Atendimento odontológico de pacientes com necessidades especiais na atenção secundária em um estado do nordeste do Brasil / Dental care of special needs patients in secondary care in a northeastern state of Brazil / Atención odontológica a pacientes con necesidades especiales en la atención secundaria en un estado del nordeste de Brasil

O objetivo desse estudo foi descrever a produção dos atendimentos oferecidos aos pacientes com necessidades especiais nos Centros de Especialidades Odontológicas (CEO) da Paraíba (Brasil) e sua relação com o cumprimento das metas de produtividade, entre o período de 2019 e 2022. Trata-se de um estudo descritivo e ecológico em que foram coletados dados secundários do Sistema de Informações Ambulatoriais do SUS (SIA/SUS), através da captação da produção ambulatorial individualizada (BPA-I), por meio da ferramenta TabWin, dos 98 CEO operantes na Paraíba. Realizou-se análise descritiva e analítica, por meio dos testes Qui-Quadrado de Pearson e Exato de Fisher entre a variável dependente "alcance da meta" e a variável independente "adesão à Rede de Cuidados à Pessoa com Deficiência (RCPD)". Em todos os anos, a porcentagem de CEO cumpridores da meta (15,3% em 2019; 1% em 2020; 12,2% em 2021; e 11,2% em 2022) foi substancialmente menor que os números expressados por aqueles que não alcançaram a produção mínima. Os resultados também apontaram maior realização de procedimentos restauradores (29,6% em 2019; 28,6% em 2020; 32,7% em 2021; e 37,8% em 2022) em detrimento aos periodontais, cirúrgicos e preventivos. No que concerne a estar aderido à RCPD, no ano de 2022, 90,9% dos CEO que alcançaram a meta estavam aderidos à Rede (p<0,05). Concluiu-se que uma baixa frequência de CEO alcançou o cumprimento da meta de produtividade da especialidade de Odontologia para Pacientes com Necessidades Especiais nos CEO. No entanto, a adesão à RCPD manifestou-se como elemento influenciador para aqueles que cumpriram suas metas mensais e anuais.

The objective of this study was to describe the production of care provided to special needs patients in the Dental Specialties Centers (CEO) of Paraíba (Brazil) and its relationship with the achievement of productivity goals, between the period 2019 and 2022. This is a descriptive and ecological study in which secondary data were collected from the SUS Outpatient Information System (SIA/SUS), by capturing the individualized outpatient production (BPA-I), through the TabWin tool, of the 98 operating CEOs in Paraíba. We carried out descriptive and analytical analysis, using Pearson's Chi-square and Fisher's Exact tests between the dependent variable "goal attainment" and the independent variable "adherence to the Care Network for People with Disabilities (RCPD)". In all years, the percentage of CEOs meeting the goal (15.3% in 2019; 1% in 2020; 12.2% in 2021; and 11.2% in 2022) was substantially lower than the numbers expressed by those who did not meet the minimum output. The results also indicated greater performance of restorative procedures (29.6% in 2019; 28.6% in 2020; 32.7% in 2021; and 37.8% in 2022) to the detriment of periodontal, surgical, and preventive procedures. Regarding being adhered to the RCPD, in the year 2022, 90.9% of the CEOs who reached the goal were adhered to the Network (p<0.05). It was concluded that a low frequency of CEOs achieved compliance with the productivity target of the specialty of Dentistry for Special Needs Patients in CEOs. However, adherence to the RCPD manifested itself as an influential element for those who met their monthly and annual goals.

