 95% CI: 1.96-2.10), at individual level, and 'oral health teams that assisted no more than a single family health team (FHT)' (OR = 1.29, 95% CI: 1.23-1.36) at contextual level. Other variables were also associated with the outcome, but with a smaller effect size. CONCLUSION: In conclusion, users' age and work process of OHT were indicators for dental appointment scheduling. Our results suggest that when OHT put the National Oral Health Policy guidelines into practice, by assisting only one FHT, the chance for PHC users seeking dental appointments is higher than OHTs that assist more than one FHT. Regarding age, patients aged up to 42 years are more likely to seek an appointment with a dentist.

A extensão universitária na formação do cirurgião-dentista / Importance of university extension in the professional training of dentalsurgeons

As universidades têmse transformado ao longo dos tempos. O foco principal no ensino foi sendo ampliado com ações de pesquisa e de extensão. Esta vem ganhando cada vez mais espaço nas instituições de ensino superior, fazendo parteda tríade que sustenta a formação universitária. O objetivo desta revisão de literatura foi mostrar a importância da extensão universitária na formação profissional de cirurgiões-dentistas e para a sociedade. A estratégia de busca de artigos se deu por palavras-chave relacionadas à Odontologia e à extensão universitária em bases de dados eletrônicas, no período de agosto a outubro de 2019. A prática da extensão,em comunidades diversas, fortalece a compreensão dos estudantes quanto ao processo saúde-doença, permite conhecer arealidade econômica e social em diferentes cenários, permite vivenciar a rede deserviços públicos de saúde, assim comoparticipar da prestação de serviços à população, tornando-osmais humanizadose capacitados a promover a saúde da comunidade em que estão inseridos. A extensão universitária tem um importante papel na formação profissional do cirurgião-dentista, colaborando para que atue deforma competente para contemplar as diversas necessidades da população, estimulando ações de promoção de saúde e informação à população emgeral, que também se torna beneficiada com estas ações, e fortalecendo o compromisso da universidade com a sociedade (AU).

Universities have transformed over time. The main focus of teachingstarted to expandwith research and extension activities. Extensioncourseshavebeen increasingly introducedin higher education institutions, participating inthe triad that sustains university education. Thisliterature review aimed to show the importance of university extension in the professional training of dental surgeons and society. The strategy for searching articles was based on keywords related to dentistry and university extension,in electronic databases, from August to October 2019. In different communities, the practice of extension strengthens the understanding of students about the health-disease processandallows knowing the economic and social realitiesof different scenarios, experiencing the public health care network, and participating in the provision of services to the population, which makesstudents more humanized and able to promote health to theircommunities. University extension plays an important role in the professional training of dental surgeons, helping them to workcompetently assisting in the diverse needs of the population, stimulating health promotion and information tothe general population who also benefitsfrom these activities, andstrengthening the commitmentof the universityto society (AU).

Construção de competências colaborativas para o trabalho em saúde nos estágios curriculares de Odontologia no SUS / Construction of collaborative skills for health work in curricular internships in Dentistry in SUS

Com a implementação do Sistema Único de Saúde (SUS), foram necessárias mudanças curriculares que preparassem os profissionais para atuar em equipe na rede de saúde. No início do século XXI passaram a ser implementadas as Diretrizes Curriculares Nacionais (DCN) que trouxeram várias mudanças, dentre as quais destaca-se a inserção do estudante de graduação no SUS. O objetivo desse estudo é analisar as percepções dos egressos do curso de graduação em Odontologiadiurnode uma universidade pública do Rio Grande do Sul, acerca da construção de competências colaborativas, durante a formação nos Estágios Curriculares Supervisionados (ECS)no SUS. Trata-se de um estudo de natureza descritiva com análise de dados qualitativos e quantitativos. Inicialmente, 133egressos, que vivenciaram os ECS entre 2012/1 a2016/1, responderam a um questionário online com questões abertas e fechadas. Com uma amostra intencional de 14 egressos,que responderam ao questionário,foram realizadas entrevistas semiestruturadas em profundidade. O material quantitativo foi submetidoà análise descritiva e o material qualitativo àanálise de conteúdo temática. Considerando que os dados quantitativos e qualitativos são complementares, eles foram submetidos a triangulaçãoe os resultados são apresentados em duas unidades de análise: Caracterização,inserção e escolhas profissionais dos egressos e Construção de competências colaborativas. A maioria dos egressos participantes (67,7%) são do sexo feminino e estão atuando em Porto Alegre ou região metropolitana (78,6%), 29,1% deles estão vinculados a serviços públicos de saúde. A satisfaçãocom os ECSé destacada pelos egressos, que os descrevemcomoindispensáveispara sua formação. Dentre as competências colaborativas construídas por meio dos estágios, o aprendizado de trabalhar em equipeinterprofissional é destacado pela maioria dos egressos (85,3%), sendolembrada comofundamental paraa atenção integral do usuário. Conclui-se que o curso de Odontologia tem obtido sucesso na formação de profissionais voltados para atuação no SUS, tendo um percentual considerável de egressos vinculados aos serviços públicos de saúde (AU).

