Desinfección y esterilización en odontología frente al COVID-19 / Disinfection and sterilization in dentistry against COVID-19 / Desinfecção e esterilização em odontologia contra a COVID-19

A partir de la declaración de la Organización Mundial de la Salud del comienzo de la pandemia COVID-19 causada por el virus SARS-CoV-2 en marzo de 2020, los profesionales de la salud se vieron expuestos a esta enfermedad altamente contagiosa y potencialmente mortal que generó múltiples desafíos a toda la comunidad científica. Provocando cambios de paradigmas en la atención de los pacientes y en el uso de las barreras de protección personal. A nivel mundial se crearon múltiples protocolos para la atención odontológica a medida que se iba desarrollando e investigando el comportamiento del virus. Esta revisión bibliográfica resume las indicaciones y recomendaciones basadas en las evidencias disponibles para disminuir las posibilidades de contaminación ante la exposición a este virus, incluyendo medidas a utilizar desde el ingreso del paciente, los métodos de protección personal, la descontaminación y esterilización del material, así como también la desinfección del área de trabajo. Aunque se ha hecho un gran esfuerzo por mejorar los procesos de bioseguridad a nivel científico tecnológico, hay evidencias de que el factor humano sigue siendo el eslabón más débil de esta cadena.

Since the declaration by the World Health Organization of the beginning of the COVID-19 pandemic caused by the SARS-CoV-2 virus in March 2020, health professionals were exposed to this highly contagious and potentially fatal disease that generated multiple challenges to the entire scientific community. It caused paradigm shifts in patient care and in the use of personal protective barriers. Multiple protocols for dental care were created worldwide as the behavior of the virus was developed and investigated. This bibliographic review summarizes the indications and recommendations based on the available evidence to reduce the possibilities of contamination when exposed to this virus, including measures to be used from patient admission, personal protection methods, decontamination and sterilization of material, as well as disinfection of the work area. Although a great effort has been made to improve biosafety processes at the scientific and technological level, there is evidence that the human factor continues to be the weakest link in this chain.

Desde a declaração pela Organização Mundial da Saúde do início da pandemia de COVID-19 causada pelo vírus SARS-CoV-2 em março de 2020, os profissionais de saúde foram expostos a essa doença altamente contagiosa e potencialmente fatal, que criou vários desafios para toda a comunidade científica. Ela causou mudanças de paradigma no atendimento ao paciente e no uso de barreiras de proteção individual. Em todo o mundo, vários protocolos para atendimento odontológico foram criados à medida que o comportamento do vírus foi desenvolvido e pesquisado. Esta revisão da literatura resume as indicações e recomendações baseadas em evidências para reduzir a probabilidade de contaminação por exposição a esse vírus, incluindo medidas a serem usadas desde a admissão do paciente, métodos de proteção individual, descontaminação e esterilização de equipamentos, bem como desinfecção da área de trabalho. Embora muitos esforços tenham sido feitos para melhorar os processos de biossegurança em nível científico e tecnológico, há evidências de que o fator humano continua sendo o elo mais fraco dessa cadeia.

Contaminación microbiana durante la atención odontológica por la producción de aerosoles y salpicaduras / Microbial contamination during dental care due to aerosol and splash production

RESUMEN Objetivo: Analizar la contaminación microbiana durante la atención odontológica por la producción de aerosoles y salpicaduras. Metodología: De tipo documental, bibliográfica. La búsqueda se realizó a través de las bases de datos PubMed y Scopus. Considerando los lineamientos de la declaración PRISMA obteniendo un total de 221 artículos. Posteriormente se aplicaron los criterios de exclusión como de inclusión, obteniendo un total de 25 artículos. Resultados: La carga microbiana presente en el ambiente odontológico ha sido analizada de manera cuantitativa a través de las Unidades Formadoras de Colonias (UFC) en diferentes espacios y superficies de las clínicas dentales. En conclusión: La contaminación microbiológica asociada con la generación de aerosoles es una problemática que se experimenta en la consulta diaria, relacionándose principalmente con procedimientos asociados con equipos como las piezas de mano de alta velocidad, el equipo ultrasónico y la jeringa triple.

ABSTRACT Objective: To analyze microbial contamination during dental care due to the production of aerosols and splashes. Methodology: Documentary, bibliographic type. The search was carried out through the Pubmed and SCOPUS databases. Considering the guidelines of the PRISMA declaration, a total of 221 articles were obtained. Subsequently, the exclusion and inclusion criteria were applied, obtaining a total of 25 articles. Results: The microbial load present in the dental environment has been analyzed quantitatively through Colony Forming Units (CFU) in different spaces and surfaces of dental clinics. In conclusion: Microbiological contamination associated with the generation of aerosols is a problem that is experienced in the daily dental practice, mainly related to procedures associated with equipment such as high-speed handpieces, ultrasonic equipment and triple syringe.

Contaminación microbiana durante la atención odontológica por la producción de aerosoles y salpicaduras / Microbial contamination during dental care due to aerosol and splash production

Analizar la contaminación microbiana durante la atención odontológica por la producción de aerosoles y salpicaduras. Metodología: De tipo documental, bibliográfica. La búsqueda se realizó a través de la en las bases de datos Pubmed y SCOPUS. Considerando los lineamientos de la declaración PRISMA obteniendo un total de 221 artículos. Posteriormente se aplicó los criterios de exclusión como de inclusión, obteniendo un total de 25 artículos. Resultados: La carga microbiana presente en el ambiente odontológico ha sido analizada de manera cuantifica a través de Unidades Formadoras de Colonias (UFC) en diferentes espacios y superficies de las clínicas dentales. En conclusión: La contaminación microbiológica asociada con la generación de aerosoles es una problemática que se experimenta en la consulta diaria, relacionándose principalmente con procedimientos asociados con equipos como las piezas de mano de alta velocidad, el equipo ultrasónico y la jeringa triple.

To analyze microbial contamination during dental care due to the production of aerosols and splashes. Methodology: Documentary, bibliographic type. The search was carried out through the Pubmed and SCOPUS databases. Considering the guidelines of the PRISMA declaration, a total of 221 articles were obtained. Subsequently, the exclusion and inclusion criteria were applied, obtaining a total of 25 articles. Results: The microbial load present in the dental environment has been analyzed quantitatively through Colony Forming Units (CFU) in different spaces and surfaces of dental clinics. In conclusion: Microbiological contamination associated with the generation of aerosols is a problem that is experienced in the daily dental practice, mainly related to procedures associated with equipment such as high-speed handpieces, ultrasonic equipment and triple syringe.