El objetivo de este estudio fue describir la producción de la atención prestada a pacientes con necesidades especiales en los Centros de Especialidades Odontológicas (CEO) de Paraíba (Brasil) y su relación con el alcance de las metas de productividad, entre el período de 2019 y 2022. Se trata de un estudio descriptivo y ecológico en el que se recogieron datos secundarios del Sistema de Información Ambulatoria del SUS (SIA/SUS), mediante la captura de la producción ambulatoria individualizada (BPA-I), a través de la herramienta TabWin, de los 98 CEOs en funcionamiento en Paraíba. Se realizaron análisis descriptivos y analíticos, utilizando las pruebas Chi-cuadrado de Pearson y Exacta de Fisher entre la variable dependiente "cumplimiento de metas" y la variable independiente "adhesión a la Red de Atención a Personas con Discapacidad (RCPD)". En todos los años, el porcentaje de directores generales que cumplieron el objetivo (15,3% en 2019; 1% en 2020; 12,2% en 2021; y 11,2% en 2022) fue sustancialmente inferior a las cifras expresadas por los que no alcanzaron el rendimiento mínimo. Los resultados también indicaron una mayor realización de procedimientos restauradores (29,6% en 2019; 28,6% en 2020; 32,7% en 2021; y 37,8% en 2022) en detrimento de los procedimientos periodontales, quirúrgicos y preventivos. Respecto a estar adherido a la RCPD, en el año 2022, el 90,9% de los CEOs que alcanzaron el objetivo estaban adheridos a la Red (p<0,05). Se concluyó que una baja frecuencia de CEOs alcanzó el cumplimiento de la meta de productividad de la especialidad de Odontología para Pacientes con Necesidades Especiales en CEOs. Sin embargo, la adhesión al RCPD se manifestó como un elemento influyente para aquellos que cumplieron sus objetivos mensuales y anuales.

Association between place of dental check-ups and work absenteeism among Japanese workers.

OBJECTIVES: Dental check-ups at the workplace provide the opportunity for early detection of dental diseases. Dental check-ups during working hours could reduce the number of days of absence from work due to visits to dental clinics outside the workplace. Although health check-ups are provided to workers in Japan, dental check-ups is not mandatory. This study aimed to determine the association between the place of dental check-ups and absenteeism due to visits to the dental clinic. METHODS: This cross-sectional study used data from an online self-reported worker survey conducted for 2 weeks in March 2017. We applied linear regression analysis with robust variance to determine the association between the place of dental check-ups and absenteeism due to dental clinic visits while adjusting for sociodemographic, health, and oral health covariates. RESULTS: The average age of the 3930 participants was 43.3 ± 11.7 years, and 52.3% were male. The number of days of absenteeism due to dental clinic visits in the past year for those who received check-ups only at the dental clinic and at the workplace were 0.57 ± 2.67 days and 0.21 ± 1.20 days, respectively. After adjusting for covariates, it was found that those who received dental check-ups at the workplace had 0.35 (95% CI, 0.12-0.58) fewer days of absence than those who received dental check-ups at the dental clinic. CONCLUSION: Workers who received dental check-ups at the workplace were associated with fewer days of absence due to dental visits than those who received at the dental clinic.

Implementation of a Teledentistry Platform for Dental Emergencies for the Elderly in the Context of the COVID-19 Pandemic in Chile.

Objectives: To develop and implement a "semi-presential" technology platform to support urgent and priority dental care for the elderly in the context of the COVID-19 pandemic among the Chilean population. Methods: A dental mobile clinic was implemented along with the development of a technological platform designed to support emergency and priority dental procedures, including teleconsultation with specialists. Under strict biosafety protocols, dental care was provided in five Chilean regions between February and May 2021. Sociodemographic, medical, and dental data were recorded. Results: A total of 135 patients over sixty years old, with a mean age of 72 years, were treated, 48 males and 87 females were attended between February and May 2021 in five different regions of Chile. 53.3% required immediate or urgent treatment, and 24.4% were derived to specialists from whom 60.6% needed immediate or urgent treatment. 74.3% of teleconsultations were derived to an oral pathology specialist. Conclusion: It was shown that a "semi-presential" technology platform implemented in a mobile dental clinic can help elderly people who are impeded to look for traditional dental assistance during a pandemic.