With the establishment of the Brazilian Unified Health System (SUS), curricular changes were necessary to prepare the professionals for teamwork in the healthcarenetwork. In the early 21stcentury, the National CurricularGuidelines (DCN) were implementedand brought several changes, mainly the insertion of undergraduate students in SUS. This study analyzedthe perceptions of graduates of the daytime Dentistry course from a public university in Rio Grande do Sul about the construction of collaborative skills during training in the Supervised Curricular Internships (ECS) in SUS. This descriptive study analyzed qualitative and quantitative data. Initially, 133 graduates who experienced the ECS between 2012/1 to 2016/1 answered an online questionnaire with open and closed questions. Deeper semi-structured interviews were conductedon an intentional sample of 14 graduates who answered the questionnaire. The quantitative material was submitted to descriptive analysis and the qualitative material to thematic content analysis. Considering that quantitative and qualitative data are complementary, they were submitted to triangulation and the results are presented in two units of analysis: Characterization, insertion and professional choices of graduates;and Construction of collaborative skills. Most participating graduates (67.7%) are femalesand are working in Porto Alegre or metropolitan area (78.6%), being 29.1% inserted in public health services. The satisfaction with the ECS is highlighted by the graduates, who describe them as fundamental for their training. Among the collaborative skills built during internships, learning how to work in an interprofessional team was highlighted by most graduates (85.3%), being remembered as fundamental for the integral care to the user. It is concluded that the Dentistry course has been successful in the training of professionals to workin SUS, with a considerable percentage of graduates inserted in public health services (AU).

Satisfação das gestantes durante a consulta odontológica no Sistema Unico de Saúde, Brasil / Satisfaction of pregnant women during dental consults in Brazilian Unified Health System / Satisfacción de las mujeres embarazadas durante la consulta odontológica en el Sistema Único de Salud de Brasil

RESUMO Objetivo O objetivo do trabalho foi verificar a taxa de gestantes satisfeitas com a consulta odontológica realizada no Sistema Único de Saúde (SUS-Brasil) e fatores associados. Metodologia O estudo foi do tipo transversal. Para coleta de dados foi elaborado um questionário abordando variáveis sociodemográficas e relacionadas a gestação. A coleta de dados foi realizada através de entrevistas face a face em um hospital maternidade da região metropolitana de Porto Alegre-RS-Brasil. O teste de qui-quadrado e a regressão de Poisson com variância robusta (p<0,05) foram utilizados nas análises bi e multivariada. Resultados Das 302 mulheres entrevistadas, 50%(n=151) realizaram consulta odontológica durante a gestação e destas, 86% (n=131) estavam satisfeitas com a consulta. Na análise multivariada verificou-se que a variável avaliação das consultas de pré-natal como boa aumentou em 14% [Razão de Prevalência (RP)=1,14; Intervalo de Confiança (IC) 95%:1,01-1,27] a probabilidade de as mulheres expressarem satisfação com a variável desfecho. Conclusão Conclui-se que foi alta taxa de satisfação com as consultas odontológicas realizadas no SUS pelas gestantes e avaliação das consultas de pré-natal como boa foi fator associado. Estes resultados poderiam ser considerados durante o planejamento estratégico, execução e avaliação das políticas de saúde direcionadas para este grupo operativo.

ABSTRACT Objective The study aimed to verify the rate of satisfaction among pregnant women with dental consults performed in the Brazilian Unified Health System (BUHS), and associated factors. Methodology The design of the study was cross-sectional. To collect data a questionnaire approaching variables sociodemographic and relationship whit pregnancy were used. The data gathering was realized across interviews face to face in a maternity hospital in the metropolitan region of Porto Alegre-RS-Brazil. The chi-square test and Poisson regression with robust variance (p<0.05) were used for the bivariate and multivariate analyses. Results A total of 302 pregnant women were interviewed, 50% (n=151) performed dental consults, and 86% (131) related that they were satisfied with the consult. In the multivariate analysis it was found that the variable evaluating prenatal visits as good increased the likelihood of women expressing satisfaction with the outcome variable by 14% [Prevalence Ratio (PR) =1.14; 95% Confidence Interval (CI): 1.01-1.27]. Conclusions The present study suggests that a high satisfaction rate with dental consult could be due to the highest satisfaction in prenatal consults performed in primary health care units, materializing the relationship of trust/connection between professional and user. This variable can be considered by workers and health managers during estrategic planning, performance, and evaluation of health policies.