Manifestaciones orales de la viruela símica y recomendaciones para su prevención en la práctica odontológica / Oral manifestations of monkeypox and recommendations for its prevention in dental practice

El brote reciente de viruela símica ha despertado el interés de la comunidad internacional por su creciente número de contagiados en países no endémicos. Entre sus síntomas se encuentran la fiebre, dolor de cabeza, fatiga, dolor muscular, exantema y linfadenoma. La cavidad bucal es el lugar en el que suelen aparecer los primeros signos de la enfermedad. Por tanto, el objetivo de este trabajo fue establecer las principales manifestaciones orales de la viruela del mono y enumerar algunas recomendaciones de prevención. Para ello, se hizo una revisión bibliográfica entre 2012 y 2022 en la base de datos PubMed, usando las palabras clave, en inglés, monkeypox, oral manifestation y transmission. Se garantizó que, de los 14 documentos seleccionados, al menos el 80%, fueran publicaron en 2022. Las manifestaciones orales más frecuentes fueron: úlcera eritematosa, vesículas-ulcerosas y las asociadas a linfadenopatía (disfagia, odinofagia y faringitis). Entre las recomendaciones se encuentran: uso de mascarilla N95 y visores faciales, lavado constante de manos y espacios y atención de contagiados solo por eventos agudos (urgencias). Aunque no se ha confirmado, es posible que el Tecovirimat sea de ayuda en pacientes con sintomatología grave. Se concluye que es necesario que los odontólogos sepan distinguir los signos orales de la enfermedad para que contribuyan a cortar la cadena de contagio y deriven prontamente a los sospechosos para que se hagan las pruebas diagnósticas y las terapias medicamentosas de manera oportuna(AU)

The recent outbreak of monkeypox has aroused the interest of the international community due to its growing number of infections in non-endemic countries. Its symptoms include fever, headache, fatigue, muscle pain, rash, and lymphadenoma. The oral cavity is the place where the first signs of the disease usually appear. Therefore, the objective of this work was to establish the main oral manifestations of monkeypox and list some prevention recommendations. For this, a bibliographic review was carried out between 2012 and 2022 in the PubMed database, using the keywords, in English, monkeypox, oral manifestation and transmission. It was guaranteed that, of the 14 selected documents, at least 80% would be published in 2022. The most frequent oral manifestations were: erythematous ulcer, ulcer-vesicles and those associated with lymphadenopathy (dysphagia, odynophagia and pharyngitis). Among the recommendations are: use of N95 mask and face visors, constant washing of hands and spaces, and attention to those infected only due to acute events (emergencies). Although it has not been confirmed, it is possible that Tecovirimat is helpful in patients with severe symptoms. It is concluded that it is necessary for dentists to know how to distinguish the oral signs of the disease so that they contribute to breaking the chain of contagion and promptly refer suspects to diagnostic tests and drug therapies in a timely manner(AU)

Use and management of disinfectants by dentists in San Luis Potosi, Mexico, during the covid-19 pandemic / Uso y manejo de desinfectantes por odontólogos de San Luis Potosí, México durante la pandemia covid-19

Introduction: Chlorine, ethyl alcohol, and quaternary ammonium are disinfectants with antiviral activity against SARS-Cov2. However, there are no previous reports of their use and handling for cleaning and disinfection in dental offices. Objetive: To determine the use and management of disinfectants in critical and non-critical areas used by dentists in San Luis Potosí, Mexico, during the COVID-19 pandemic. Material and Methods: A validated cross-sectional survey was applied online to 100 dentists in San Luis Potosí between February and June 2021. Participants were informed about the handling of personal data according to the standard DOF regulations (DOF 07-05-2010). Results: A total of 100 dentists were included in the study, 63% female and 37% male, with a mean age of 26 years. The most widely used disinfectants during the pandemic in critical areas were Lysol® and 0.1% sodium hypochlorite in non-critical areas. Eighty-five percent of dentists know the adverse effects of inappropriate use of disinfectants, 72% did not have any sign or symptom associated with the use of disinfectants. The most used protection barrier was gloves (97%). Sixty-seven per cent of dentists disposed of disinfectant waste down the drain. Conclusion: Sodium hypochlorite and quaternary ammonium compounds and/or ethanol are used to clean non-critical and critical areas in dental offices. However, appropriate measures for their management are not adopted. It is necessary to implement educational strategies to improve the use and management of disinfectants in dental practice.

Introducción: Cloro, alcohol etílico y amonio cuaternario son desinfectantes que muestran actividad antiviral contra el SARS-Cov2, sin embargo, no existen reportes previos de su uso y manejo para la limpieza y desinfección en clínicas dentales. Objetivo: Determinar el uso y manejo de los desinfectantes en áreas críticas y no críticas empleados por los odontólogos en San Luis Potosí durante la COVID-19. Material y Métodos: Encuesta transversal validada y aplicada on-line a 100 odontólogos de San Luis Potosí durante febrero-junio 2021. Se informó a los participantes sobre el manejo de datos personales de acuerdo a la norma (DOF 05-07-2010). Resultados: Se incluyeron un total de 100 odontólogos, 63% del sexo femenino y 37% del sexo masculino, con una edad promedio de 26 años. Los desinfectantes más utilizados durante la pandemia en las áreas críticas fueron el Lysol® y el hipoclorito de sodio al 0.1% en áreas no críticas. El 85% de los odontólogos conocen los efectos adversos del uso inadecuado de los desinfectantes, 72% no tuvieron algún signo o síntoma asociado al uso de desinfectantes. La barrera de protección más utilizada fueron los guantes (97%). El 67% de los odontólogos eliminó los desechos de desinfectantes por la coladera. Conclusión: Para la limpieza de las áreas no críticas y críticas en las clínicas dentales se utilizan el hipoclorito de Sodio y compuestos de amonio cuaternario y/o etanol, sin embargo, no se utilizan las medidas adecuadas para su manejo. Es necesario implementar estrategias educativas para mejorar el uso y manejo de desinfectantes en la práctica dental.