A gestão da informação, do registro ao indicador, na saúde bucal da Estratégia de Saúde da Família de Anápolis/GO / The information management, from the data collection to the indicator, at the Anápolis/GO Family Health Strategy oral health

Introdução/Objetivos: A pesquisa apresenta como a Gestão da Informação (GI) é desenvolvida e qual a influência desta nas tomadas de decisão, relativas ao Planejamento Estratégico das ações e serviços a serem realizados, da Saúde Bucal da Estratégia de Saúde da Família (ESF) de Anápolis/GO. Metodologia: Para atingir tal objetivo foram analisados os seguintes processos: a coleta de dados pelos Cirurgiões-Dentistas, o processamento dos dados pelo Setor de Informação para a Atenção Básica (SISAB), e a formação e utilização dos indicadores pelos gestores. A investigação foi conduzida por meio de entrevistas à profissionais da assistência, da Tecnologia da Informação e da Coordenação da Saúde Bucal da ESF de Anápolis/GO; roteiros semiestruturados foram usados como instrumento de coleta de dados e a Análise de Conteúdo de Bardin1 como técnica de interpretação dos dados coletados. Resultados: Os resultados puderam identificar que a Saúde Bucal da ESF de Anápolis/GO não possui um processo institucionalizado de formação de indicadores de saúde, sendo que a maioria dos dados tem apenas função burocrática e financeira. Conclusões: Consequentemente, as decisões da gestão são automáticas e sem embasamento estatístico ou científico. Além disso, revelou-se a dualidade de sentimentos que é trabalhar na saúde pública brasileira, uma mistura de prazer e sofrimento. Outros estudos são necessários para acompanhar a mudança imposta pelo "Previne Brasil", já que a formação de indicadores de saúde passa a ser obrigatória para o recebimento de recursos financeiros.

Introduction/Objectives: The research presents how the Information Management (IM) is developed and its influence on the Anápolis/GO Family Health Strategy (FHS) Oral Health decisions making related to Strategic Planning. Methodology: To achieve this objective, it analyzed the following processes: the Dental Surgeons data collection, the data processing by the Primary Care Information Sector (SISAB), and the indicators formation and use by the managers. The investigation was conducted through interviews with Anápolis/GO FHS Oral Health care, information technology and coordination professionals; semi-structured questionnaires were used as data collection instrument and Bardin1. Content Analysis as collect data interpretation technique. Results: The results were able to identify that the Anápolis/GO FHS Oral Health does not have a health indicators formation institutionalized process and most of the data has only bureaucratic and financial function. Conclusions: Consequently, management decisions are automatic and without statistical or scientific basis. In addition, it was revealed the dual feeling While Working in Brazilian public health, a suffering and pleasure mixture. Further studies are needed to monitor the change imposed by "Previne Brasil", since the health indicators formation becomes mandatory for the financial resources receiving

[Proposal to reorder dental health care in the National Health System. The experience of Toledo's "Unidad de Medicina y Cirugía Oral".] / Propuesta para reordenar la asistencia sanitaria odontológica en el Sistema Nacional de Salud. La experiencia de la unidad de Medicina y Cirugía Oral de Toledo.

The portfolio of services in Oral Health of the National Health System (SNS in Spanish) is very broad and includes different areas of assistance. The focus of the System managers has focused on improving dental health benefits for children. The relevance that Children´s Dental Assistance Programs (PADI, Planes de Atención Dental Infantil in Spanish) have been acquiring in the oral care of the SNS has led to the resources being directed towards the prevention, diagnosis and treatment of dental pathology in the child population. The structure in Unidades de Salud Bucodental focused on strictly dental pathology does not allow the development of all health services. There is a large number of services that within the oral benefits provided by Primary Care are diverted to other hospital services or that are not even provided. Different experiences have been developed in different autonomous Health Systems to improve these benefits. Since 2012, the Toledo Unidad de Medicina y Cirugía Oral has carried out actions that have managed to improve oral care for the population, thus improving their general health. This Unit allows resources to be allocated to those activities that require training and guidance in the more medical-surgical than dental service. We recommend the implementation of services of this type within Primary Services to improve the provision of oral health services.

