WebPalestra: a atuação do cirurgião-dentista no atendimento a pacientes com epidermólise bolhosa

O papel do cirurgião-dentista no tratamento da Epidermólise Bolhosa é de extrema importância. Estes pacientes, na sua maioria, fazem ingestão de uma dieta hipercalórica, resultando em altas taxas de cárie, além de alterações orais que requerem certos cuidados durante o atendimento odontológico.

Improving oral health in nursing home residents: A process evaluation of a shared oral care intervention.

AIMS AND OBJECTIVES: To evaluate the process of implementing an oral care intervention in nursing homes in a Danish municipality. BACKGROUND: Older people with aged natural dentition require preventive and curative oral health care. An intervention based on principles of situated learning was implemented to establish closer cooperation between dental and nursing staff in nursing homes, leading to improved oral hygiene in nursing home residents. DESIGN: An embedded multiple-case study combined with principles of realist evaluation unfolded in three phases: Formulation of initial programme theory, Testing and Refining the programme theory. The COREQ checklist is followed in reporting. METHODS: Observations, six group interviews and 22 face-to-face interviews with dentists, dental practitioners, nursing home managers, care professionals and residents were conducted in three nursing homes (n = 41). RESULTS: Three main outcomes of a programme theory were identified, relating to (a) residents, in the form of new oral care routines; (b) interdisciplinary working, in the form of professional pride in performing sufficient oral care; (c) organisational level changes, in the form of increased interdisciplinary knowledge sharing. The overarching supportive mechanisms were the creation of relationships between residents, dental practitioners and care professionals as well as nursing home management taking responsibility for structure, planning and knowledge sharing. CONCLUSION: The situated learning perspective supported residents and care professionals' competencies in performing sufficient oral care. The shared oral care intervention supports an individual and multidisciplinary assessment of nursing home residents' ability to self-care concerning oral care. Contextual factors, supportive and restraining mechanisms influence the intervention's success. RELEVANCE TO CLINICAL PRACTICE: Understanding the complexity within interdisciplinary cooperation in primary nursing and unravelling the necessary properties to enhance nursing home residents' oral health care are areas of improvement for care service in nursing homes.

Swapping drills for dressings: redeployment of dentists to community nursing.

The COVID-19 pandemic has placed increased strain on many aspects of the NHS. Dentists have been identified as having skills transferable to support community nursing teams as part of the redeployment response. This article aims to explore the roles dentists have undertaken within the community setting and reflect on dentists' transferable skills, training and personal experiences during redeployment. Despite differences in healthcare delivery, both professions share skills surrounding professionalism, communication, raising concerns and consent. Community nurses have supported dentists through specific training and competencies so that the latter are equipped with skills to support roles including wound care, catheter care and medication administration. Dentists have been well-received by community nursing colleagues and patients during redeployment. This experience has enabled redeployed dentists to establish new skillsets while improving their appreciation for the fundamental role that community nurses play within society.

A dental workforce strategy to make Australian public dental services more efficient.

BACKGROUND: Dental services can be provided by the oral health therapy (OHT) workforce and dentists. This study aims to quantify the potential cost-savings of increased utilisation of the OHT workforce in providing dental services for children under the Child Dental Benefits Schedule (CDBS). The CDBS is an Australian federal government initiative to increase dental care access for children aged 2-17 years. METHODS: Dental services billed under the CDBS for the 2013-2014 financial year were used. Two OHT-to-dentist workforce mix ratios were tested: Model A National Workforce (1:4) and Model B Victorian Workforce (2:3). The 30% average salary difference between the two professions in the public sector was used to adjust the CDBS fee schedule for each type of service. The current 29% utilisation rate of the CDBS and the government target of 80% were modelled. RESULTS: The estimated cost-savings under the current CDBS utilisation rate was AUD 26.5M and AUD 61.7M, for Models A and B, respectively. For the government target CDBS utilisation rate, AUD 73.2M for Model A and AUD 170.2M for Model B could be saved. CONCLUSION: An increased utilisation of the OHT workforce to provide dental services under the CDBS would save costs on public dental service funding. The potential cost-savings can be reinvested in other dental initiatives such as outreach school-based dental check programmes or resource allocation to eliminate adult dental waiting lists in the public sector.

