Early Childhood Caries: Epidemiology, Severity and Sociobehavioural Determinants.

PURPOSE: To investigate the association between sociobehavioural variables and the pattern and severity of early childhood caries in Brazilian infants and toddlers ages 0-3 years. MATERIALS AND METHODS: This was a cross-sectional study with 768 children who attended 58 public nursery schools. Five previously calibrated teams (Kappa = 0.842) performed oral examinations, using the decayed, missing, filled teeth (dmft) index according to the WHO methodology. A pretested, self-administered questionnaire was given to the subjects' parents or guardians to obtain sociobehavioural information. RESULTS: Caries was observed in 134 of the 768 (17%) children. Caries and rampant caries were significantly more prevalent in low-income families (p = 0.0121) and the incidence of caries was associated with access to dental services (p < 0.05). The percentages of children who were caries free in the age groups of 0-11 months, 12-23 months, 24-35 months and 36-47 months were 100%, 96%, 88% and 76%, respectively. CONCLUSION: Programmes for prevention and oral health education should be instituted, preferably during the first year of life, especially for those in the most socioeconomically deprived groups.

Perception and attitude about systemic health and periodontal disease among dentistry undergraduates.

PURPOSE: To evaluate the perceptions held by dentistry undergraduates about the relationship between general health and periodontal disease. In addition, student knowledge about treatment of patients with systemic disorders was also examined. MATERIALS AND METHODS: Participants were all undergraduates in the last year of dental school from three different universities (N = 253). Inclusion criteria were students enrolled in their last year of the dental curriculum and who agreed to participate in the research. After the participants filled out a structured questionnaire, the results were analysed using Epi Info 3.5.1 software and the chi-square, Friedman and Wilcoxon tests. RESULTS: The majority of participants recognised the relationship between periodontal and cardiac disease and diabetes mellitus. However, only half of the participants were aware of the relationship between periodontal disease and stroke (50.5%). In relation to caring for patients with systemic diseases, 61.4% of students surveyed did not know the blood glucose level that characterises a hypoglycemic status. The majority of participants (61.8%) stated the importance of evaluating vital signs prior to dental treatment. However, only 13.3% of the participants included temperature and respiratory rate as vital signs. CONCLUSION: The perception and attitude of undergraduates about the items on the questionnaire were deficient. Thus, a more holistic view of the patient is warranted within dental education, promoting health and quality of life.

COVID-19 and changes in dental practices in the Brazilian Public Health System: perception of the oral health team.

The aim of this study was to verify the perception of the oral health team regarding work safety and aspects related to changes in dental practices during the COVID-19 pandemic. A descriptive, exploratory, quantitative, and qualitative cross-sectional study was conducted using an electronic questionnaire sent via email to health professionals (n = 197) affiliated with the Brazilian Public Health System (SUS), from December 2020 to September 2021, in a municipality located in the northeast of the state of São Paulo, Brazil. The variables of interest were sociodemographic characteristics and those related to the professionals' perception of oral health care during the pandemic and its impact on these workers' occupational safety. Descriptive statistics were performed, and the absolute and relative frequencies of quantitative variables were calculated, whereas lexical analysis was performed for textual content using the descending hierarchical classification (CHD). Out of the total sample, elective and urgent/emergency care was provided by 58.95% (n = 56); physical barriers were absent between the teams in 54.74% (n = 52); minimally invasive techniques were applied in 71.58% (n = 68); personal protective equipment (PPE) was replaced in 81.05% (n = 77) between appointments; and occupational safety was reported by 49.47% (n = 47). Textual analysis showed a decrease in appointments and consultations, with a longer interval between appointments. The professionals noticed changes in dental practices during the pandemic, mainly regarding the use of PPE, the type of treatment performed, the number of treated patients, and the greater time interval between consultations. The physical infrastructure of health units and the availability of PPE to patients needed some adjustments. A significant number of workers felt safe in providing dental care during the pandemic.

Analysis of the Dental Caries Epidemiological Profile in Children of Benguela city, Angola.