RESUMEN Objetivo El objetivo del trabajo fue evaluar la tasa de mujeres embarazadas satisfechas con la consulta odontológica que realiza el Sistema Único de Salud-Brasil (SUS-Brasil) y factores asociados. Metodología Estudio de tipo transversal. Para colección de los dados se elaboró un cuestionario que abordaba las variables sociodemográficas y relacionadas con la gestación. La colección de los datos fue realizada por medio de entrevistas cara a cara en un hospital de maternidad de la región metropolitana del Porto Alegre, Brasil. Para comprobar la asociación de los factores con la satisfacción de las mujeres embarazadas con la consulta odontológica se usó el test de chi-cuadrado y la regresión del Poisson, con varianza robusta (p<0,05). Resultados De las 302 mujeres entrevistadas, 50% (n=151) realizaron consulta odontológica durante de la gestación y estas 86%(n=131) manifestaron estar satisfechas con la consulta. En el análisis multivariado se encontró que la variable que evaluaba las consultas prenatales como buenas aumentaba en un 14% [Razón de Prevalencia (RP)=1,14; Intervalo de Confianza (IC) del 95%:1,01-1,27] la probabilidad de que las mujeres expresaran satisfacción con la variable de resultado. Conclusiones Se concluyó que un alto índice de satisfacción con las consultas odontológicas realizadas en el SUS por parte de las embarazadas y la evaluación de las consultas prenatales como buenas fue un factor asociado. Estos resultados podrían ser considerados durante la planificación estratégica, ejecución y evaluación de las políticas de la salud pública direccionadas para este grupo operativo.

A Psychometric Network Analysis of OHIP-14 across Australian and Brazilian Populations.

OBJECTIVES: The aim of this study was to assess the structural validity of the Oral Health Impact Profile-14 (OHIP-14) instrument in Indigenous and non-Indigenous populations from Australia and Brazil using a network analysis approach. METHODS: Cross-sectional data collected using OHIP-14 were obtained for Indigenous and non-Indigenous populations from Australia and Brazil. Networks were estimated using the Gaussian graphical model. Items of the OHIP-14 instrument are represented as nodes and the partial correlations between items as edges. Dimensionality was assessed using exploratory graph analysis. Structural consistency and item stability were computed using a bootstrap sampling method. Standardized node strength across each dimension was also calculated. RESULTS: Four dimensions were identified across all samples, although the item arrangement of most dimensions presented variation. Similarities with the theoretical domains of the instrument were found. Items from the conceptually derived OHIP-14 domains formed separated clusters or blended with other items in a single dimension. Most dimensions across all samples showed an acceptable structural consistency. Item stability revealed some discrepancies among items of dimensions of both Indigenous networks. CONCLUSION: The psychometric network perspective adopted in this study provides validation of the OHIP-14 structure in Indigenous and non-Indigenous populations. The structural consistency and item stability analyses showed that both Indigenous networks present a higher number of cross-domain items and less defined boundaries between dimensions. These findings indicate that OHIP-14 does not measure attributes in the same extent among different cultures. KNOWLEDGE TRANSFER STATEMENT: This study demonstrates a new analytical framework from which to conceptualize and interpret the construct oral health-related quality of life using the Oral Health Impact Profile (OHIP-14). Network graphs facilitate knowledge translation of findings to professionals with no expertise in psychometric methods. OHIP-14 is a valuable tool to oral health research and clinical practice. Differences in conceptions of health may influence the extent that the instrument measures oral health impacts. Consequently, dimension scores do not always provide appropriate measures and should be avoided in research reports and assessments of treatment outcomes.

Brazilian Oral health teams in primary care and oral cancer: Results of a national evaluation

Abstract Oral cancer is one of the most prevalent cancers in Brazil. An understanding of how public policies are implemented to address this problem can contribute to the construction of solutions. The "Programa de Melhoria do Acesso e da Qualidade" (PMAQ-AB and PMAQ-CEO) at the level of primary and secondary care are evaluations that also collect data on prevention and monitoring strategies for oral cancer. This study aimed to analyze the results of the incorporation of oral health teams to evaluate the strategies adopted by Brazil regarding the impact on the diagnosis of oral cancer. Of the 17,202 family health teams evaluated, 72.10% had oral health teams (OHT). Considering the strategies for prevention, screening, campaign, and follow-up of suspected cases, 72.27% of the campaign teams and 59.09% of the teams who accompanied suspected cases had OHT. In secondary care, more than 65% of the teams in the Southeast and South regions registered cases of oral cancer, and the referral network was more represented. The inclusion of OHT had a positive impact on campaign actions, follow-up, referral to specialists, and registration of suspected cases throughout Brazil.