A medicalização na prática de dentistas no SUS: um olhar qualitativo para os sentidos da prática / Dentistry medicalization at SUS: a qualitative practice-based perspective

Resumo Este artigo explora sentidos e significados do trabalho odontológico no SUS, no contexto da relação profissional-paciente. Pesquisa qualitativa com 20 cirurgiões-dentistas que atuavam em um município paulista de médio porte, abordada por meio de três grupos focais, com a pergunta disparadora "Qual é o sentido ou significado do seu trabalho, aqui na prefeitura, para você?". O material foi áudio-gravado, transcrito na íntegra e analisado pelo método de análise de conteúdo temática. Procedemos a realização de leitura flutuante, categorização e discussão dos achados junto aos pares de pesquisadores para validação final. Como resultados, aponta-se a construção das categorias 1) Estranheza às necessidades percebidas pelos pacientes e a consequente medicalização da vida, e 2) Poder e consumo como significados da prática. O trabalho do cirurgião dentista, nesse contexto, evidenciou as diferenças entre as necessidades percebidas pelo paciente e aquelas que o dentista considera. Além disso, revelou o poder que emana da assimetria entre paciente e profissional como dificultador da produção de autonomia do paciente. Tais significações parecem trazer sofrimento para esses profissionais no seu trabalho. Concluiu-se que há necessidade de reflexão sobre o trabalho em saúde como forma de se evitar sofrimento, e que a prática desses dentistas é carregada de sentidos e significados.

Abstract This study explores the senses and meanings attributed to dental work in the Brazilian National Health System (SUS) focusing on dentist-patient relations. A qualitative research was conducted with 20 dentists working in a medium-sized municipality in São Paulo, divided into three focus groups and asked the guiding question "What sense or meaning do you attribute to your work here in the city?" Data were audio-recorded, fully transcribed, and analyzed using thematic content analysis. Floating reading, categorization, and peer discussion of the findings were performed for the final validation, resulting in two categories: 1) Strangeness to patients' needs and the subsequent medicalization of life, and 2) Power and consumption as meanings of practice. In this context, the dental practices showed the differences between patients' needs and those considered relevant by dentists. It also showed the power imbalance between patients and professionals as a hindrance to patients' autonomy. Such meanings seem to cause suffering to these professionals. In conclusion, reflections on health work are paramount to avoid suffering and understand that the practice of these dentists bears many senses and meanings.

Contribución de la ética convergente en la enseñanza de la odontología / Contribution of convergent ethics in the teaching of dentistry

Objetivo: refexionar sobre la aplicación de la ética convergente en la práctica odontológica de pregrado para comprender las tensiones entre los principios cardinales que pueden suscitarse en la relación estudiante-paciente. Métodos: se exponen los fundamentos teóricos de la ética convergente y se relacionan las tensiones bio(éticas) que propone con un ejemplo en la práctica formativa estudiante-paciente de odontología. Resultados: se desarrolló una articulación de la ética convergente con un caso práctico en odontología. Conclusión: la ética convergente puede brindar un punto de partida para aplicar el análisis bioético en la práctica clínica odontológica, por parte del estudiante.

Objective: To refect on the application of convergent ethics in undergraduate dental practice to understand the tensions between the cardinal principles that can arise in the student-patient relationship. Methods: The theoretical foundations of convergent ethics are exposed and the bio(ethical) tensions proposed in convergent ethics are related to an example of their application in the dental student-patient training practice. Results: An articulation of convergent ethics was developed with a practical case in dentistry. Conclusion: Convergent ethics can provide a starting point to apply bioethical analysis in the clinical practice of dental students.

Medo odontológico e saúde bucal: avaliação transversal do ciclo do medo entre universitários brasileiros / Dental fear and oral health: cross-sectional evaluation of the cycle of dental fear theory among Brazilian undergraduate students