PURPOSE: To analyse the epidemiological profile of dental caries in children aged 5 and 12 years in the city of Benguela, Angola. MATERIALS AND METHODS: This was an observational, analytical, cross-sectional study conducted in 2019 with 190 12-year-old schoolchildren and 240 5-year-old schoolchildren from the public education system in Benguela, Angola. The relationship between dental caries and dental characteristics, sociodemographic factors, access to dental services, oral hygiene practices, and eating habits was analysed. Dental condition was evaluated using the dmft and decayed, missing, and filled teeth (DMFT) indices. RESULTS: It was found that 62.63% (n = 119) of 12-year-old students and 42.08% (n = 101) of 5-year-old students were free from dental caries. The average DMFT was 0.76 + 1.35 and dmft was 2.19 + 2.95. The majority of children (56.51%) had never been to the dentist, had no dental elements restored, and none of the students used dental floss. The proportion of students who consumed sweets every day was higher at 5 years of age (46.25%) than at 12 years of age (22.63%). There was a statistically significant association (P = 0.01) between the higher incidence of dental caries and peri-urban location among 5-year-old schoolchildren. CONCLUSION: This study showed that the prevalence of dental caries in the permanent dentition of schoolchildren in Benguela is very low; however, the situation is critical in the primary dentition, especially in the peri-urban area. The limited access to dental surgeons and lack of treatment for affected teeth highlight the need to implement and develop public policies to promote oral health.

Sickness absenteeism of Primary Health Care professionals before and during the COVID-19 pandemic.

OBJECTIVE: to identify the frequency of occurrence of sickness absenteeism, according to the profile of Primary Health Care (PHC) professionals, and verify if there was an impact of the pandemic on absence duration and reason. METHODS: a cross-sectional study, from January/2019 to December/2020, with PHC professionals from a municipality in northeastern São Paulo. Descriptive statistics were performed, with frequency calculation. RESULTS: of the 977 PHC professionals, 633 (64.79%) used a medical certificate to justify their absence from work in 2019, and 837 (85.67%) in 2020. The main reason for leave was diseases of the musculoskeletal system and connective tissue in the two years. The mean duration of leave was 7.33 days (SD=17.33) in 2019 and 9.88 days (SD=16.05) in 2020. Nursing assistants were the ones who took the most leave in both years. CONCLUSIONS: there was an impact of the pandemic on absence duration and reason.

[A quantitative and qualitative study of exclusive breastfeeding intention by high-risk pregnant women]. / Estudo quanti-qualitativo sobre amamentação exclusiva por gestantes de alto risco.

The scope of this research was to assess the breastfeeding intention among high-risk pregnant women and related factors. It is a cross-sectional, qualitative and quantitative study, with 1,118 high-risk pregnant women who attended the prenatal care unit at a specialized center of the Unified Health System. The dependent variables were exclusive breastfeeding intention, intended duration and conditions that might interfere with breastfeeding. The Epi Info 7.4.1, Bioestat 5.3 and IRAMUTEQ 0.7.2.0 programs were used for data processing. The results showed that 8.76% of the pregnant women had conditions that could affect lactation. Among the women, 93.83% affirmed having exclusive breastfeeding intention, of which 69.86% intended to breastfeed until the child was six months old, revealing an association with sociodemographic variables (p<0.05). The intended breastfeeding duration was related to the age (p=0.0041), marital status (p=0.0053) and level of education (p=0.0116). The main reasons reported for not providing exclusive breastfeeding were the following: HIV, use of medications, work and lack of information. This research concluded that a small cohort of high-risk pregnant women presented conditions that could interfere with breastfeeding. Most of them intended to breastfeed exclusively for six months.

Health surveillance: public water supply fluoridation in 40 municipalities of São Paulo, Brazil. / Vigilância em saúde: fluoretação das águas de abastecimento público em 40 municípios do estado de São Paulo, Brasil.

Since fluoridation of water is an established public health measure for the prevention of dental caries and considering that monitoring of the method is crucial to its success, this study aimed to analyze the results of the analysis of the fluorine content of public water supply of 40 municipalities in the state of São Paulo, from November 2004 to December 2016. Samples were analyzed monthly using the potentiometric method. Of the 32,488 samples, 50.94% contained fluoride levels within the recommended range. In 2004, it was verified that 21 cities (52.50%) had mean levels within the recommended parameter, increasing to 32 cities (80.00%) in 2016. It was observed that 15 municipalities that initially had levels of fluoride below 0.55 mgF/L in their water supply adjusted to adequate levels during the project. In the first year of the study, 47.76% of the samples had values in the recommended range, which increased to 58.22% in 2016. Most of the municipalities adjusted the levels of fluoride in their waters over the years, evidencing the performance of heterocontrol programs as important strategies that assist in the monitoring of the method and have significant participation in the control of the water quality supplied to the population.