O escopo da prática do cirurgião-dentista na atenção primária em saúde: estudo de caso na região metropolitana de Manaus ­ AM / The scope of the dental surgeon's practice in primary health care: a case study in the metropolitan region of Manaus - AM

O Ministério da Saúde estabeleceu o incentivo financeiro à inclusão de equipes de saúde bucal no Programa Saúde da Família, resultando em um grande impulso de expansão de equipes de saúde bucal no Brasil. Com a implantação das Diretrizes Curriculares Nacionais em Odontologia, em 2002, foram propostas várias mudanças de paradigmas na formação do profissional cirurgião-dentista. Neste contexto, esta tese teve como objetivo analisar o escopo da prática da equipe de saúde bucal no âmbito da atenção primária em saúde, tendo como base sua formação na graduação e atribuições na Estratégia Saúde da Famía da Região Metropolita de Manaus, Amazonas. A pesquisa de campo foi realizada por meio de aplicação de questionário e entrevistas aos cirurgiões-dentistas, no período de Julho de 2017 a Maio de 2018. As entrevistas foram gravadas e realizadas com base no questionário semiestruturado com 19 questões divididas, em blocos, relativas à caracterização do trabalho, escopo de prática na atenção primária à saúde, escopo de prática da equipe de saúde bucal, e as características demográficas dos entrevistados. Os dados quantitativos foram analisados estatisticamente e os qualitativos submetidos à análise de conteúdo. Participaram da pesquisa 129 cirurgiões-dentistas, com predominância do sexo feminino, com mediana de idade de 38 anos, sendo a maioria de nacionalidade brasileira, com naturalidade amazonense. A maioria dos respondentes possuem mais de 10 anos de formação, egressos de faculdades públicas do Estado do Amazonas, dos quais 56,6% com título de especialista, atuando há mais de 5 anos na APS. Foi encontrado que todos os dentistas da capital são estatutários. 60% dos cirurgiões-dentistas afirmou que aprendeu a realizar a maioria dos procedimentos no curso de graduação e que poderiam realizar mais procedimentos se tivesse materiais disponíveis e infraestrutura adequada. Os cirurgiões-dentistas da capital avaliaram o acesso aos serviços de especialidade como "bom", e os dos outros municípios como "ruim", justificando a ausência de Centro de Especiaolidades Odontológicas nesses municípios. Os dentistas concordarm que poderiam delegar ao Técnico de Saúde Bucal 17 dos 27 procedimentos realizados por cirurgião-dentista na atenção primária à saúde. A maioria das equipes de saúde bucal está organizada na modalidade I. Os técnicos em saúde bucal da região metropolitana de Manaus atuam exercendo atribuições de assistente em saúde bucal. O escopo de prática profissional dos cirurgiões-dentistas estrevistados é coerente com sua formação profissional. Para uma melhor qualificação da prática do cirurugião-dentista no âmbito do SUS, é indispensável que além de esforços continuados no campo da gestão do trabalho, da formação e da educação permanente, haja maior empenho da gestão municipal quanto ao planejamento das ações, tanto no contexto urbano, como no rural, objetivando a integralidade da atenção à saúde

The Ministry of Health established the financial incentive to include oral health teams in the Family Health Program, resulting in a major expansion of oral health teams in Brazil. With the implementation of the National Curricular Guidelines in Dentistry in 2002, several paradigm changes were proposed in the training of the professional dental surgeon. In this context, this thesis aimed to analyze the scope of the oral health team practice in primary health care, based on graduation and attributions in the Family Health Strategy of the Metropolitan Region of Manaus, Amazonas. The field research was carried out through the application of a questionnaire and interviews to dental surgeons, from July 2017 to May 2018. The interviews were recorded and performed based on the semi-structured questionnaire with 19 divided questions, in blocks, relative to the characterization of the work, scope of practice in the primary health care, scope of practice of the oral health team, and the demographic characteristics of the interviewees. Quantitative data were analyzed statistically and qualitative data were analyzed. A total of 129 dentists, predominantly female, with a median age of 38 years, were the majority Brazilian, with natural amazonense. Most respondents have more than 10 years of training, graduating from public schools in the State of Amazonas, of which 56.6% have a specialist degree, having been working for more than 5 years in the APS. It was found that all dentists in the capital are statutory. 60% of dental surgeons stated that they learned to perform most of the procedures in the undergraduate course and that they could perform more procedures if they had available materials and adequate infrastructure. The dentists in the capital evaluated access to specialty services as "good", and those of other municipalities as "bad", justifying the absence of a Center for Dental Specialties in these municipalities. The dentists agreed that they could delegate to the Oral Health Technician 17 of the 27 procedures performed by a dental surgeon in primary health care. Most oral health teams are organized in modality I. Oral health technicians in the metropolitan region of Manaus act as assistant assistants in oral health. The scope of professional practice of the dentists that are being studied is consistent with their professional training. In order to better qualify the practice of dentistry in SUS, it is essential that in addition to ongoing efforts in the field of work management, training and lifelong education, there is a greater commitment of municipal management in planning urban context, as in the rural, aiming at the integrality of health care