The impact of the COVID-19 pandemic on dental practice in Brazil / O impacto da pandemia de COVID-19 na prática odontológica no Brasil

INTRODUCTION: Dentists are at high risk of contamination by COVID-19 due to the proximity to the patients' oral cavity and airways. OBJECTIVE: To elucidate thebehaviors and adversities experienced by dentists because of the COVID-19 pandemic. METHODS: This descriptive study invited 1.811 dentists affiliated with professional associations, dental cooperatives, and health insurance providers from São Paulo State, Brazil, in 2020 of which 473 agreed to participate. The data collection, using Google Forms, included the variables: sociodemographic conditions; characteristics of dental work; level of healthcare and sources of information about the pandemic; changes in the work process, financial impact with personal protective equipment (PPE) andbiosafety measures; and consequences of the pandemic in the professional practice. RESULTS: The 473 dentists (40.36±13.44 years), were mostly women (52.22%), had a specialty (55.60%), and were self-employed professionals (73.36%). It was observed that 78.01% of professionals had a reduction in their monthly income. The average ofpatients treated daily decreased by 35.48%. It was found that 30.44% of professionalshad difficulty with the use of PPE, 3.59% contracted COVID-19, and 53.03% decided to postpone the appointment if the patient with suspected or confirmed COVID-19 sought treatment, even in emergencies. The use of high-speed handpieces was reported by most professionals (n=428; 90.48%). CONCLUSION: Behaviors: dentists used PPE and assigned very high or high levels of precaution about COVID-19. Adversities: dentists reported an increase in operating costs, changes in the work process, a decrease in appointments, and a reduction in the monthly income.

INTRODUÇÃO: Os cirurgiões-dentistas apresentam alto risco de contaminação pelo COVID-19 devido à proximidade com a cavidade oral e vias aéreas dos pacientes. OBJETIVO: Elucidar os comportamentos e adversidades vivenciados por cirurgiões-dentistas devido à pandemia de COVID-19. MÉTODOS: A pesquisa descritiva envolveu 1.811 cirurgiões-dentistas de associações profissionais, cooperativas odontológicas e convênios do Estado de São Paulo, Brasil, em 2020, dos quais 473 concordaram em participar. A coleta de dados, por meio do Formulários Google, incluiu as variáveis: condições sociodemográficas; características do trabalho odontológico; nível de atenção e fontes de informação sobre a pandemia; mudanças no processo de trabalho, impacto financeiro com equipamentos de proteção individual (EPI) e medidas de biossegurança; e consequências da pandemia na prática profissional. RESULTADOS: Dos 473 dentistas (40,36±13,44 anos), a maioria era mulher (52,22%), especialista (55,60%) e trabalhava como autônomo (73,36%). Observou-se que 78,01% dos profissionais apresentaram redução na renda mensal. A média de pacientes atendidos diminuiu 35,48%. Constatou-se que 30,44% dos profissionais tiveram dificuldade com o uso de EPI, 3,59% contraíram COVID-19 e 53,03% postergaram o atendimento de paciente com suspeita ou confirmação de COVID-19, mesmo em emergências. O uso de peça de alta rotação foi relatado pela maioria dos profissionais (n=428; 90,48%). CONCLUSÃO: Como comportamentos: os dentistas usaram EPI e atribuíram níveis muito altos ou altos de cuidados sobre o COVID-19. Como adversidades: os dentistas relataram aumento nos custos operacionais, mudanças no processo de trabalho, diminuição no atendimento e redução na renda mensal.

Un enfoque digital para restaurar un diente anterior traumatizado durante la pandemia COVID-19: reporte del caso / A digital approach to restore a traumatized anterior tooth during the COVID-19 pandemic: A clinical report

Los profesionales de la salud oral tienen un mayor riesgo de infección con el nuevo coronavirus 2019 (COVID-19), debido a la comunicación cercana a la cavidad oral y la exposición a saliva, sangre y otros fluidos corporales. Los enfoques digitales pueden reducir el tiempo clínico y contribuir a limitar el riesgo de infección. El objetivo del presente trabajo es presentar un enfoque digital para restaurar un diente anterior traumatizado, durante la pandemia de COVID-19. Paciente sexo feminino de 28 años, con movilidad anormal de la pieza 1.1 y antecedente de traumatismo dental en la adolescencia. Se realizó una evaluación inicial para detectar signos y síntomas de una posible infección por COVID-19. Las imágenes de la tomografía computarizada mostraron fractura coronaria y presencia de reabsorción cervical externa en el incisivo central derecho. El plan de tratamiento consistió en la rehabilitación del diente fracturado a través de una restauración retenida con un poste de fibra de vidrio, usando un abordaje digital por medio de un escáner intraoral con diseño y fabricación asistido por computadora (CAD/CAM). Los enfoques digitales en odontología podrían contribuir a reducir el riesgo de infección por COVID-19 en pacientes y dentistas durante los tratamientos restauradores.

Dental professionals are at increased risk of infection with the new coronavirus 2019 (COVID-19) due to face-to-face communication and exposure to saliva, blood and other body fluids. Digital approaches can reduce clinical time and contribute to limiting the risk of infection. The objective of this work was to report a digital approach to restoring a traumatized anterior tooth during the COVID-19 pandemic. A 28-year-old female with abnormal mobility in the crown of an upper anterior tooth with history of dental trauma in the adolescence. An initial screening was performed to check for signs and symptoms of possible COVID-19 infection. Cone Beam Computed Tomography images showed a crown fracture and the presence of external cervical resorption in the right permanent central incisor. The treatment plan consisted of rehabilitation of the fractured tooth through a restoration retained with a fiberglass post with a digital approach using an intraoral scanner, and computer-aided design and fabrication - CAD/CAM. Digital approaches in dentistry including intraoral scanners and CAD/CAM could contribute to reducing the risk of COVID-19 infection in patients and dentists during restorative treatments.

Herramientas digitales para la obtención de registros, posicionamiento y articulación virtual de modelos / Digital tools for obtaining records, positioning and virtual articulation of casts

La siguiente revisión bibliográfica busca describir las alternativas digitales disponibles para la obtención de registros, posicionamiento y articulación virtual de modelos junto con ejemplificar algunos softwares que permitan la implementación de estas tecnologías en su trabajo diario. Se realizó una búsqueda de literatura en las bases de datos: Pubmed, LILACS, SciELO y Cochrane Library. Finalmente, luego de ser filtrados los resultados, se utilizaron un total de 36 publicaciones. Existen diversas herramientas disponibles actualmente para digitalizar una gran cantidad de técnicas que solo hasta hace algunos años eran realizadas manualmente por un operador. Algunas de ellas, facilitan una inmersión paulatina al mundo virtual del odontólogo novato ya que carecen de altos costos y recur-sos. Se sugiere que los odontólogos implementen estas tecnologías en su trabajo habitual según cada caso particular.