Sendo a fluoretação das águas uma medida de saúde pública consagrada na prevenção de cárie dentária e considerando que a vigilância do método é fundamental para o seu sucesso, este estudo objetivou analisar os resultados das análises dos teores de flúor das águas de abastecimento público de 40 municípios do estado de São Paulo, de novembro de 2004 a dezembro de 2016. A análise das amostras foi realizada mensalmente por meio do método potenciométrico. De 32.488 amostras, 50,94% continham níveis de flúor dentro do intervalo recomendado. Em 2004, verificou-se que 21 cidades (52,50%) apresentaram teores médios dentro do parâmetro recomendado, passando, em 2016, para 32 cidades (80,00%). Observou-se que 15 municípios que possuíam inicialmente níveis de flúor abaixo de 0,55 mgF/L em suas águas de abastecimento adequaram-se no decorrer do projeto. No primeiro ano do estudo, 47,76% das amostras possuíam valores no intervalo preconizado e, em 2016, houve um aumento para 58,22%. Foi verificado que no decorrer dos anos, a maioria dos municípios adequou os níveis de flúor em suas águas, evidenciando a atuação dos programas de heterocontrole como importantes estratégias que auxiliam na vigilância do método, tendo participação fundamental no controle da qualidade da água ofertada à população.

Characterization of the self-perception of oral health in the Brazilian adult population.

This article aims to perform an analysis of the factors that determine the self-perception of oral health of Brazilians, based on a multidimensional methodology basis. This is a cross-sectional study with data from a national survey. A household interview was conducted with a sample of 60,202 adults. Self-perception of oral health was considered the outcome variable and sociodemographic characteristics, self-care and oral health condition, use of dental services, general health and work condition as independent variables. The dimensionality reduction test was used and the variables that showed a relationship were submitted to logistic regression. The negative oral health condition was related to difficulty feeding, negative evaluation of the last dental appointment, negative self-perception of general health condition, not flossing, upper dental loss, and reason for the last dental appointment. The use of a multidimensional methodological basis was able to design explanatory models for the self-perception of oral health of Brazilian adults, and these results should be considered in the implementation, evaluation, and qualification of the oral health network.

Fluoride intake from meals served in daycare centres in municipalities with different fluoride concentrations in the water supply.

PURPOSE: The aim of this study was (1) to determine the fluoride content in the meals served to children aged up to 36 months in daycare centres of two municipalities with different levels of fluoride in the water supply, (2) to calculate the mean fluoride ingested daily by the children when consuming those meals and (3) to analyse the contribution of this consumption to the development of dental fluorosis. MATERIALS AND METHODS: Samples of the meals served to the children were collected during a whole week. The fluoride content of the samples of solid foods and milk was analysed using an ion-specific electrode combined with reference electrode after diffusion facilitated by hexamethyldisiloxane. Samples of beverages were buffered with an equal volume of total ionic strength adjustment buffer and analysed using a combined electrode. The results were compared using the Mann-Whitney test. RESULTS: Mean fluoride contents of the meals were of 0.204 +/- 0.179 and 0.322 +/- 0.242 microg F/mL (P < 0.05), respectively, in the municipalities with low and adequate fluoride content. Daily fluoride intake in the former was 0.013 +/- 0.003 mg/kg body weight/day and in the latter was 0.012 +/- 0.001 mg/kg body weight/day (P > 0.05). CONCLUSIONS: The children were not exposed to dental fluorosis in the daycare centres. However, the risk cannot be ignored, considering the meals and the use of fluoridated dentifrices at home may also contribute to fluoride intake.

Dentistry in Brazil: its history and current trends.

The objectives of this article are to provide a short history of dentistry and dental education in Brazil and to analyze the nature of its development to date. The databases consulted are those provided by the Brazilian Federal Council of Dentistry, Brazilian Ministry of Health, Brazilian Ministry of Education, National Institute of Studies and Educational Research Anísio Teixeira, and Brazilian Institute of Geography and Statistics. Formal dental education in Brazil started in the late nineteenth century with the creation of courses annexed to existing schools of medicine in Rio de Janeiro and Bahia. Today, there are 191 institutions of higher education nationwide granting degrees in dentistry (137 private [71.7 percent] and fifty-four public [28.3 percent]), with a total of 17,157 student positions offered annually. These schools graduate around 10,000 professionals per year-one of the highest rates in the world. Both the distribution of schools of dentistry and of dentists varies among the regions of the country, with the greatest concentrations in major metropolitan centers with high population density, resulting in limited coverage in the more deprived regions. A review of epidemiological data for oral health and distribution of dentists in Brazil indicates that there is a lack of systematic planning for the allocation of the dental workforce and a lack of consideration of regional needs in the development of dental training programs in Brazil today.