[Halitosis: multidisciplinary diagnostic and therapeutic approaches]. / Halitose: approches diagnostiques et thérapeutiques pluridisciplinaires.

INTRODUCTION: Halitosis is a morbid condition characterized by bad breath. Sometimes it has pathological and social implications. In the context of daily clinical practice, halitosis poses many diagnostic and therapeutic problems. This study aims to investigate the clinical and therapeutic features of this disorder. METHODS: We conducted a cross-sectional study over a one year period. Patients over the age of 15 years presenting with halitosis at the University Hospital Yalgado Ouedraogo were enrolled in the study. Patients with bad breath but presenting with some other problema were excluded. Patient's breath was assessed by a practitioner on the basis of Rosenberg organoleptic test. RESULTS: A total of 35 patients were included, with a sex ratio of 1.2. The average age of patients was 31.9 years. In 57.1% of cases, complaints were made by patients themselves. The mean duration of halitosis was 4.3 years. Nineteen patients had Mel Rosenberg score ≥ 2. Dental caries (07 cases), sinusitis (07 cases), Helicobacter pylori infection (09 cases) and gastrointestinal ulcer (10 cases) were associated with halitosis. Treatment was based on etiology in 82.9% of cases with satisfactory improvement after two weeks in 71.8% of cases. CONCLUSION: Halitosis is a little studied disorder which poses problem in positive diagnosis as well as etiologic problems in our context. The dentist plays a crucial role in identifying the possible cause of halitosis. However, multidisciplinary approach would enable a more effective response.

[Training in Family Health and its association with work processes of Primary Care Dentistry Teams]. / Formação em Saúde da Família e sua associação com processos de trabalho das Equipes de Saúde Bucal da Atenção Básica.

The National Oral Health Policy emphasizes the importance of training in Primary Health Care and adapting the work processes to the new health care model. This study seeks to investigate the association between the training of Dental-Surgeons in Family Health and the work process. It involved a cross-sectional and multicentric study, with 18,114 Oral Health Teams that participated on the National Program to Enhance Access and Quality of Primary Health Care. Data were collected through interviews, using a structured questionnaire. Professionals with post-graduate education in Family Health share their schedule with other Primary Care professionals more frequently (PR: 1.04; CI 95%: 1.03 - 1.06), organize their schedule to offer educational activities in Oral Health more frequently (PR:1.03; CI 95%: 1.02 - 1.04), ensure completion of the treatment of patients more frequently (OR: 1.68; CI 95%: 1.19 - 2.38), conduct more home visits (PR: 1.08; CI 95%: 1.07 - 1.09) and use more protocols for prioritizing actions more frequently (PR: 1.06; CI 95%:1.04 - 1.07). Investment in training in Family Health may be important for better performance in Primary Care Dentistry, thereby leading to changes in the model of Comprehensive Oral Health care.

A Política Nacional de Saúde Bucal aponta como pressuposto qualificar a Atenção Básica e adequar o processo de trabalho ao novo modelo de atenção à saúde. Objetiva-se investigar a associação entre a formação profissional dos Cirurgiões-Dentistas em Saúde da Família e o processo de trabalho. Estudo transversal, multicêntrico, com 18.114 Equipes de Saúde Bucal que aderiram ao segundo ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica. Os dados foram coletados por meio de entrevistas, através de instrumento estruturado. Profissionais com formação em Saúde da Família compartilham mais sua agenda com os outros profissionais da Atenção Básica (RP: 1,04; IC de 95%: 1,03 ­ 1,06), organizam mais a agenda para ofertar atividades educativas de Saúde Bucal (RP: 1,03; IC de 95%: 1,02 ­ 1,04), garantem conclusão de tratamento dos usuários mais frequentemente (OR: 1,68; IC de 95%: 1,19 ­ 2,38), realizam mais visitas domiciliares (RP: 1,08; IC de 95%: 1,07 ­ 1,09) e utilizam mais protocolos para definição de ações prioritárias (RP: 1,06; IC de 95%:1,04 ­ 1,07). Investir em formação em Saúde da Família pode ser importante, portanto, para a efetivação de mudanças no modelo de atenção à Saúde Bucal, o qual ainda é pouco preocupado no cuidado integral.