La cartera de servicios en Salud Bucodental del Sistema Nacional de Salud (SNS) es muy amplia y contempla distintas áreas de asistencia. El foco de los gestores del Sistema desde hace décadas se ha centrado en mejorar las prestaciones de salud dental en población infantil. La importancia que los Planes de Atención Dental Infantil (PADI) han ido adquiriendo en la asistencia Bucodental del SNS ha hecho que los recursos se orienten a la prevención, diagnóstico y tratamiento de la patología dentaria de la población infantil. La estructura en Unidades de Salud Bucodental centradas en la patología estrictamente dentaria no permite desarrollar todas las prestaciones sanitarias. Existe una gran cantidad de servicios que dentro de las prestaciones bucodentales que tiene la Atención Primaria (AP) se desvían a otros servicios hospitalarios o que incluso no se prestan. En diferentes sistemas de salud autonómicos se han desarrollado experiencias para conseguir mejorar estas prestaciones. Desde 2012, la Unidad de Medicina y Cirugía Oral de Toledo realiza acciones que han conseguido mejorar la asistencia bucodental de la población, mejorando así su salud general. Esta Unidad permite destinar los recursos a aquellas actividades que necesitan una formación y una orientación en el servicio más médico-quirúrgico que dentario. Recomendamos la implantación de servicios de este tipo dentro de la AP para mejorar la prestación de los servicios de salud bucodental.

Organização de Centros de Especialidades Odontológicas numa Região de Saúde na Bahia / Organization of Dental Specialty Centers in a Health Region in Bahia, Brazil

Resumo Este artigo analisa a organização dos Centros de Especialidades Odontológicas (CEOs) numa região de saúde e discute o percurso de implantação dos CEOs na Bahia. Trata-se de um estudo de caso, com abordagem qualitativa, por meio de entrevistas semiestruturadas, abarcando gestores diretamente envolvidos com as políticas de saúde bucal em âmbitos estadual, regional e municipal. Além disso, a análise documental foi utilizada para complementar e estabelecer interconexão com os dados produzidos nas entrevistas. A análise de conteúdo temática orientou a interpretação dos resultados. Grande parte da população baiana permanece descoberta de serviços públicos especializados para saúde bucal, sem expectativas de implantação de novos CEOs tanto na perspectiva municipal, quanto na lógica regional. Houve dificuldade de conformar uma cooperação intermunicipal na região para ações compartilhadas em saúde bucal, assim como a agenda do governo estadual não fomentou arranjos de CEO regionais. Dessa forma, existe uma fragmentação da assistência, sem garantias na continuidade do cuidado em saúde bucal e, por conseguinte, o arrefecimento da capacidade resolutiva dos sistemas locais de saúde.

Abstract This article analyzes the organization of the Dental Specialty Centers (CEO) in a health region and discusses the implementation of the CEO's in Bahia. This is a case study with a qualitative approach using semi-structured interviews and with managers dealing directly with oral health policies at the state, regional and municipal level. In addition, the documentary analysis was used to complement and establish interconnection with the data produced in the interviews. Thematic content analysis guided the interpretation of results. Much of the Bahia's population remains without receiving the specialized public services of oral health, without expectations of the implementation of new CEOs both in the municipal and in the regional levels. There was difficulty in implementing an intermunicipal cooperation in the region for shared actions in oral health. In addition, the state Government's agenda did not foster regional CEO arrangements. Thus, there is a fragmentation of care, without guarantees in the continuity of oral health care and, as a result, the decrease in the resolution capacity of local health systems.

Webpalestra: atendimento odontológico ao paciente idoso

Na Odontologia, assim como em outras áreas da saúde, atendimentos especializados são direcionados às diferentes etapas da vida do indivíduo, sendo que o acompanhamento da saúde bucal está criando condições para que o indivíduo envelheça com maior número de dentes saudáveis.