Clinical and Microbiological Analysis of Mechanical and Chemomechanical Methods of Caries Removal in Deciduous Teeth.

PURPOSE: This study evaluated carious tissue removal by mechanical and chemomechanical methods (Carisolv and Papacárie) through colony-forming unit (CFU) counts of Streptococcus mutans and Lactobacillus sp. Treatment acceptability, presence and level of pain, use of anesthesia, time required for caries removal and pain 24 h after treatment were also compared. MATERIALS AND METHODS: A clinical trial with 32 individuals who had at least two deciduous molars with active occlusal caries lesions were selected and randomly divided into two groups (I and II). One lesion in each individual was excavated with hand excavator only. The remaining lesions were excavated using modified hand excavation and Carisolv in group 1 or modified hand-excavation and Papacárie in group 2. Bacterial samples were taken from each caries lesion before and after treatment. RESULTS: All the methods reduced the amount of cultivable Streptococcus mutans and Lactobacillus sp. after treatment (p < 0.05) and no statistically significant difference was found between the groups (p > 0.05). There was 97% acceptability of treatments, and anesthesia was used in 14% of teeth. Pain was present 24 h after treatment in 6% of teeth. The mean times for caries removal by the mechanical and chemomechanical treatments were not statistically significantly different (p > 0.05). CONCLUSIONS: All treatments were found to effectively reduce bacterial counts (p < 0.05). There were no statistically significant differences (p > 0.05) among treatments or between clinical variables (p > 0.05).

Dental caries of lifetime residents in Baixo Guandu, Brazil, fluoridated since 1953--a brief communication.

OBJECTIVES: This study aimed to verify the dental caries prevalence in Baixo Guandu, the first Brazilian city to fluoridate its public water supplies; to compare the findings with the data from the national survey; and also to compare the prevalence in the 12-year-old age group with the data obtained before the beginning of the fluoridation. METHODS: All the lifetime residents aged 5, 12, 15 to 19, and 35 to 44 years old were clinically examined (World Health Organization). RESULTS: The means of dmft/DMFT were lower than in the Brazilian population living in fluoridated communities. The DMFT Index in 12-year-old residents decreased between 1953 and 2005 from 8.61 to 1.55. CONCLUSIONS: The addition of fluoride to public water supplies was an important ally in the improvement of the oral health of Baixo Guandu inhabitants.

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.

COVID-19 and changes in dental practices in the Brazilian Public Health System: perception of the oral health team

Abstract The aim of this study was to verify the perception of the oral health team regarding work safety and aspects related to changes in dental practices during the COVID-19 pandemic. A descriptive, exploratory, quantitative, and qualitative cross-sectional study was conducted using an electronic questionnaire sent via email to health professionals (n = 197) affiliated with the Brazilian Public Health System (SUS), from December 2020 to September 2021, in a municipality located in the northeast of the state of São Paulo, Brazil. The variables of interest were sociodemographic characteristics and those related to the professionals' perception of oral health care during the pandemic and its impact on these workers' occupational safety. Descriptive statistics were performed, and the absolute and relative frequencies of quantitative variables were calculated, whereas lexical analysis was performed for textual content using the descending hierarchical classification (CHD). Out of the total sample, elective and urgent/emergency care was provided by 58.95% (n = 56); physical barriers were absent between the teams in 54.74% (n = 52); minimally invasive techniques were applied in 71.58% (n = 68); personal protective equipment (PPE) was replaced in 81.05% (n = 77) between appointments; and occupational safety was reported by 49.47% (n = 47). Textual analysis showed a decrease in appointments and consultations, with a longer interval between appointments. The professionals noticed changes in dental practices during the pandemic, mainly regarding the use of PPE, the type of treatment performed, the number of treated patients, and the greater time interval between consultations. The physical infrastructure of health units and the availability of PPE to patients needed some adjustments. A significant number of workers felt safe in providing dental care during the pandemic.