The following literature review seeks to bring together the digital alternatives available for obtaining records, positioning and virtual articulation of models together with exemplifying some softwares to allow the implementation of these technologies in their daily workflow. A literature search was carried out in the following databases: Pubmed, LILACS, SciELO and Cochrane Library. Finally, after the results were filtered, a total of 36 publications were used. There are various tools currently available to digitize a large number of techniques that were only performed manually by an operator until a few years ago. Some of them facilitate a gradual immersion into the virtual world of the novice dentist since they lack high costs and resources. It is suggested that dentists implement these technologies into daily dental practice according to each particular case.

Evaluation of microbiological and physical parameters of water from dental clinics in a brazilian university / Evaluación de parámetros microbiológicos y físicos del água de clínicas odontológicas en una universidad brasileña / Avaliação de parâmetros biológicos e físicas da água de clínicas odontológicas de uma universidade brasileira

Abstract Introduction and objective : Contamination of the water used in health care units can induce adverse individual and collective consequences. The objective of this study was to evaluate the water quality in dental clinics of a dentistry program of a university in Brazil, calculating the total coliforms, thermotolerant coliforms, heterotrophic bacteria and pH. Materials and methods: In each clinic, water samples were collected for analysis at different points: external cistern, clinic faucet, dental chair tank and triple syringe. After sample collection, analysis was performed: the presence of total coliforms and thermotolerant coliforms was determined by chromogenic substrate technique, the presence or absence of Escherichia coli by fluorescence in ultraviolet light, the count of heterotrophic bacteria through the number of colonies and the determination of pH. Results: In all studied sites, the presence of total coliforms, Escherichia coli and thermotolerant coliforms was observed in at least 26% of the samples. In relation to CFU / ml, all mean values were much higher than the maximum established by legislation (500 CFU / ml). It was verified a statistically significant difference was found in the external cistern and tap when compared to the chair tank and triple syringe (p < 0.05). All pH samples were within the standards. Conclusion : The global analysis showed that 100% of the samples were inadequate, which classified the water potability as nonstandard in regard to the current Brazilian legislation.

Resumen Introducción y objetivo : La contaminación del agua utilizada en las unidades de salud puede inducir malas consecuencias individuales y colectivas. El objetivo de esta investigación fue evaluar la calidad del agua en clínicas odontológicas de una universidad en Brasil, a través del análisis de coliformes totales, coliformes termotolerantes, bacterias heterotróficas y pH. Materiales y métodos: En cada clínica, las muestras de agua fueron recolectadas para análisis en diferentes puntos: cisterna externa, grifo clínico, reservatorio de la silla odontológica y jeringa tríplice. Después de la recolección de las muestras, el análisis fue realizado: la presencia de coliformes totales y coliformes termotolerantes fue determinada por la técnica del sustrato cromogénico; la presencia o ausencia de Escherichia coli por fluorescencia en luz ultravioleta; el recuento de bacterias heterotróficas a través del número de colonias y de la determinación del pH. Resultados: En todos los puntos estudiados, se observó la presencia de coliformes totales, Escherichia coli y coliformes termotolerantes en al menos el 26% de las muestras. Respecto a la UFC / ml, todos los valores medios fueron muy superiores al máximo establecido por la legislación (500 UFC / ml). Todas las muestras de pH estaban dentro de los patrones. Conclusión : El análisis global mostró que el 100% de las muestras fueron inadecuadas, lo que clasificó la capacidad de agua como fuera del estándar en relación a la legislación brasileña actual.

Resumo Introdução e objetivo: A contaminação da água utilizada nas unidades de saúde pode induzir consequências adversas individuais e coletivas. O objetivo deste estudo foi avaliar a qualidade da água em clínicas odontológicas de um curso de odontologia de uma universidade no Brasil, através da análise de coliformes totais, coliformes termotolerantes, bactérias heterotróficas e pH. Materiais e métodos: Em cada clínica, amostras de água foram coletadas para análise em diferentes pontos: cisterna externa, torneira clínica, reservatório da cadeira odontológica e seringa tríplice. Após a coleta das amostras, a análise foi realizada: a presença de coliformes totais e coliformes termotolerantes foi determinada pela técnica do substrato cromogênico; a presença ou ausência de Escherichia coli por fluorescência em luz ultravioleta; a contagem de bactérias heterotróficas através do número de colônias e a determinação de pH. Resultados : Em todos os pontos estudados, a presença de coliformes totais, Escherichia coli e coliformes termotolerantes foi observada em pelo menos 26% das amostras. Em relação à UFC/ml, todos os valores médios foram muito superiores ao máximo estabelecido pela legislação (500 UFC/ml). Todas as amostras de pH estavam dentro dos padrões. Conclusão: A análise global mostrou que 100% das amostras foram inadequadas, o que classificou a capacidade de água como fora do padrão em relação à legislação brasileira atual.

Repercusiones de la pandemia de COVID 19 en la atención odontológica, una perspectiva de los odontólogos clínicos / Implications of COVID-19 pandemic for dental care: a perspective for clinical dentists

RESUMEN: Introducción: La atención odontológica va a cambiar rotundamente debido a la pandemia de COVID-19. En el futuro cobrará mayor importancia, surgirán transformaciones rotundas y necesarias, pero mejorará. Objetivo: Conocer las perspectivas de los odontólogos clínicos peruanos sobre los cambios y repercusiones que tiene y tendrá la pandemia COVID-19 en la atención odontológica. Materiales y métodos: Estudio cualitativo con enfoque fenomenográfico que utilizó la técnica de la entrevista a profundidad a dentistas clínicos en el contexto de la cuarentena en el mes de abril de 2020 en Lima (Perú). La entrevista se efectuó de forma digital y las categorías incluyeron: rol del odontólogo, inconvenientes en la práctica asistencial, soluciones y estrategias frente a la pandemia, apreciaciones sobre las medidas del gobierno, medidas de prevención, atención odontológica en el futuro, y protocolos de atención frente a un paciente con diagnóstico de coronavirus. Resultados: Los odontólogos tienen claro que tanto la indumentaria como los equipos en el consultorio deben estar condicionados a las medidas de protección para proteger tanto al paciente como al personal de salud presente; esto incluye que los ambientes deban estar distanciados, espaciar la atención entre paciente y paciente. Conclusiones: Existe una gran preocupación en los dentistas por el cierre repentino de las clínicas dentales y aumento de personas infectadas, ya que son la primera línea de contagio al tener contacto directo con los pacientes. Los servicios dentales van a tener que adaptarse a los nuevos lineamientos y protocolos dados. Cambiará el modo de atención odontológica priorizando a las urgencias y emergencias, para aminorar la difusión de la enfermedad y lograr una atención más segura y adecuada(AU)