Webpalestra: manifestações bucais das Infecções Sexualmente Transmissíveis

Webpalestra COVID-19 (Coronavírus): condutas de biossegurança para as urgências em Odontopediatria

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Dental Health Services Response to COVID-19 in Norway.

We aimed to investigate the management of urgent dental care, the perception of risk and workplace preparedness among dental staff in Norway during the COVID-19 pandemic. An electronic questionnaire regarding the strictest confinement period in Norway (13 March-17 April 2020) was distributed to dental staff. Among the 1237 respondents, 727 (59%) treated patients, of whom 170 (14%) worked in clinics designated to treat patients suspected or confirmed to have COVID-19. Out of them 88% (143) received training and 64% (103) simulation in additional infection prevention procedures, while 27 (24%) respondents reported deviation. In total, 1051 (85%) respondents perceived that dental staff had a high risk of being infected, 1039 (84%) that their workplace handled the current situation well, 767 (62%) that their workplace had adequate infection control equipment and 507 (41%) agreed that their workplace is well equipped to handle an escalation. Before an appointment, 1182 (96%) respondents always/often inquired per phone information if a patient experienced symptoms of COVID-19, and 1104 (89%) asked about a history of travel to affected areas. Twice as many patients on average per week were treated by phone than in a clinic. A lower proportion of dental staff in high incidence counties applied additional infection prevention measures compared to low and medium incidence counties. To conclude, urgent dental health care was managed relatively well in Norway. Additional training of the dental staff in adequate infection prevention and step-by-step procedures may be needed. These results may be used to improve the dental health service's response to future outbreaks.

Developments in oral health care in the Netherlands between 1995 and 2018.

BACKGROUND: Over the past several decades, changes in legislation and regulations have been implemented in oral health care in the Netherlands. In 1995, for example, a major transformation in the funding of oral health care was implemented, after which most oral health care for adults was no longer covered by national insurance. In 1997, the Individual Healthcare Professions Act, in which the authorizations of care providers were described, was established. The Healthcare Quality, Complaints and Disputes Act, established in 2016, concerns the accountability of professional behavior. Regulations concerning employment have changed several times since 1995. These changes have affected the work and practice situation of oral health care providers. METHODS: Data from many publicly available sources were gathered and combined with internal reports mainly derived from the Data Stations project of the Royal Dutch Dental Association. This project was established in 1995 and, since its initiation, 6716 dentists have participated an average of 6.7 times. RESULTS: Between 1995 and 2018, nearly all professional groups in oral health care increased, particularly those of dental hygienists and prevention assistants. The number of dental practices decreased, but practices got larger in terms of dental units, number of patients, and personnel. The percentage of inhabitants visiting oral health care professionals remained unchanged, but the type of care provided moved towards more prevention. Oral health care providers exploited new opportunities to enhance and express their professional behavior. CONCLUSIONS: Oral health care in the Netherlands has evolved in recent years toward more collaboration in teams, and professions have established institutions to promote the quality and safety of care. Greater emphasis has been placed on prevention of dental diseases. These processes were influenced by new legislation and regulations, demographic changes within professional groups, and other social developments.

Can Teledentistry Improve the Monitoring of Patients during the Covid-19 Dissemination? A Descriptive Pilot Study.

The aim of this pilot study was to describe the advantages of telemedicine (TM) in dental practice during the current national emergency condition due to the Covid-19 dissemination. At Department of Oral Surgery and Pathology-Magna Graecia University of Catanzaro, regional reference center for Covid-19-two groups of patients were determined: patients with urgent conditions (group U) and patients in follow-up (group F). Both groups were instructed to implement remote consultations using a messaging service (WhatsApp Messenger, WhatsApp Inc., Mountain View, California, USA) to send photos. A total of 418 photos were collected by 57 patients. Thirty-four photos were obtained by five patients in the U group after surgical procedures. All patients sent photos on the established evening, except for two patients who sent two photos outside the set days. In the F group, 384 photos were collected by 52 patients. None of them sent more photos than the number that was established by the protocol. Telemedicine allowed a monitoring of all patients, reducing costs and limiting human contact, decreasing the risk of Covid-19 dissemination.