Objetivo: Avaliar a presença do medo odontológico em universitários brasileiros e observar se a teoria do ciclo vicioso do medo é identificada nesta população. Materiais e métodos: Foi realizado um estudo transversal com universitários ingressantes na Universidade Federal de Pelotas em 2016. Os dados sociodemográficos, medo odontológico, o uso de serviços odontológicos, a percepção de cárie e dor dentária foram coletados através de um questionário auto--administrado. A exposição do estudo foi medo odontológico, e os desfechos incluíram padrão de consulta odontológica, experiência de cárie e dor dentária e autopercepção de saúde bucal. Características sociodemográficas foram incluídas como fatores de confusão. Para testar a associação do medo odontológico com os desfechos, foram utilizados modelos de regressão de Poisson com variância robusta, a fim de estimar as Razões de Prevalência e Intervalos de Confiança. Resultados: Foram avaliados 2.014 universitários, dos quais 22.4% reportaram medo odontológico. Aqueles que reportaram medo odontológico apresentaram uma maior prevalência de não terem ido ao dentista no último ano e, entre os que consultaram, a visita ter sido motivada por dor/problema. Adicionalmente, ter medo aumentou a presença de cárie, dor dentária e autorrelato da saúde bucal negativa. Discussão: Os achados sugerem a presença do ciclo vicioso do medo nesta população de universitários do sul do Brasil. Conclusão: Evidenciou-se a associação entre a presença de medo odontológico e a menor procura por atendimento odontológico, a presença de cárie dentária, dor dentária e saúde bucal autorreportada negativa, corroborando com a teoria do ciclo do medo.

Aim: To evaluate the presence of dental fear among Brazilian undergraduate students and to observe whether the cycle of dental fear theory applies to this population. Materials and methods: A cross-sectional study were conducted with first year students of the Federal University of Pelotas, Brazil, in 2016. Sociodemographic data, dental fear, as well as the use of dental services and perception of caries and dental pain were collected through a self-administered questionnaire. The exposure was dental fear, and the outcomes included dental visit pattern, experience of dental caries and dental fear and self-rated oral health (SROH). Sociodemographic characteristics were included as aconfounding factor. To test the association between dental fear and the outcomes, Poisson regression models with robust variance were used, to estimate Prevalence Rations and Confidence Intervals. Results: 2,014 undergraduate students were evaluated and 22.4% of them reported dental fear. Those who reported dental fear had a higher prevalence of not visiting the dentist in the last year and, among those who visited, to have had only a pain/problem-oriented visit. Additionally, having fear increased the presence of dental caries, dental pain and negative SROH. Discussion: Our findings suggest the presence of the vicious cycle of dental fear in this population of undergraduate students in southern Brazil. Conclusion: This study provided evidence on the association between dental fear and the lower frequency of dental visit, dental caries, dental pain experience and negative SROH, corroborating with the cycle of dental fear theory.

Translation, Cross-cultural Adaptation and Reliability Analysis of the Survey of Anxiety and Information for Dentists (SAID) among Brazilian Adolescents

ABSTRACT Objective: To translate, perform a cross-cultural adaptation and reliability analysis of the Survey of Anxiety and Information for Dentists (SAID) for use with Brazilian adolescents. Material and Methods: The SAID was translated into Brazilian Portuguese and back-translated to English. An expert committee compared both versions and examined their equivalence. Then, a face validation was performed with 10 adolescents. The SAID was applied in printed format with 25 questions. Participants answered and commented on the questions with a researcher to confirm the understanding and provide suggestions. The suggestions were implemented, and the expert committee approved the final version of the SAID in Brazilian Portuguese. The psychometric properties were tested with 60 adolescents aged 10 to 19 years. Participants answered the Brazilian version of the SAID before their first dental appointment and two weeks later to determine test-retest reliability. Reliability was analyzed by internal consistency analysis (Cronbach's alpha) and test-retest (ICC). Results: The instrument presented excellent reliability according to internal consistency (Cronbach's alpha = 0.77) and test-retest coefficients (ICC = 0.88; 95% CI: 0.81-0.93). The Kappa coefficients and the degree of agreement of the dichotomous questions indicated good reproducibility of the new version. Conclusion: The SAID translation, cross-cultural adaptation and reliability analysis were completed successfully. Thus, the Brazilian version of the SAID can be a useful survey tool for dental care of adolescent patients.