Ansiedade dos profissionais da atenção primária à saúde na pandemia de COVID-19 / Anxiety in Primary Health Care professionals during the COVID-19 pandemic

Fundamentos: O desequilíbrio entre o dever profissional e o medo na COVID-19 causaram instabilidade emocional nos trabalhadores da saúde. Objetivos: Avaliar a ansiedade dos profissionais da Atenção Primária à Saúde (APS) e fatores associados e analisar a percepções, positivas e negativas, da pandemia. Metodologia: Estudo transversal descritivo-exploratório, quanti-qualitativo, com profissionais da APS, em município do Estado de São Paulo, Brasil, de dezembro/2020 a março/2021. Realizou-se estatística descritiva e aplicou-se, ao nível de 5%, o teste Qui-quadrado. Para o conteúdo textual, efetuou-se a análise léxica pela Classificação Hierárquica Descendente. Principais resultados: Foi identificado que mais de 50% dos participantes apresentaram ansiedade e ela esteve associada ao fato de ter contraído COVID-19 (p-valor = 0.0327); à interferência nas atividades diárias (P-valor < 0.0001) e com a profissão (p-valor = 0.0483). Os pontos negativos foram a saúde mental; condições de trabalho; atendimentos e comportamento. Os positivos foram biossegurança, autocuidado e uso de equipamentos de proteção individual. Conclusões: A maioria dos profissionais da APS apresentou ansiedade e esteve associada aos fatores sociodemográficos. A pandemia trouxe pontos positivos e negativos na ótica dos profissionais da APS (AU).

Fundaments: The imbalance between professional duty and fear during the in COVID-19 pandemic caused emotional instability in health workers. Objectives: To assess anxiety in Primary Health Care (PHC) professionals and associated factors and analyze the positive and negative perceptions of the pandemic. Methodology: This is a descriptive-exploratory, quantitative and qualitative cross-sectional study, with PHC professionals, in a municipality in the state of São Paulo, Brazil, from December 2020 to March 2021. Descriptive statistics were carried out, and the chi-square test was applied at the 5% level. For textual content, lexical analysis was carried out by Descending Hierarchical Classification. Main results: It was identified that more than 50% of participants had anxiety, and it was associated with having contracted COVID-19 (p-value = 0.0327), interference with daily activities (p-value < 0.0001) and occupation (p-value < 0.0001) -value = 0.0483). Negative points were mental health, working conditions, service and behavior. Positive points were biosafety, self-care and personal protective equipment use. Conclusions: Most PHC professionals presented anxiety, and it was associated with sociodemographic factors. The pandemic brought positive and negative points from PHC professionals' perspective (AU).

Comparative study of satisfaction of users and health professionals with the public dental service. / Estudo comparativo da satisfação de usuários e profissionais da saúde com o serviço público odontológico.

The objective was to confront the view of users and health professionals about the satisfaction with the public dental service. Interviews were conducted with users, professionals considered directly (ESB) and indirectly (ACS) involved in oral health. Variables were evaluated individually and grouped into domains. A score was created for the analysis and the Kruskal-Wallis test was applied. The respondents positively assessed the quality of the dental services. The ACS demonstrated less satisfaction compared to users regarding general satisfaction in the Physical Structure and Medical Care domains and the variables: quality of clinical care; guidance to the patient after treatment performed in the specialty; and period of dental care. The ESB professionals expressed greater satisfaction than the users in the Medical Care domain and in the variables related to the provision of guidance, answering questions, attention solvability and consultation scheduling. It is concluded that the ESB professionals demonstrated a high degree of similarity to the satisfaction displayed by users, although positively expanded, and the ACS expressed more critically discrepant opinions in relation to users.

Determinants of oral self-care in the Brazilian adult population: a national cross-sectional study.