Access to Oral health care: a focus on dental caries treatment provision in Enugu Nigeria.

BACKGROUND: Dental caries, despite improvement in oral health across the globe, is still a large contributor to the global burden of oral diseases and a major public health concern. In Enugu state, Nigeria, there is minimal access to adequate and proper oral health care. This study examined the determinants of dental caries treatment provision and the challenges of providing equitable access to oral health care. METHOD: This was a mixed-method cross-sectional descriptive urban-rural study conducted in selected oral health facilities offering primary oral health care in Enugu state. The study was conducted in two phases over a 2 month period. Quantitative data was initially collected from all selected oral health care providers using a survey questionnaire format after which qualitative data were collected through in-depth interviews of heads of the selected oral health facilities. The determinants of dental caries treatment services were explored with a focus on provider behavior, cost of dental services, human resource availability and availability of dental equipment. RESULTS: Quantitative findings show that to a larger extent, the cost of raw materials (100%), human resources (98.1%), infection control resources (98.1%), geographical location (98.1), Government policies (88%) and the price of other goods (80.8%) influence provision of dental caries treatment services. Qualitative results show that location and number of oral health facilities, government funding and policies for oral health, cost of dental equipment and materials, the ability of consumers to pay, human resource availability and consumer awareness of oral health are also factors that influence the provision of dental caries treatment services. CONCLUSION: Adequate access to oral health care services is a major concern that affects all aspects of healthcare and a determining factor in the country's drive to achieve universal health coverage. In order to address this, oral health facilities need to be strategically located and have adequate materials, equipment and skilled staff. There is a need to incorporate oral health into the general health care system and improve government policies and funding for oral health.

Indicators proposed by the Brazilian Ministry of Health for monitoring and evaluating oral health actions in the National Health System: documentary research, 2000-2017. / Indicadores de saúde bucal propostos pelo Ministério da Saúde para monitoramento e avaliação das ações no Sistema Único de Saúde: pesquisa documental, 2000-2017.

OBJECTIVE: to present the indicators for monitoring and evaluation of oral health actions in the Brazilian National Health System (SUS), proposed in the period 2000-2017. METHODS: documental research conducted on the Ministry of Health website regarding government guidelines on oral health monitoring and evaluation systems; the indicators were classified according to the following categories: access to care; resolutive capacity and continuity; and availability of oral health services. RESULTS: oral health indicators were identified in the following guidelines: 'Health Services Performance Evaluation Methodology Project', 'SUS Qualification Evaluation Program', 'National Program for Improving Primary Care Access and Quality', and 'SUS Performance Index'; most of them refer to access to services and resolutive capacity and continuity of care. CONCLUSION: oral health indicators in the four government guidelines identified provide important input for health management, but new indicators are needed for effective monitoring and evaluation of oral health actions.

Potentially over 3 million children in EU Europe believed not to be receiving needed medical and dental treatment-and parents' reasons why.

BACKGROUND: Children have the right to health and countries a duty under the United Nations Convention on the Rights of the Child to facilitate this. The European Union has emphasized the importance of investing in children, but at times this seems more wish than pragmatism. Furthermore, European statistical systems do not provide any relevant data, and the degree of unmet need has hitherto been unknown. However, new ad hoc household survey data have now been published by Eurostat showing the percentage of children with a purported unmet medical or dental need and the expressed reasons for this. METHOD: This paper critically reviews these data on children with a reported unmet medical or dental need to create an indication of the number of European children with unmet medical and dental needs, and the contributory factors. RESULTS: This paper calculates that some 1 million European children can be estimated to have an unmet medical need and 2 million children an unmet dental need, though the survey approach has some weaknesses. A probable overestimate of children affected in sample households offsets the likely failure to capture data about children in institutions, homeless, or in fractured families, or about multiple needs. The reported reasons for not obtaining treatments are a valuable first step in highlighting an important issue for Europe's children-measurement of service accessibility. CONCLUSION: Potentially over 3 million European Union children are failing to have their health needs and their rights met. If the incoming European Commission is serious about its predecessor's promise to invest in children and to take seriously their rights, action is needed to improve quantification of unmet need and to reduce suffering and potential lasting damage.