Formação em Saúde da Família e sua associação com processos de trabalho das Equipes de Saúde Bucal da Atenção Básica / Training in Family Health and its association with work processes of Primary Care Dentistry Teams

Resumo A Política Nacional de Saúde Bucal aponta como pressuposto qualificar a Atenção Básica e adequar o processo de trabalho ao novo modelo de atenção à saúde. Objetiva-se investigar a associação entre a formação profissional dos Cirurgiões-Dentistas em Saúde da Família e o processo de trabalho. Estudo transversal, multicêntrico, com 18.114 Equipes de Saúde Bucal que aderiram ao segundo ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica. Os dados foram coletados por meio de entrevistas, através de instrumento estruturado. Profissionais com formação em Saúde da Família compartilham mais sua agenda com os outros profissionais da Atenção Básica (RP: 1,04; IC de 95%: 1,03 - 1,06), organizam mais a agenda para ofertar atividades educativas de Saúde Bucal (RP: 1,03; IC de 95%: 1,02 - 1,04), garantem conclusão de tratamento dos usuários mais frequentemente (OR: 1,68; IC de 95%: 1,19 - 2,38), realizam mais visitas domiciliares (RP: 1,08; IC de 95%: 1,07 - 1,09) e utilizam mais protocolos para definição de ações prioritárias (RP: 1,06; IC de 95%:1,04 - 1,07). Investir em formação em Saúde da Família pode ser importante, portanto, para a efetivação de mudanças no modelo de atenção à Saúde Bucal, o qual ainda é pouco preocupado no cuidado integral.

Abstract The National Oral Health Policy emphasizes the importance of training in Primary Health Care and adapting the work processes to the new health care model. This study seeks to investigate the association between the training of Dental-Surgeons in Family Health and the work process. It involved a cross-sectional and multicentric study, with 18,114 Oral Health Teams that participated on the National Program to Enhance Access and Quality of Primary Health Care. Data were collected through interviews, using a structured questionnaire. Professionals with post-graduate education in Family Health share their schedule with other Primary Care professionals more frequently (PR: 1.04; CI 95%: 1.03 - 1.06), organize their schedule to offer educational activities in Oral Health more frequently (PR:1.03; CI 95%: 1.02 - 1.04), ensure completion of the treatment of patients more frequently (OR: 1.68; CI 95%: 1.19 - 2.38), conduct more home visits (PR: 1.08; CI 95%: 1.07 - 1.09) and use more protocols for prioritizing actions more frequently (PR: 1.06; CI 95%:1.04 - 1.07). Investment in training in Family Health may be important for better performance in Primary Care Dentistry, thereby leading to changes in the model of Comprehensive Oral Health care.

For preventive medicine to include oral health care, the dental profession, licensing agencies, payers, and the public must effect change.

Dentistry is represented to the US public in large part by the various professional associations, which speak for the interests of general and specialized dentists, mostly in private proprietary practice. Unfortunately, the interests of dental professional associations may often be in conflict with those of the public. To resolve this continued disparity, it behooves the dental leadership to become more involved with the overall health care system than continuing to enhance the economic interests of the profession without sufficient regard for the world-wide burden of unmet dental needs. An assessment of policy failures is provided with some recommendations for greater involvement of organized dentistry in the integration of oral and general health care. Dentistry must recommit itself to being a health profession rather focusing on the business aspects of health care. Another aspect to be considered is a reorganization of the American Dental Association to better represent the oral health care workforce.

Medical-dental considerations in the care of children with facial cellulitis of odontogenic origin. A disease of interest for pediatricians and pediatric dentists. / Consideraciones médico-odontológicas en la atención del niño con celulitis facial odontogénica. Una patología de interés para pediatras y odontopediatras.