ABSTRACT: Introduction: Dental care is going to change dramatically due to the COVID-19 pandemic. In the future, it will become more important; resounding and necessary changes will emerge, but it will improve for good. Objective: To know the perspectives of Peruvian clinical dentists on the changes and repercussions that the COVID-19 pandemic has and will have in dental care. Materials and methods: Qualitative study with a phenomenographic approach that used the technique of in-depth interview with clinical dentists in the context of quarantine in April 2020 in Lima (Peru). The interview was carried out digitally and the categories included: role of the dentist, inconveniences in healthcare practice, solutions and strategies in the face of the pandemic, insights from government measures, prevention measures, future dental care, and protocols for care in front of a patient diagnosed with coronavirus. Results: Dentists are clear that both clothing and equipment in the office must be subject to protective measures to protect the patient and health personnel present; this includes that environments must be spaced, spacing patient-patient care. Conclusions: There is great concern among dentists over the sudden closure of dental clinics and the increase of infected people since they are on the first line of contagion when having direct contact with patients. Dental services will have to adapt to the new guidelines and protocols given. The way of dental care will change, prioritizing urgencies and emergencies to lessen the spread of the disease and achieve safer and more adequate care(AU)

Restorative dental treatment in times of COVID-19 / Tratamento dentário restaurador em tempos de COVID-19

ABSTRACT Since the outbreak of the Coronavirus Disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), numerous restrictive measures have been adopted by governments of different countries. The return to elective dental care in Brazil is a reality even during the COVID-19 pandemic. During restorative dental procedures, the dental professional requires close contact with the patient, being exposed to contaminated saliva and fluids. In addition, transmission of COVID-19 by the generation of aerosol produced by dental handipieces may be possible. Thus, the dental staff must know how to act during restorative dental procedures, putting into practice the correct clinical protocols to avoid cross-contamination and COVID-19 spread. The purpose of this article is to review the literature on the biosafety practices especially in the context of restorative dental procedures in times of COVID-19.

RESUMO Desde o surgimento da COVID-19, causada pelo coronavírus da Síndrome Respiratória Aguda Grave 2 (SARS-CoV-2), inúmeras medidas restritivas foram adotadas pelos governos de diferentes países. O retorno ao atendimento odontológico eletivo no Brasil uma realidade mesmo durante a pandemia do COVID-19. Durante procedimentos odontológicos restauradores, o profissional de odontologia requer contato próximo com o paciente, sendo exposto a saliva e outros contaminantes. Além disso, a transmissão de COVID-19 pela geração de aerossol produzido por peças de mão odontológicas pode ser possível. Assim, a equipe odontológica deve saber agir em durante o procedimento restaurador, colocando em prática os protocolos clínicos corretos para evitar a contaminação cruzada e a disseminação do COVID-19. O objetivo deste artigo é revisar a literatura sobre as práticas de biossegurança, especialmente no contexto de procedimentos odontológicos restauradores em tempo de COVID-19.

Detection and prevention of nitrous oxide iatrogenic pollution in dental treatments / 中华口腔医学杂志

Nitrous oxide (N2O), also known as laughing gas, is widely used in the dental offices as a common inhaled sedative analgesic gas to reduce anxiety and pain during treatment. Studies have shown that long-term exposure to higher concentrations of laughing gas may have a certain impact on the health of medical staff, while currently research on iatrogenic pollution in applications of laughing gas in oral therapy is not sufficient. In the United States and Europe, the condition of applications of laughing gas is relativrly mature, and there are related regulations and recommended measures to prevent and control iatrogenic pollution. However, studies in these countries still show that there is iatrogenic pollution in the clinical use of laughing gas and lack of uniform detection measures. While, in China, there is little research on the health effects of laughing gas on medical staff and on how to detect and control nitrous oxide pollution. This review is about the hazards, monitoring and control of clinical application of nitrous oxide.

" Para maior glória do nosso Brasil ": educação e cuidados para a saúde bucal infantil, 1912-1940 / " For the higher glory of our Brazil: " infant oral health education and care, 1912-1940

Resumo O artigo problematiza as ações e campanhas educativas voltadas à infância na área odontológica, abordando aspectos centrais, como a implantação de gabinetes dentários nas escolas públicas e a criação de concursos de "bons dentes" para a propagação de preceitos da higiene moderna. Os dentistas foram agentes decisivos na difusão da "ciência odontológica moderna", presentes nas escolas e em diversas instituições, atuando em atividades educativas e também no âmbito de ações e lutas por políticas públicas que reconhecessem as questões de saúde bucal. O artigo se baseia em extensa pesquisa, incluindo documentação variada e, a partir de diálogos com a nova história cultural, busca questionar as formas de prescrever a saúde bucal nas primeiras décadas do século XX.

Abstract Educational actions and campaigns in the area of dentistry geared towards children are addressed, focusing on the introduction of dental cabinets, or offices, at public schools and the creation of "good teeth" competitions to spread modern precepts of hygiene. Dentists were key agents in the spread of "modern dental science" at schools and different institutions, taking part in educational activities and also in actions and struggles for public policies that recognized the issues of oral health. The article is based on extensive research of a variety of documental sources and, through dialogues with the new cultural history, questions the ways oral health was prescribed in the early decades of the twentieth century.

Disposição dos Cirurgiões-Dentistas para identificar condições médicas em consultório odontológico / Dentists' willingness to identify medical conditions in a dental setting

Objetivo: As doenças crônicas não transmissíveis bem como a infecção pelo HIV e as hepatites virais representam hoje problemas de saúde importantes liderando as causas de mortes e causando grande gasto de dinheiro público. O objetivo desta pesquisa foi avaliar as atitudes e vontade de Cirurgiões- Dentistas brasileiros em relação a detecção de condições médicas em consultório odontológico, e comparar os resultados com pesquisa semelhante conduzida com Cirurgiões-Dentistas americanos. Material e métodos: Entrevistamos 323 Cirurgiões-Dentistas de São Paulo. O questionário anônimo avaliou a opinião e disposição dos Cirurgiões-Dentistas em realizar procedimentos médicos no consultório odontológico. A escala de respostas de 5 pontos incluía 1 (muito importante/ muito disposto) até 5 (muito pouco importante/ muito pouco disposto). Resultados: Igualmente aos Cirurgiões-Dentistas americanos, a maioria dos entrevistados acredita ser muito importante detectar doença cardiovascular (80.8%), hipertensão (83.3%), diabetes (83.3%), infecção pelo HIV (86%), e hepatite (86.7%). A maioria está disposta a realizar exame com resultado imediato (54% dos Cirurgiões-Dentistas), mas apenas 47% estão dispostos a discutir o resultado de exames com o paciente imediatamente após realizá-lo. Menos da metade dos entrevistados (47%) consideram seguro saúde como "muito importante" na decisão de incorporar ou não os exames médicos no consultório. Tempo, custo, responsabilidade legal e a vontade do paciente foram considerados "muito importantes" pela maioria dos entrevistados. Conclusão: A maioria dos Cirurgiões-Dentistas brasileiros entrevistados acredita que a triagem para condições médicas em cadeira odontológica seja muito importante e estão dispostos a conduzir um rastreio para condições médicas específicas em consultório odontológico..