O uso de whatsapp® na relação dentista-paciente: uma revisão de literatura / The use of whatsapp® in the dentist-patient relationship: a literature review

Introdução: as relações dentista-paciente, atualmente, também estão sendo mediadas pelas Tecnologias de Comunicação e Informação, como, por exemplo, pelo WhatsApp®. Objetivo: verificar o uso do aplicativo WhatsApp® nas relações dentista-paciente com a finalidade de discutir as questões éticas e legais. Material e Métodos: revisão de literatura dos artigos científicos publicados nas bases PubMed, Bireme e Scielo, utilizando como descritores em inglês "WhatsApp®" and "Dentistry" e em português "WhatsApp®" and "Odontologia". Resultados: o uso do WhatsApp® nas relações dentista-paciente foi para teleconsulta/diagnóstico, segunda opinião, educação e prevenção em saúde bucal, adesão ao tratamento e monitoramento de pacientes. Conclusão: o WhatsApp® se for utilizado de forma correta e competente, em consonância com os preceitos éticos inscritos no Código de Ética Odontológica sobre o valor eminente do sigilo das informações e do exercício digno da profissão, pode potencializar os benefícios e otimizar as relações estabelecidas entre cirurgião-dentista e paciente

Introduction: dentist-patient relations are currently also being mediated by Communication and Information Technologies, such as WhatsApp®. Purpose: to verify the use of the WhatsApp® application in the dentist-patient relations to discuss the ethical and legal issues. Material and Methods: literature review of scientific articles published in PubMed, Bireme and Scielo databases. The descriptors used were "WhatsApp®" and "Dentistry". Results: the use of WhatsApp® in the dentist-patient relations were for teleconsultation/diagnosis, second opinion, oral health education and prevention, treatment adherence and patient monitoring. Conclusion: the WhatsApp®, if used correctly and competently, according the ethical precepts contained in the Brazilian Code of Dental Ethics about the value of information confidentiality and the proper exercise of the profession, can enhance the benefits and optimize the relationships established between dentist and patient

Variaciones del tercio inferior de la cara, disturbios temporomandibulares y necesidades asistenciales / Variations of the lower third of the face and temporomandibular disorders: needs of health care

RESUMEN Introducción: la articulación temporomandibular es una de las estructuras craneofaciales más complejas, mantiene una íntima relación con el sistema neuromuscular, tónico postural y la oclusión dentaria. Objetivo: identificar las variaciones verticales del tercio inferior de la cara, su relación con trastornos temporomandibulares y las necesidades asistenciales. Métodos: se realizó un estudio observacional, descriptivo y transversal en el período comprendido de enero del 2017 a febrero 2018, en la Clínica Estomatológica Docente "Antonio Briones Montoto". El universo estuvo constituido por 803 estudiantes de las secundarias básicas del área de salud próxima al centro, la muestra quedó constituida por 256 escolares. El análisis de los datos se realizó en tablas de distribución de frecuencias y se procesaron mediante técnicas estadísticas. Resultados: el 14,8 % de los escolares examinados presentó proporción facial, un 33,9 % presentó disminución del tercio inferior y un 51,1 % el tercio inferior aumentado, prevalecieron los adolescentes con disturbios temporomandibulares para un 52,3 % predominando el tercio inferior de la cara aumentado, asociado a esta alteración, el Síndrome de clase I de Moyers se presentó en un 24,2 % y el Síndrome clase II de Moyers en un 18,3 %, relacionado a los disturbios de la articulación temporomandibular, el tratamiento correctivo fue la mayor necesidad para un 47,4 %. Conclusiones: el tercio inferior aumentado fue la mayor alteración determinada, al presentar una relación estadísticamente significativa con los disturbios de la articulación temporomandibular independientemente del sexo, el síndrome de clase I de Moyers predominó y el tratamiento ortodóncico correctivo fue la mayor necesidad asistencial.

ABSTRACT Introduction: temporomandibular joint is one of the most complex craniofacial structures; it maintains a close relationship with the neuromuscular, postural-tonic systems and the dental occlusion. Objective: to identify the vertical variations of the lower third of the face, its relationship with temporomandibular disorders and care needs. Methods: an observational, descriptive and cross-sectional study was conducted in the period from January 2017 to February 2018, at the "Antonio Briones Montoto" Teaching Stomatological Clinic. The universe was constituted by 803 students of the basic secondary schools of the health area near the center, the sample was constituted by 256 schoolchildren. The data analysis was performed in frequency distribution tables and processed using statistical techniques. Results: of the students examined 14,8 % presented facial proportion, 33,9 % showed a decrease in the lower third and 51,1 % in the lower third increased, adolescents with temporomandibular disorders prevailed 52,3 % with the lower third of the increased face predominating the association with this disorder, 24,2 % of them presented Moyers Class I Syndrome and 18,3 % Moyers Class II Syndrome related respectively to temporomandibular joint disorders, corrective treatment was most needed ( 47,4 %). Conclusions: the increased lower third was the greatest disorder determined presenting a statistically significant relationship with temporomandibular joint disorders regardless of gender, the Moyers class I syndrome was the most predominant and corrective orthodontic treatment showing the greatest need for health care.