Guía de práctica clínica salud oral integral: tratamiento y rehabilitación oral en personas adultas y personas mayores con edentulismo parcial o total oral integral: tratamiento y rehabilitación oral en personas adultas y personas mayores con edentulismo parcial o total / Comprehensive oral health clinical practice guide: oral treatment and rehabilitation in adults and older people with partial or total edentulism. Comprehensive oral: oral treatment and rehabilitation in adults and older people with partial or total edentulism

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A proposed one-stop-shop approach for the delivery of integrated oral, mental, sexual and reproductive healthcare to adolescents in Nigeria.

The interconnectedness of oral, mental, sexual, and reproductive health (OMSRH) in adolescents prompts exploration of novel approaches to facilitate comprehensive access of this population to the relevant health services. This paper proposes an integrated one-stop-shop approach to increasing adolescents' access to OMSRH care by leveraging on dental clinics as a template for integration, using a non-stigmatized platform to deliver stigmatized healthcare. Novel healthcare delivery models are needed to enhance adolescents' access to the comprehensive prevention and treatment services that they critically need. Effective, integrated health care for this population is lacking, especially across various health areas. This is a proposal for leveraging dental clinics for integrated OMSRH care, using facility-based services, to adolescents. Emphasis will be placed on reducing stigma as a barrier to service accessibility, acceptability, equitability and appropriateness. Empirical studies will be required to test the feasibility, validity and effectiveness of this proposed model.

The Seychelles Dental Service.

The Seychelles Dental Service dates back to the 1920s, growing from rudimentary dentistry to the evidence-based dentistry of today. Until the 1970s, dental care was provided by a small number of dentists. However, since the establishment of the School Dental Service (SDS) in the 1980s, child oral health has been the responsibility of Dental Therapists (DTs). Today Seychelles has a well organised oral health care system in place with modern infrastructure and equipment and trained personnel. Locally trained DTs constitute 85% of the SDS workforce. A national oral health plan serves as a guide to ensure that programmes are developed in accordance with WHO global oral health goals, guided by periodic reviews. We present a resume of the major strengths and challenges of the Seychelles Dental Service, concluding with recommendations for staff development. Findings and recommendations of reviews and assessments of various dental health issues conducted in the country between 1977 and 1999 are summarised in the appendix.

Success of Two Caries Risk Assessment Tools in Children: A Pilot Study With a 3-Year Follow-Up.

Caries risk is defined as the dental caries probability under the individual bacteriological environment, dietary habits, and environmental factors. Assessment of caries risk plays a major role in the prevention of dental caries. The aim of this study was to compare the effectiveness of two different caries risk assessment methods on caries-free preschool children. A sample of 90 caries-free 4- to 6-year-old children were selected from 400 preschool children. The selection was limited to children who had no dental caries, visible plaque, and systemic disease. American Academy of Pediatric Dentistry's Caries Risk Assessment Tool (CAT) and Clinpro Cario L-Pop (CCLP; 3M ESPE, Germany) were used to categorize children into caries risk groups. Children were classified as being in high-, medium-, or low-risk groups by two methods. Determining risk factors according to CAT were examined. The compliance among the two methods was evaluated. Sixty-eight children were reevaluated intraorally after 3 years. The compliance between CAT and CCLP was sought using Kappa test. Statistical evaluation revealed moderate compliance among methods at baseline. The three most determinant factors in the high-risk group according to CAT were no topical fluoride exposure, no use of dental services, and active caries in mother. CAT is found statistically more successful than CCLP in predicting caries risk 3 years later. Caries risk assessment is effective to predict future caries and can be helpful for the clinician to choose the right tailor-made caries prevention plans.