Objective: Non-communicable diseases as well as HIV infection and viral hepatitis represents today a major health problem leading causes of death and great expenditures for society. The objective of this survey was to assess Brazilians dentists' attitudes and willingness regarding chairside medical screening in the dental office, and compare the results with a similar survey conducted with American dentists. Material and methods: We interviewed 323 dentists from São Paulo city. The anonymous questionnaire aimed assessing the opinions of dentists in relation to medical procedures in the dental office. The 5-point response scale enclose 1 (very important/very willing) to 5 (very unimportant/very unwilling). Results: In the same way as the American dentists, the majority of the respondents believed it is very important for dentists to conduct screening for cardiovascular disease (80.8%), hypertension (83.3%), diabetes (83.3%), human immunodeficiency virus (86%), and hepatitis (86.7%). Most are willing to conduct screening that generated immediate results (54%), but only 47% are disposed to discuss results immediately with the patient during the dental visit. Less than half of interviewed dentists (47%) considered that having insurance coverage was "very important" in deciding whether or not incorporating medical screening into dental practice. Time, cost, liability and patient´s willing were considered more important among majority of the respondents. Conclusion: Most respondents believed that chair side screening for medical conditions was very important and were disposed to conduct screening for specified medical conditions in a dental setting.

Access to Dental Services and Related Factors in Adolescents from Vitória, Espírito Santo, Brazil, 2011

To characterize access of adolescents to dental services and identify its determinants. Material and Methods:This is a cross-sectional, population-based study conducted with a representative sample of 431 adolescents aged 15-19 years in a health district of Vitória, ES. The interviews were guided by a structured questionnaire with socio-demographic questions, service utilization, and self-perceived oral health. SPSS statistical software version 15.0 was used. Statistical analysis consisted of the use of simple frequency with proportion and chi-square tests. Significance level of 5% was adopted.Results:Most respondents visit the dentist at least once a year, having as main reason routine visit, are attended in public services and positively evaluate the service provided. Factors associated with greater access to dental services (consultation once a year) were care in private service (p = 0.000), schooling (p = 0.019) and positive self-perceived oral health (p = 0.047). Conclusion:It was concluded that the prevalence of recent use of dental services among adolescents was high and access was related to service profile, self-perceived oral health and schooling...

Preditores da realização de consultas odontológicas de rotina e por problema em pré-escolares / Predictors of dental visits for routine check-ups and for the resolution of problems among preschool children / Predictores de la realización de consultas odontológicas de rutina y por problema en preescolares

OBJETIVO: Estimar a prevalência do uso de serviços odontológicos por pré-escolares e fatores associados. MÉTODOS: Estudo transversal com 1.129 crianças de cinco anos de idade da Coorte de Nascimentos de Pelotas 2004, RS, de setembro de 2009 a janeiro de 2010. Registrou-se o uso de serviço odontológico pelo menos uma vez na vida e o motivo para a primeira consulta odontológica da criança. As categorias do desfecho foram: ter feito a primeira consulta por rotina, para resolver um problema ou nunca ter ido ao dentista. Os exames bucais e as entrevistas foram realizados nos domicílios. Aspectos socioeconômicos e variáveis independentes ligadas à mãe e à criança foram analisados por meio de regressão logística multinomial. RESULTADOS: A prevalência de uso por qualquer motivo foi 37,0 por cento. Os principais preditores para consulta de rotina foram nível econômico mais elevado, mãe com maior escolaridade e ter recebido orientação sobre prevenção. Principais preditores para consulta por problema foram ter sentido dor nos últimos seis meses, mãe com maior escolaridade e ter recebido orientação sobre prevenção. Cerca de 45,0 por cento das mães receberam orientação de como prevenir cárie, principalmente fornecida por dentistas. Filhos de mães com história de maior aderência a programas de saúde tiveram maior probabilidade de ter feito uma consulta odontológica de rotina. CONCLUSÕES: A taxa de utilização dos serviços odontológicos por pré-escolares foi inferior às de consultas médicas (puericultura). Além da renda e da escolaridade, comportamentos maternos têm papel importante no uso por rotina. Relato de dor nos últimos seis meses e número elevado de dentes afetados por cárie, independentemente dos demais fatores, estiveram associados ao uso para resolver problema. É necessária a integração de ações de saúde bucal nos programas materno-infantis.

OBJECTIVE: To estimate the prevalence of dental visits among preschool children and determine the factors associated with using dental services. METHODS: A cross-sectional study was conducted with 1,129 five-year-old children from the Pelotas Birth Cohort Study in Pelotas (Southern Brazil) 2004, from September 2009 to January 2010. Use of dental services at least once in the child's life and the reason for the child's first dental visit were recorded. The categories assigned for the first dental visit were: routine check-up, resolution of a problem, or never saw a dentist. The oral examinations and interviews were performed in the children's homes. Socioeconomic aspects and independent variables related to the mother and child were analyzed using multivariable logistic regression. RESULTS: The prevalence of dental visits (both categories combined) was 37.0 percent. The main predictors for a routine visit were higher economic status, mothers with more schooling, and mothers who had received guidance about prevention. Major predictors for a visit because of a problem were having felt pain in the previous six months, mothers with higher education level, and mothers who had received guidance about prevention. Approximately 45.0 percent of mothers received information about how to prevent cavities, usually from the dentist. Children of mothers who adhered to health programs were more likely to have had a routine dental visit. CONCLUSIONS: The rate of preschool visits to dental services was lower than the rate for medical appointments (childcare). In addition to income and education, maternal behavior plays an important role in routine visits. Pain reported in the last six months and a high number of teeth affected by tooth decay, independent of other factors, were associated with visits for a specific problem. It is important to integrate oral health instruction into maternal and child health programs.