Experiencias relacionadas con la pérdida dental durante la niñez y la juventud / Experiences related to dental loss during childhood and youth

Background: Early tooth loss is recognized as a public health problem not only in Colombia but also worldwide. This phenomenon has been approached by positive research, but the approach hasn't been enough from social outlooks. Aim: to understand tooth loss related experiences and reveal the implications of social and emotional interactions of children and teenagers. Methods: Qualitative cross sectional study, this study collects elements of phenomenological approach and method. In data construction, ten children and teenagers with tooth loss were deeply interviewed. Data condensation in significance units was made for the analysis. several trends emerged around those units. Results: among the highlight trends, shame and acquiescence appeared after tooth loss, also dental pain were a key factor to choose dental extraction as a choice. To be afraid of the dentist and the dental attention process were related to the problem. Conclusion: this study contributed to the comprehensive setting extension, revealing shame and fear as emerged emotions through tooth loss suffering. Besides transforming actions in the macro-social level, it is required to build educational process that helps to overcome the imaginary relationship between dental practice and painful experiences and to generate skills that provide a humanized dental practice over an instrumental dental practice in order to change these realities.

Antecedentes: La pérdida dental temprana es reconocida como una problemática de salud pública en Colombia y en otros países del mundo. El fenómeno ha sido abordado por la investigación de enfoque positivo, pero es insuficiente la aproximación desde perspectivas sociales. Objetivo: Comprender las experiencias relacionadas con la pérdida dental y develar implicaciones para la interacción social y emocional de niños y jóvenes. Materiales y Métodos: Estudio cualitativo que retoma elementos del enfoque y método fenomenológico. En la construcción de los datos participaron veinte niños y jóvenes con antecedentes de perdida dental. Se realizó entrevista en profundidad a los participantes. El análisis consistió en un proceso de condensación de los datos en unidades de significado, alrededor de las cuales emergieron varias categorías de análisis. Resultados: Entre las categorías emergentes, se destaca la aparición de emociones como la vergüenza y la resignación luego de perder los dientes. Así mismo la experiencia de dolor fue significativa y guio la decisión de optar por la extracción dental. El miedo al odontólogo y al proceso de atención odontológica fueron reconocidos como aspectos relacionados con la problemática. Conclusión: El estudio contribuyó a la ampliación de los marcos comprensivos, develando que la pérdida dental es un padecimiento atravesado por emociones como la vergüenza y el miedo. Transformar estas realidades, requiere además de la implementación de acciones en lo macro social, construir procesos educativos orientados a superar el imaginario que asocia la práctica odontológica con experiencias dolorosas, y generar capacidades que posibiliten el ejercicio de una práctica profesional más humana que instrumental.

Social Representations of Children in Relation to the Image of the Dentist

Objective: To identify the social representations of children in relation to the image of the dentist. Material and Methods: This is a descriptive cross-sectional study with quantitativequalitative approach. The sample consisted of 80 children of both sexes aged 7-10 years attended at a clinic-school of a university in eastern Minas Gerais, Brazil. For data collection, the Test of Free Words Association (TALP) was used, with the word "dentist" as its inducing theme. The four items included in the research instrument were: 1) evoke up to five words or expressions related to the dentist; 2) to order each of them numerically, with number one being the most important and number five being the least important; 3) to conceptualize the one elected as number one; and 4) to justify the reason for that choice. The EVOC software was used to carry out quantitative analyses and the Analysis of Content of Bardin for qualitative analyses. Results: The words that composed the central nucleus of social representations were "tooth", "pain", "brushing" and "treats". This grouping of ideas points to the following conceptual formulation: "The dentist is someone who 'brushes' and 'treats' teeth, but sometimes performs procedures that cause 'pain'. The categories abstracted from participants' discourse were "oral health", "personal characteristics of the dentist" and "child-dentist interaction". Conclusion: Children presented predominantly positive image regarding the dentist.