An odontogenic infection is a polymicrobial, mixed infection (aerobic and anaerobic bacteria). It comprises various clinical conditions, whose importance varies depending on their frequency and potential severity. It is the most common type of oral infection and its treatment involves up to 10% of all antibiotic prescriptions. Facial cellulitis is a diffuse inflammation of soft tissue that is not confined or limited to a specific region and tends to spread. The objective of this review is to update the aspects considered in the care of children with facial cellulitis of odontogenic origin and the multidisciplinary management between dentists and pediatricians.

La infección odontogénica es una infección polimicrobiana y mixta (aerobios/anaerobios). Comprende diversos cuadros clínicos, cuya importancia deriva de su frecuencia y gravedad potencial. Es el tipo de infección más frecuente en la cavidad bucal y su tratamiento supone hasta el 10% del total de prescripciones de antibióticos. La celulitis facial es una inflamación difusa de los tejidos blandos que no está circunscrita o limitada a una región y tiende a diseminarse. El objetivo de esta revisión es actualizar las consideraciones para la atención del niño con celulitis facial de origen dental y el manejo multidisciplinario entre el odontólogo y el pediatra.

Factors associated with the utilization of dental health services by the pediatric population: an integrative review. / Fatores associados à utilização dos serviços de saúde bucal pela população pediátrica: uma revisão integrativa.

This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.

O objetivo desta revisão integrativa da literatura foi analisar estudos publicados entre 2006-2016, disponibilizados em português, inglês ou espanhol, sobre fatores associados à utilização dos serviços de saúde bucal pela população pediátrica entre 0 e 15 anos. Foi realizado um levantamento nas bases de dados Lilacs e Medline, utilizando a estratégia de busca: ("dental care/utilization" OR "dental health services/utilization") AND (child OR "child, preschool") AND NOT adult. Para análise da qualidade metodológica, utilizou-se o Critical Appraisal Skill Programme (CASP) adaptado e o Agency for Healthcare and Research and Quality (AHRQ). Destacam-se como preditores do uso: fatores da criança ou adolescente (idade, frequência de escovação, condições crônicas), do cuidador (escolaridade, percepção da saúde bucal do filho, necessidades bucais referidas), do dentista (disponibilidade à noite e nos finais de semana) e o acompanhamento da saúde bucal pela equipe de saúde da família. Estes fatores são inerentes ao planejamento de políticas ou programas em saúde bucal na população pediátrica, entretanto, variam de acordo com o contexto em que se inserem. Portanto, uma análise contextual é necessária.

Case-resolving capacity of dental care of the Unified Health System: the perception of users in a city in the state of São Paulo, Brazil.

The aim of this study was to learn about the users' perceptions concerning the case-resolving capacity of dental care in the Unified Health System and to analyze the associations between solving capacity and both sociodemographic characteristics and access to the service. This was a cross-sectional study with a quantitative approach, in which 461 users responded to individual interviews. The outcome variable was the case-resolving capacity of dental care, obtained through the question: "In your opinion, is the dentist of this health center managing to solve all your oral health problems (Yes/No)". Independent variables were grouped into the following: sociodemographic and related to the access to the service. Most participants reported that their oral health problems were being solved. By using the Poisson regression, the lack of case-resolving capacity was found to be associated to the patients' not considering the dental surgeon's working hours convenient; to the long time they had to wait to get an appointment in the health center; and to the long time they had to wait in the waiting room. The results showed the positive view that users have about the case-resolving capacity of public dental care, and the relationship between access to the service and the said solving capacity.

Case-resolving capacity of dental care of the Unified Health System: the perception of users in a city in the state of São Paulo, Brazil / Resolutividade do serviço odontológico no Sistema Único de Saúde: a percepção de usuários de um município paulista, Brasil

Abstract The aim of this study was to learn about the users' perceptions concerning the case-resolving capacity of dental care in the Unified Health System and to analyze the associations between solving capacity and both sociodemographic characteristics and access to the service. This was a cross-sectional study with a quantitative approach, in which 461 users responded to individual interviews. The outcome variable was the case-resolving capacity of dental care, obtained through the question: "In your opinion, is the dentist of this health center managing to solve all your oral health problems (Yes/No)". Independent variables were grouped into the following: sociodemographic and related to the access to the service. Most participants reported that their oral health problems were being solved. By using the Poisson regression, the lack of case-resolving capacity was found to be associated to the patients' not considering the dental surgeon's working hours convenient; to the long time they had to wait to get an appointment in the health center; and to the long time they had to wait in the waiting room. The results showed the positive view that users have about the case-resolving capacity of public dental care, and the relationship between access to the service and the said solving capacity.