OBJETIVO: Estimar la prevalencia del uso de servicios odontológicos por preescolares y factores asociados. MÉTODOS: Estudio transversal con 1.129 niños de cinco años de edad de la Cohorte de Nacimientos de Pelotas 2004, RS, de septiembre de 2009 a enero de 2010. Se registró el uso de servicio odontológico por lo menos una vez en la vida y el motivo para la primera consulta odontológica del niño. Las categorías del resultado fueron: haber realizado la primera consulta por rutina, para resolver un problema, o no haber ido nunca al dentista. Los exámenes bucales y las entrevistas se realizaron en los domicilios. Aspectos socioeconómicos y variables independientes ligadas a la madre y al niño fueron analizados por medio de regresión logística multinomial. RESULTADOS: La prevalencia de uso por cualquier motivo fue de 37,0 por ciento. Los principales predictores para consulta de rutina fueron nivel económico más elevado, madre con mayor escolaridad y haber recibido orientación sobre prevención. Los principales predictores para consulta por problema fueron haber sentido dolor en los últimos seis meses, madre con mayor escolaridad y haber recibido orientación sobre prevención. Cerca de 45,0 por ciento de las madres recibieron orientación de cómo prevenir caries, principalmente suministrada por dentistas. Hijos de madres con historia de mayor adherencia a programas de salud tuvieron mayor probabilidad de haber hecho una consulta odontológica de rutina. CONCLUSIONES: La tasa de utilización de los servicios odontológicos por preescolares fue inferior a la de consultas médicas (puericultura). Además de la renta y de la escolaridad, conductas maternas tienen papel importante en el uso por rutina. Relato de dolor en los últimos seis meses y número elevado de dientes afectados por caries, independientemente de los demás factores, estuvieron asociados al uso para resolver problema. Es necesaria la integración de acciones de salud bucal en los programas materno-infantiles.

Contaminación bacteriana en el agua de unidades dentales de una institución de salud pública / Bacterial contamination in dental unit water from a public health institution

Se evaluó la calidad bacteriológica del agua de 8 clínicas de una institución de salud pública (ISSSTE) de 2 zonas de la ciudad de México, determinándose coliformes fecales y coliformes totales, por medio de la técnica de filtro de membrana, realizándose en 2 diferentes periodos y 3 puntos de muestreo (jeringa triple, llena vasos y suministro) en 9 unidades dentales. De las 8 clínicas analizadas 7 presentaron contaminación bacteriana. Perteneciendo 4 a la zona norte y 3 a la zona sur. El problema de la contaminación en la zona norte se debe principalmente a la mala calidad del agua de suministro la cual en esta zona provenía en su mayoría de las botellas del sistema abastecedor de agua. La otra causa de contaminación se debió a la deficiente o nula desinfección de la jeringa triple. En la zona sur 3 de las 4 clínicas en general presentaron baja contaminación bacteriana solo en el primer periodo, lo cual se puede atribuir a la mejor calidad del agua proveniente de los suministros. Se concluye que los factores determinantes de la presencia de contaminación bacteriana en el agua utilizada en las unidades dentales de ambas zonas fueron: la calidad del agua de suministro y la inadecuada desinfección de la jeringa triple. Mantener una buena calidad de agua en las unidades dentales es muy importante, pues el líquido entra directamente en contacto con la mucosa de cavidad oral, estructuras dentarias, sangre y saliva del paciente, evitando procesos infecciosos que podrían poner en riesgo su salud integral

It was assessed the bacteriological quality of water in 8 clinics of a public health institution (ISSSTE) in 2 areas of Mexico City, determined fecal coliform and total coliform, by means of the technique of membrane filter. There were made 2 different periods and 3 sampling points (syringe triple, flood glasses and supply) in 9 dental units. Of the 8 clinics analyzed 7 presented bacterial pollution. 4 Belonged to the north and 3 to the south zone. The problem of pollution in the north zone is mainly due to the poor water quality of supply which in this area came mostly from the bottles of the flush system. The other source of pollution was due to the poor or non-existent disinfection of the triple syringe. In the south zone in general 3 of 4 clinics presented low bacterial pollution only in the first period, which can be attributed to the better quality of water from the supplies. It concludes that the determining factors in the presence of bacterial pollution in water used in dental units of both areas were: the quality of water supply and inadequate disinfection of the triple syringe. Maintain a good water quality in dental units is very important, because liquid makes direct contact with the mucous membrane of oral cavity, dental structures, blood and saliva of the patient, avoiding infectious processes that could put in risk their integral health

Riesgo en el manejo de la amalgama dental en las entidades odontológicas medianas y pequeñas en el departamento de Antioquia, Colombia / Risk in the management of dental amalgan in dental medium and small entities in the departament of Antioquia, Colombia

Este artículo se deriva de la investigación aplicada “gestión ambiental de la amalgama dental en el departamento de Antioquia”, financiada por la empresa New Stetic S.A. y la Universidad de Antioquia, realizado desde el año 2005 hasta principios del 2007 por los grupos de ciencia y tecnología biomédica (CTB), materiales preciosos (MAPRE) e investigaciones pirometalúrgicas y de materiales (GIPIMME) y desarrollo de la mencionada empresa. Objetivo: describir y caracterizar las actividades relacionadas con el maneo del mercurio, la amalgama y sus residuos en 107 entidades prestadoras de servicios en salud oral, clasificadas entre medianas y pequeñas, y definidas como aquellas que tienen menos de cinco sillas o unidades odontológicas en el mismo sitio de trabajo. Metodología: en cada institución se realizo una encuesta personalizada, diligenciado un cuestionario sobre los datos del entrevistado, el manejo del mercurio y la amalgama, salud ocupacional, capacitación, condiciones ambientales y gestión de los residuos. Cada entidad fue visitada por un ingeniero investigador y un estudiante avanzado de ingeniería, previamente capacitados para recoger la información. Resultados: debe producirse una reflexión en el personal odontológico y administrativo de las instituciones prestadoras de servicios en salud oral, las entidades de vigilancia y control y las instituciones académicas formadoras del talento humano, con el fin de implementar acciones integrales y metodologías seguras a corto plazo que generen un servicio de mejor calidad y mínimo riesgo para el personal laboralmente expuesto y para el ecosistema.

This article is bases on the applied research “Environmental Management of the Dental Amalgan in Antioquia, Colombia”, which was financed by the company New Stectic S.A. and the University of Antioquia. The research was carried out between 2005 and 2007 by the following groups: Biomedical Science and Technology, Precius Materials, and Pymetallurgical and Material Research and Development Division of the mentioned company. Objective: to describe and characterize the activities about handling mercury, dental amalgam and its waste in 107 dental offices defined as medium and small, that is to say those with less than five dental chairs in the same workplace. Methodology: a poll was made in each institution filling a questionnaire about personal details of the interviewee, mercury and amalgam handling, occupational health, training, environmental conditions, and wasted management. Each dental office was visited by research engineer and an advance in order to collect the information. Results: a reflection aimed to establish integral actions and safe methodologies in the short term to promote a better quality service and a minimum risk for the people exposed to mercury and the ecosystem must be encouraged by dental and administrative staff, as well as by surveillance and control institutions and the educational institutions devoted to the formation of dental professionals.