Anxiety presented by children facing dental treatment / Ansiedade apresentada por crianças frente ao tratamento odontológico

ABSTRACT Objective: To determine the profile of children from 6 to 12 years of age, in relation to anxiety towards dental treatment and evaluate the main factors that trigger anxiety in this population. Methods: The sample was composed of 200 children with an average age of 8.5 years who attended the Clinic of the School of Dentistry of the Federal University of Campina Grande and the Basic Healthcare Units of the municipality of Patos, Paraíba, Brazil between June 2015 and May 2016. Anxiety was assessed using the Dental Anxiety Scale and the Venham Picture Test. The Chi-Square test and Fisher's exact test were used to explore the level of significance of the associations between the variables Results: Anxiety was observed in the majority of children (Dental Anxiety Scale - 89% and Venham Picture Test - 70.5%) and the predominant levels were low to moderate. The child´s age group was significantly associated with anxiety (p=0.014) by the Venham Picture Test, while gender did not present this correlation. Anxiety was influenced by all the factors studied: making the appointment, waiting room, rotary instrument and periodontal scaling. Conclusion: The majority of children presented anxiety and the trigger factors: making the appointment, waiting room, rotary instrument and periodontal scaling contributed considerably to its development.

RESUMO Objetivo: Determinar o perfil das crianças de 6 a 12 anos de idade, com relação à ansiedade frente ao tratamento odontológico e avaliar os principais fatores desencadeadores de ansiedade nesta população. Métodos: A amostra foi composta por 200 crianças com idade média de 8,5 anos que frequentaram a Clínica-Escola de Odontologia da Universidade Federal de Campina Grande e as Unidades Básicas de Saúde da Família do município de Patos-PB entre junho de 2015 e maio de 2016. A ansiedade foi avaliada utilizando a Dental Anxiety Scale e o Venham Picture Test. O teste Qui-Quadrado e Exato de Fisher foram usados para explorar o nível de significância das associações entre as variáveis. Resultados: A ansiedade foi observada na maioria das crianças (Dental Anxiety Scale - 89% e Venham Picture Test - 70,5%) e os níveis predominantes foram baixo e moderado. A faixa etária da criança foi associada significativamente à ansiedade (p=0,014) através do teste Venham Picture Test, ao passo que o gênero não apresentou essa correlação. A ansiedade sofreu influência de todos os fatores estudados: marcação da consulta, sala de espera, caneta odontológica e raspagem periodontal. Conclusão: A maioria das crianças apresentou ansiedade e os fatores desencadeadores marcação da consulta, sala de espera, caneta odontológica e raspagem periodontal atuaram consideravelmente para o seu desenvolvimento.

A importância da participação do paciente para a manutenção da saúde periodontal ­ revisão de literatura / The importance of patient participation in periodontal health maintenance - literature review

As doenças gengivais e periodontais mais comuns e prevalentes são a gengivite e as periodontites, ambas têm como fator etiológico o biofilme dental periodontopatogênico, que é composto principalmente por bactérias. Alguns fatores de risco podem favorecer o aparecimento ou o agravo dessas doenças, podendo estar associado ao acúmulo/agregação do biofilme (fatores locais) ou a exacerbação do processo imuno-inflamatório (fatores sistêmicos), sendo de extrema importância a identificação dos mesmos para o devido controle destas. O objetivo desse trabalho foi analisar, por meio de uma revisão da literatura, a importância da participação do paciente no sucesso do tratamento periodontal, considerando as obrigações entre as partes, referendadas nos estudos revisados, no Código de Ética Odontológica e no Código de Defesa do Consumidor. Os trabalhos, legislação e normativa revisados mostraram que o sucesso da terapia periodontal depende de uma adequada informação e conscientização do paciente por parte do profissional assistente, além da sua aceitação, compreensão e colaboração em relação ao tratamento que será executado, seguido por uma rigorosa terapia periodontal de suporte mediante à(s) sua(s) necessidade(s). A prática odontológica, portanto, deve ser alerta em tratamentos de Periodontia, por sua complexidade de contexto de informação, pelo compromisso paritário, sendo o cuidado ético e o conhecimento odontolegal fundamentais para uma prática clínica de baixo risco.