Resumo O objetivo neste estudo foi conhecer a percepção do usuário sobre a resolutividade do serviço odontológico no Sistema Único de Saúde, e analisar as associações entre resolutividade e características sociodemográficas e de acesso ao serviço. Tratou-se de uma pesquisa transversal com abordagem quantitativa, na qual 461 usuários responderam a entrevistas individuais. A variável desfecho foi a resolutividade do serviço odontológico, obtida através da seguinte pergunta: "Em sua opinião, o dentista desta unidade de saúde está conseguindo resolver todos os seus problemas de saúde bucal? (sim/não)". As variáveis independentes foram agrupadas em: sociodemográficas, e de acesso ao serviço. A maioria dos participantes relatou que seus problemas de saúde bucal estavam sendo resolvidos. Por meio da regressão de Poisson, observou-se que a falta de resolutividade esteve associada a não considerar o horário de trabalho do cirurgião-dentista conveniente; à grande demora para conseguir realizar o agendamento para a unidade de saúde; e ao tempo na sala de espera ser muito demorado. Os resultados revelaram a percepção positiva que o usuário teve sobre a resolutividade do serviço público odontológico, e a relação existente entre o acesso ao serviço e a capacidade resolutiva referida.

Fatores associados à utilização dos serviços de saúde bucal pela população pediátrica: uma revisão integrativa / Factors associated with the utilization of dental health services by the pediatric population: an integrative review

Resumo O objetivo desta revisão integrativa da literatura foi analisar estudos publicados entre 2006-2016, disponibilizados em português, inglês ou espanhol, sobre fatores associados à utilização dos serviços de saúde bucal pela população pediátrica entre 0 e 15 anos. Foi realizado um levantamento nas bases de dados Lilacs e Medline, utilizando a estratégia de busca: ("dental care/utilization" OR "dental health services/utilization") AND (child OR "child, preschool") AND NOT adult. Para análise da qualidade metodológica, utilizou-se o Critical Appraisal Skill Programme (CASP) adaptado e o Agency for Healthcare and Research and Quality (AHRQ). Destacam-se como preditores do uso: fatores da criança ou adolescente (idade, frequência de escovação, condições crônicas), do cuidador (escolaridade, percepção da saúde bucal do filho, necessidades bucais referidas), do dentista (disponibilidade à noite e nos finais de semana) e o acompanhamento da saúde bucal pela equipe de saúde da família. Estes fatores são inerentes ao planejamento de políticas ou programas em saúde bucal na população pediátrica, entretanto, variam de acordo com o contexto em que se inserem. Portanto, uma análise contextual é necessária.

Abstract This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.

Comparison of Anesthesia for Dental/Oral Surgery by Office-based Dentist Anesthesiologists versus Operating Room-based Physician Anesthesiologists.

Few studies have examined the practice characteristics of dentist anesthesiologists and compared them to other anesthesia providers. Using outcomes from the National Anesthesia Clinical Outcomes Registry and the Society for Ambulatory Anesthesia Clinical Outcomes Registry for dental/oral surgery procedures, we compared 7133 predominantly office-based anesthetics by dentist anesthesiologists to 106,420 predominantly operating room anesthetics performed by physician anesthesia providers. These encounters were contrasted with 34,191 previously published encounters from the practices of oral and maxillofacial surgeons. Children younger than 6 years received the greatest proportion of general anesthetic services rendered by both dentist anesthesiologists and hospital-based anesthesia providers. These general anesthesia services were primarily provided for complete dental rehabilitation for early childhood caries. Overall treatment time for complete dental rehabilitation in the office-based setting by dentist anesthesiologists was significantly shorter than comparable care provided in the hospital operating room and surgery centers. The anesthesia care provided by dentist anesthesiologists was found to be separate and distinct from anesthesia care provided by oral and maxillofacial surgeons, which was primarily administered to adults for very brief surgical procedures. Cases performed by dentist anesthesiologists and hospital-based anesthesia providers were for much younger patients and of significantly longer duration when compared with anesthesia administered by oral and maxillofacial surgeons. Despite the limited descriptive power of the current registries, office-based anesthesia rendered by dentist anesthesiologists is clearly a unique and efficient mode of anesthesia care for dentistry.