Fatores associados à insatisfação dos usuários dos centros de especialidades odontológicas do Brasil em 2014: estudo transversal / Factores asociados con la insatisfacción de usuarios de los centros de especialidades odontológicas brasileños en 2014: estudio transversal / Factors related to the dissatisfaction of users of specialized dental care centers in Brazil in 2014: a cross-sectional study

Objetivo: avaliar os fatores associados à insatisfação dos usuários dos centros de especialidades odontológicas (CEOs) do Brasil. Métodos: estudo transversal, com dados do Programa de Melhoria do Acesso e da Qualidade dos CEOs; realizado em 2014, o estudo incluiu amostra não probabilística de usuários; foram classificados como insatisfeitos aqueles que responderam ser o atendimento por eles recebido regular, ruim ou muito ruim. Resultados: foram incluídos 8.730 usuários, dos quais 4,8% relataram insatisfação; maior tempo de deslocamento até o serviço (OR=1,38 - IC95% 1,10;1,74) e maior tempo de espera (OR=1,37 - IC95% 1,07;1,75) associaram-se positivamente à insatisfação; encontrou-se associação negativa com o acolhimento (OR=0,12 - IC95% 0,09;0,16), a possibilidade de tirar dúvidas (OR=0,37 IC95% 0,24;0,58) e o recebimento de orientações (OR=0,33 - IC95% 0,25;0,44). Conclusão: a insatisfação dos usuários teve baixa prevalência e foi associada a fatores relativos à organização dos serviços e ao recebimento de informação e apoio.

Objetivo: evaluar los factores asociados con la insatisfacción de los usuarios de los centros de especialidades dentales (CEO) de Brasil. Métodos: estudio transversal con datos del Programa de Mejoramiento de Acceso y Calidad de los Centros de Especialidad Dental de 2014, que incluyó una muestra no probabilística de usuarios; los que respondieron que el servicio recibido era regular, malo o muy malo fueron clasificados como insatisfechos. Resultados: se incluyeron 8.730 usuarios, 4,8% reportaron insatisfacción; mayor tiempo de viaje (OR=1,38 - IC95% 1,10;1,74) y espera (OR=1,37 - IC95% 1,07;1,75) se asociaron positivamente con la insatisfacción; hubo asociación negativa con la recepción (OR=0,12 - IC95% 0,09;0,16), la posibilidad de despejar dudas (OR=0,37 - IC95% 0,24;0,58) y recibir orientación (OR=0,33 - IC95% 0,25;0,44). Conclusión: la prevalencia de insatisfacción fue baja y se asoció con factores relacionados con la organización de los servicios y la recepción de información y apoyo.

Objective: to evaluate factors related to the dissatisfaction of users of the specialized dental care centers (CEO) in Brazil. Methods: this was a cross-sectional study with data from the Dental Specialty Center Access and Quality Improvement Program; the study was conducted in 2014 and included a non-probabilistic sample of users; those who answered that the service received was regular, poor or very poor were classified as dissatisfied. Results: a total of 8,730 users were included, 4.8% reported dissatisfaction; longer time taken to get to the service (OR=1.38 - 95%CI1.10;1.74), and longer waiting time until treatment (OR=1.37 - 95%CI1.07;1.75), were positively associated with dissatisfaction, whereas negative association was found with attention received (OR=0.12 - 95%CI0.09;0.16), the possibility of asking questions about treatment (OR=0.37 - 95%CI0.24;0.58), and receiving advice during treatment (OR=0.33 - 95%CI0.25;0.44). Conclusion: prevalence of user dissatisfaction was low and was associated with factors related to service organization and receipt of information and support.