This study aims to investigate variables related to adherence to oral self-care in the Brazilian adult population. It is an exploratory study, using secondary data from a population-based survey on a representative sample of the adult population of the entire Brazilian territory (n=60202). The sample was selected using a multiple stage approach. The oral self-care indicator was defined by grouping the variables: periodicity of dentist appointments, use of dental floss, toothbrush and toothpaste, frequency of brushing and replacement of the toothbrush. The scores obtained from the indicator were categorized into adequate, partially adequate, and inadequate care. Statistical analysis consisted of dimensionality reduction, and oral self-care-related variables were submitted to logistic regression. The variables mostly related to inadequate or partially adequate oral self-care were: illiteracy (OR = 11.20, OR = 4.81), low educational level (OR = 3.50, OR = 1.96), negative oral health self-concept (OR=3.73, OR=1.74), absence of natural teeth (OR = 4.98, OR=2.60), edentulous lower arch (OR = 3.09; _____), number of missing upper teeth (OR=1.14, OR=1.05), absence of health insurance (OR=2.23, OR=2.07), sedentary lifestyle (OR=2.77, OR=1.51), and smoking (OR=2.18, OR=1.40). It was concluded that the individual's level of education is one of the main factors for adherence to adequate oral self-care, followed by level of oral health self-concept and tooth loss. Likewise, lifestyle also bears a significant influence.

Sickness absenteeism of Primary Health Care professionals before and during the COVID-19 pandemic / Ausentismo-enfermedad de los profesionales de Atención Primaria de Salud antes y durante la pandemia de COVID-19 / Absenteísmo-doença dos profissionais da Atenção Primária à Saúde antes e durante a pandemia de COVID-19

ABSTRACT Objective: to identify the frequency of occurrence of sickness absenteeism, according to the profile of Primary Health Care (PHC) professionals, and verify if there was an impact of the pandemic on absence duration and reason. Methods: a cross-sectional study, from January/2019 to December/2020, with PHC professionals from a municipality in northeastern São Paulo. Descriptive statistics were performed, with frequency calculation. Results: of the 977 PHC professionals, 633 (64.79%) used a medical certificate to justify their absence from work in 2019, and 837 (85.67%) in 2020. The main reason for leave was diseases of the musculoskeletal system and connective tissue in the two years. The mean duration of leave was 7.33 days (SD=17.33) in 2019 and 9.88 days (SD=16.05) in 2020. Nursing assistants were the ones who took the most leave in both years. Conclusions: there was an impact of the pandemic on absence duration and reason.

RESUMEN Objetivo: identificar la frecuencia de ocurrencia del ausentismo-enfermedad, según el perfil de los profesionales de la Atención Primaria de Salud (APS), y verificar si hubo impacto de la pandemia en la duración y motivos de las ausencias. Métodos: estudio transversal, de enero/2019 a diciembre/2020, con profesionales de la APS de un municipio del nordeste del estado de São Paulo. Se realizó estadística descriptiva, con cálculo de frecuencia. Resultados: de los 977 profesionales de APS, 633 (64,79%) utilizaron el certificado médico para justificar su ausencia al trabajo en 2019 y 837 (85,67%) en 2020. El principal motivo de baja fue por enfermedades musculoesqueléticas y del tejido conectivo en los dos años. La duración media de la licencia fue de 7,33 días (DE=17,33) en 2019 y de 9,88 días (DE=16,05) en 2020. Los auxiliares de enfermería fueron los que más disfrutaron de licencia en ambos años. Conclusiones: hubo un impacto de la pandemia en la duración y motivos de las ausencias.

RESUMO Objetivo: identificar a frequência de ocorrência do absenteísmo-doença, de acordo com o perfil dos profissionais da Atenção Primária à Saúde (APS), e verificar se houve impacto da pandemia na duração e motivos dos afastamentos. Métodos: estudo transversal, no período de janeiro/2019 a dezembro/2020, com os profissionais de APS de um município do nordeste do estado de São Paulo. Realizou-se estatística descritiva, com cálculo de frequências. Resultados: dos 977 profissionais da APS, 633 (64,79%) utilizaram o atestado médico para justificar sua ausência no trabalho em 2019, e 837 (85,67%), em 2020. O principal motivo dos afastamentos foi as doenças osteomusculares e do tecido conjuntivo nos dois anos. A duração média dos afastamentos foi de 7,33 dias (DP=17,33) em 2019 e de 9,88 dias (DP=16,05) em 2020. Os auxiliares de enfermagem foram os que mais se afastaram em ambos os anos. Conclusões: houve impacto da pandemia na duração e motivos dos afastamentos.