The most common and prevalent gingival and periodontal diseases are gingivitis and periodontitis, both of which have as their etiological factor the periodontal pathogenic dental biofilm, which is composed mainly of bacteria. Some risk factors may favor the appearance or aggravation of these diseases, and may be associated with accumulation / aggregation of the biofilm (local factors) or exacerbation of the immune-inflammatory process (systemic factors), being extremely important the identification of the same for the due to their control. The objective of this study was to analyze, through a review of the literature, the importance of patient participation in the success of periodontal treatment, considering the obligations between the parties, endorsed in the reviewed studies, the Code of Ethical Dentistry and the Code of Defense of the Consumer. The studies, legislation and regulations revised showed that the success of periodontal therapy depends on adequate information and awareness of the patient on the part of the assistant, as well as their acceptance, understanding and collaboration in relation to the treatment to be performed, followed by a rigorous therapy periodontal period of support through your need (s). Dental practice, therefore, should be alert in periodontal treatments, due to its complexity of information context, equal commitment, ethical care and odontolegal knowledge are fundamental to a low risk clinical practice.

Patient satisfaction and quality of emergency dental care in chilean public health services

The provision of dental care services, related to the quality requirements of health policies and patient satisfaction rates, increasingly requires the creation of qualitative indicators, instruments and criteria based on specific objectives, to validate the quality of the services provided. objective: the aim of this study is to determine the main dimensions of the dentist-patient relationship associated with patient satisfaction in a clinical context, with emphasis on the needs and expectations of patients themselves. method: a sample of 88 adults who attend primary care units at public emergency services in the central area of Chile were studied using a qualitative approach based on the social psychology of health and on grounded theory. from these, categories emerged that identify processes, attitudes and behaviors that define the assessment of care providers based on their practices. results: in an interactional context characterized by the patient's expectation regarding the provision of care and anxiety due to potential pain, two already recognized main axes emerged, namely: the capacity to generate trust through interpersonal and communicative good treatment strategies, and the capacity or technical skills of the professional care provider. conclusion: this study proposes a protocol of good care practices, which takes into account the needs and expectations of patients regarding the role of the dentist.

Training, Practices and Difficulties of Dentists in the Care of Children and Adolescents with Special Needs in the Primary Health Care

Objective: To know the training, practices and difficulties of Dentists in the care for Patients with Special Needs (PSN), in the Primary Health Care (PHC). Material and Methods: This is a Cross-sectional study with 44 Dentists. Some of the variables analyzed through the questionnaire were: dentistry specialty, PSN definition, undergraduate discipline on the subject, accomplishment of PSN care, difficulties, referral and accessibility. Data analysis was performed with the Statistical Package for the Social Sciences and measures of central tendency and dispersion by Fisher's Exact Test (p < 0.05). Results: Only one professional investigated presented PSN Specialization. About 82.5% of professionals had graduation time of over 10 years, where 75% of professionals did not have Curricular Component (P=0.006) or training to deal with PSN (85.0%), despite working in primary care for more than 10 years (60%). The care of PSN in the Primary Health Care was performed by 77.5% of professionals, in which lack of care was justified mainly because dentists did not feel prepared to perform it (37.5%), and the main difficulty found in care, refers to the lack of cooperation of these patients (27.5%). All professionals reported to refer patients to reference services, but 12.5% did not perform a previous clinical examination in the PHC. The reference service most reported by professionals was the Dental Specialty Center (82.5%). Conclusion: Although the training received by professionals present deficiencies in relation to PSN, the majority reported to attend these patients in Primary Health Care Units, and considered to be able to supply their needs. The greatest difficulties found in the care of Patients with Special Needs are related to their approach. The lack of care of these patients was justified by the fact that Dentists did not feel prepared to perform.

O impacto das reportagens divulgadas na internet relacionadas a casos de morte decorrentes de tratamento odontológico / The impact of articles published on the internet related to cases of death resulting from dental treatment

O presente estudo analisou reportagens não científicas veiculadas na internet, que divulgaram óbitos relacionados ao tratamento odontológico. Dezessete reportagens foram coletadas do site de busca Google®, utilizando-se palavras-chave específicas. Foram extraídas informações como: o ano e local de óbito; o sexo da vítima; o procedimento executado, dentre outras. A maioria dos pacientes eram do sexo feminino com idades entre 3 e 57 anos. A extração dental foi o procedimento mais vinculado aos óbitos. O presente estudo salienta a importância do planejamento clínico visando evitar situações inesperadas no consultório odontológico e chama atenção para as informações veiculadas pela mídia.