Aspectos odontolegais da insalubridade na odontologia / Legal aspects of insalubrity in dentistry

Objetivo: Avaliar os conhecimentos dos cirurgiões-dentistas quanto à insalubridade na profissão, formas de prevenção e aspectos odontolegais. Métodos: Foi feita uma pesquisa sob a forma de questionários, com 15 perguntas objetivas, distribuídas para 225 cirurgiões-dentistas que trabalham na região de Contagem, Minas Gerais. Os dados recolhidos foram submetidos a análise de distribuição conjunta de freqüência, determinando-se a significância dos efeitos pelo teste do Qui-quadrado (X²) e o teste exato de Fisher quando necessário, estabelecendo-se um nível de confiança de 95%. Resultados: Os resultados obtidos demonstraram que os profissionais desconhecem algumas normas da Agência Nacional de Vigilância Sanitária relativas à prevenção contra os agentes químicos e físicos no consultório. O tempo de formação não influenciou os cirurgiões dentistas em uma maior conscientização quanto à realização de exames audiométricos para a prevenção do ruído ocupacional. Obteve-se um alto índice de profissionais que se previnem contra o vírus HBV, através da imunização (97, 94%), no entanto, houve uma diferença estatística significativa quanto a não utilização de gorro e avental pelo gênero masculino (p=0.001 e p=0.03 respectivamente). Conclusão: A vasta literatura existente revela ser de conhecimento teórico do profissional, porém não condiz com suas ações na prática clínica diária.

Objective: To evaluate the knowledge of dentists with regard to insalubrity in the profession, ways of prevention and legal aspects. Methods: Research was conducted in the form of questionnaires, with 15 objective questions, distributed among 225 dentists that work in the region of Contagem, Minas Gerais, Brazil. The data collected were submitted to analysis of distribution in conjunction with frequency, determining the significance of the effects by the Chi-square test (X²) and the Exact Fisher test, when necessary, establishing a level of confidence of 95%. Results: The results obtained demonstrated that the professionals did not know some of the rules of the National Sanitary Vigilance Agency with regard to prevention against chemical and physical agents in the consulting room. The time since graduation did not influence the dentists as regards a greater awareness about having audiometric exams performed to prevent occupational noise. A high index of professionals who protected themselves against the HBV virus by immunization (97, 94%) was obtained, however, there was statistically significant difference with regard to non-use of cap and apron by men (p=0.001 and p=0.03 respectively). Conclusion: The vast existent literature reveals that the professional has theoretical knowledge, but this is not in accordance with his/her actions in daily clinical practice.

Avaliação ergonômica dos equipamentos presentes nos estabelecimentos de assistência odontológica pertencentes à cidade de Araçatuba - SP / Ergonomic evaluation of the equipments present in the settlements dentistry attendance belong to Araçatuba city - SP / Ergonomic evaluation of the equipments present in the settlements dentistry attendance belong to Araçatuba city ­ SP

Introdução - O objetivo do estudo foi avaliar as condições ergonômicas dos equipamentos presentes na área de tratamento dos estabelecimentos de assistência odontológica do município de Araçatuba-SP. Material e Método -Intencionalmente foram selecionados 40 estabelecimentos, 30 pertencentes ao serviço privado e 10 ao serviço público. Os estabelecimentos do setor privado foram divididos em três grupos: adequados, medianos e inadequados; tendo como critério adotado o planejamento da parte externa da edificação. Os equipamentos foram analisados a partir de 210 requisitos, sendo atribuído a cada requisito os seguintes valores: 0 (insatisfatório), 2 (satisfatório), 3 (muito satisfatório) e NA (não aplicável). A média percentual foi obtida por meio do software "Pesquisa de Clínicas", no qual foi classificada em: excelente (>80%); bom (60-79%); regular (40-59%); ruim (20-39%) e péssimo (<20%) para estabelecer o nível de satisfação ergonômica alcançado pelos equipamentos e na análise estatística foi utilizado os testes não paramétricos Kruskall-Wallis para a comparação dos grupos e Mann-Witney para a comparação dos grupos 2 a 2. Resultados - Os dados obtidos mostraram que 48% dos equipamentos presentes nos estabelecimentos avaliados apresentaram-se insatisfatórios ergonomicamente, sendo 43% regulares e 5% ruins. Estatisticamente, houve diferença significativa entre os equipamentos presentes nos estabelecimentos privados com instalação adequada e inadequada e do setor público, entretanto essa diferença não foi observada entre os equipamentos presentes nos estabelecimentos do setor público e do privado inadequado. Conclusões - Concluiu-se que o cuidado no planejamento da instalação de assistência odontógica no serviço privado tem influência na qualidade dos equipamentos adquiridos e os equipamentos localizados no setor público necessitam se adequar aos padrões ergonômicos.

Introduction - The aim of this study was to evaluate the ergonomic conditions of the equipments in settlements dentistry attendance installed in Araçatuba city-SP. Material and Method - Intentionally were selected 40 settlements, 30 private section and 10 public section. The settlements private were divided in 3 groups: adequate, medium and inadequate; having as criteria the design external of the settlement. The equipments were analyzed through 210 requirement, being attributed the following scores: 0 (unsatisfactory), 1 (little satisfactory), 2 (satisfactory), 3 (very satisfactory) and NA (unsuitable). The percentage average was gotten by means of the software "Research of Clinics", which was classified in: excellent (>80%); good (60-79%); regular (40-59%); bad (20-39%) and wretched (<20%) to establish the ergonomic satisfaction level reached by the equipments and in the statistic analysis was used the tests non parametric Kruskall Wallis for the comparison of the groups and Mann-Witney for matching of 2 the 2 groups. Results - The data obtained showed that 48% of the equipments evaluated presented ergonomic unsatisfactory, being 43% regular and 5% bad. Significant statistic difference were observed between the equipments present in the settlements private adequate and the present in the settlements private inadequate public section, however this difference wasn't observed between the equipments present in the settlements public and the present in the settlements private inadequate. Conclusions - It was concluded that the care with the design of the settlements dentistry attendance has influence in the quality of the equipments acquired and the equipments localized in the public section need if to adjust to the ergonomic patterns.