Condição de saúde bucal e acesso aos serviços odontológicos em idosos atendidos em um hospital municipal da área rural de Benguela, Angola / Oral health condition and access to dental services in older people attended at a municipal hospital in the rural area of Benguela, Angola

Resumo Objetivo Analisar a condição de saúde bucal em idosos do município de Bocoio, província de Benguela, Angola, Africa. Métodos Estudo epidemiológico, transversal e analítico, realizado com 213 idosos, em 2019. Por meio de entrevistas e exames clínicos, analisou-se o perfil sociodemográfico; percepção de saúde bucal; higiene oral; uso de serviços odontológicos; consumo de tabaco, álcool, e açúcar; prejuízos funcionais e sociais devido a problemas bucais; índice de cárie dentária (CPOD); cárie radicular; condição periodontal; uso e necessidade de prótese; e lesões bucais. Resultados A maioria dos idosos era do sexo feminino (69,01%), com 60 a 70 anos (77,46%), não trabalhava (92,96%), não frequentou a escola (82,63%), e classificou sua saúde bucal como moderada (75,59%). Verificou-se que 52,58% realizava higienização bucal duas vezes por dia, utilizando escova dentária e dentifrício fluoretado (92,49%); nenhum participante utilizava fio dental; 47,89% realizou a última consulta odontológica há mais de dois anos; 20,66% fumavam diariamente; o consumo de álcool e alimentos açucarados foi baixo; 89,67% relataram dificuldade para mastigar; e 7,04% eram edêntulos totais. Houve associação (p<0,01) entre maior número de dentes perdidos, faixa etária mais avançada e baixo nível de escolaridade. O CPOD médio foi de 20,8±5,3 e nenhum dente obturado foi encontrado; a média de raízes cariadas foi de 2,43±2,10; a maioria dos dentes apresentava bolsa periodontal (50,32%) e perda de inserção (51,00%); 99,53% dos idosos necessitava de prótese; e 0,94% apresentava lesões bucais. Conclusão A condição de saúde bucal dos idosos de Bocoio é precária e marcada pela falta de acesso aos serviços odontológicos.

Abstract Objective To analyze the oral health status of elderly people in the municipality of Bocoio, Benguela province, Angola, Africa. Methods Epidemiological, cross-sectional and analytical study carried out with 213 elderly people in 2019. Through interviews and clinical examinations, the sociodemographic profile; oral health perception; oral hygiene; use of dental services; consumption of tobacco, alcohol, and sugar; functional and social impairments due to oral problems; dental caries index (DMFT); root caries; periodontal condition; use and need for prosthesis; and presence of oral lesions were analyzed. Results Most of the elderly were female (69.01%), aged 60 to 70 years (77.46%), did not work (92.96%), did not attend school (82.63%), and classified their oral health status as moderate (75.59%). It was found that 52.58% performed oral hygiene twice a day, using toothbrush and fluoridated dentifrice (92.49%); no participant used dental floss; 47.89% had their last dental appointment more than two years ago; 20.66% smoked daily; consumption of alcohol and sugary foods was low; 89.67% reported difficulty chewing; and 7.04% were fully edentulous. There was an association (p<0.01) between the greater number of missing teeth, and older age group and low level of education. The mean DMFT was 20.8±5.3 and no filled teeth were found; the mean of decayed roots was 2.43±2.10; most teeth had periodontal pocket (50.32%) and attachment loss (51.00%); 99.53% of the elderly needed a prosthesis; and 0.94% had oral lesions. Conclusion The oral health condition of the elderly in Bocoio is precarious and marked by the lack of access to dental services.

[User evaluation on dental care in the Unified Health System: an approach from the standpoint of humanization]. / Avaliação do usuário sobre o atendimento odontológico no Sistema Único de Saúde: uma abordagem à luz da humanização.

The scope of this study was to assess user evaluation about dental care in the Unified Health System and analyze the associations between this evaluation, sociodemographic characteristics, and aspects related to humanization of the services. It involved a cross-sectional survey with a quantitative approach, in which 461 users responded to individual interviews. The outcome variable was obtained by means of the question: "How do you consider the care given by the dentist and by the team in this health unit?" Responses were grouped into "positive evaluation" and "negative evaluation." The independent variables integrated two groups: sociodemographic, and related to the humanization of care. The positive evaluation (90.4%) prevailed over the negative. Using Poisson regression, it was found that the negative evaluation was statistically associated with not having felt confidence in the dentist and staff, and not being able to talk to these professionals after the end of treatment. The results showed the preponderantly positive user evaluation of the service, and suggest that the evaluation may be more related to the humanization in services than to sociodemographic characteristics of the population.