This study examined not scientific articles published on the internet which reported deaths related to Dental treatment. Seventeen reports were collected from the Google® search engine, using specific keywords. Several data were extracted, such as: the year and place of death; the victim's gender; the dental procedure performed, among others. Most patients were female aged between 3 and 57 years. Dental extraction was the most prevalent procedure. The present study highlights the importance of proper clinical planning in order to avoid unexpected situations in the routine of Dentistry; and suggests that the information reported by the non-scientific media must be carefully interpreted.

Ansiedade ao tratamento odontológico: perfil de um grupo de adultos em situação não clínica / Dental anxiety: profile of an adult group in a non-clinical situation

O objetivo da pesquisa foi caracterizar um grupo de adultos, em situação não clínica, quanto à ansiedade ao tratamento odontológico. A pesquisa descritiva, do tipo transversal, ocorreu mediante levantamento de dados primários. A população-alvo foi constituída por sujeitos adultos que se encontravam em espaços públicos, no perímetro central de uma cidade de Santa Catarina (Brasil). O plano amostral foi não probabilístico e a obtenção da amostra deu-se por conveniência. O instrumento de coleta de dados foi um questionário elaborado com base na Dental Anxiety Scale (DAS). A amostra foi composta por 304 pessoas (56% do gênero feminino e 44% do masculino). As idades variaram de 18 a 65 anos. O percentual de mulheres com ansiedade foi de 78% e o de homens foi 58%. A maioria (62,1%) dos sujeitos sem ansiedade tinha entre 18 a 34 anos. A consulta em menores intervalos de tempo foi citada por 75,3%; os procedimentos curativos foram os mais citados (57,4%) como motivo da última consulta. Os fatores desencadeadores de ansiedade foram os instrumentos relacionados às intervenções curativas. O maior intervalo de tempo para efetivação da consulta e a consulta em decorrência de dor foram mais frequentes no grau exacerbado. Concluiu-se que a amostra se classificou como portadora de baixo grau de ansiedade; as mulheres demonstraram ser mais ansiosas do que os homens; a maioria do grupo sem ansiedade estava entre os mais jovens; e a frequência da consulta preventiva decresceu à medida que aumentava o grau de ansiedade.

The objective of this research was to characterize a group of adults in a non-clinical situation in terms of their level of anxiety during dental treatment. This is a descriptive, cross-sectional study using a survey of primary data. The target population consists of adult subjects, encountered in public spaces at the downtown area of a town in the State of Santa Catarina (Brazil). It used a non-probability sampling collected by convenience. Data were collected using a questionnaire based on the Dental Anxiety Scale (DAS). The sample consisted of 305 subjects (56% female and 44% male). Ages ranged from 18 to 65 years. The percentage of women with anxiety was 78% and of men, 58%. Most of the subjects (62.1%) who revealed no anxiety were aged between 18 and 34 years. Shorter intervals between visits to the dental clinic were mentioned by 75.3% of subjects; treatment procedures were the reasons most frequently mentioned for the last visit to the dental clinic. The factor that most triggered anxiety was the equipment used in the treatment. A longer interval between the last visit and the next one due to pain was the most frequently reason mentioned as a cause of exacerbated anxiety level. It was concluded that the sample was classified as having low anxiety; women showed more anxiety than men; most of the subjects in the group who did not suffer anxiety were younger; and the lower the frequency of preventative visits, the higher the level of anxiety.

Social representat ions of dental treatment in a group of environmental health graduate students in Lima (Peru)

Social representations are a type of common sense knowledge shared by different groups based on their experience. This study identified the social representations of dental practice in a group of environmental health graduate students in Lima, Peru. Method: We interviewed 25 graduate students using a "focus group" technique and a semi-structured guide. Three groups were formed with purposive sampling. The data were collected during the years 2010-2011, and analyzed using open, axial, selective coding with Atlas-Ti software. Results: Three substantive categories were identified: dental practice, characteristics of the dental care provider and dental practice setting. The social representations that the students identified with dental practice were fear and pain. Conclusions: The negative social representations of dental practice may affect viability and adherence to treatment, so it is important to identify them in time in order to intervene effectively.

Las representaciones sociales son un tipo de conocimiento de sentido comun que comparten diferentes grupos, basados en su experiencia. En este trabajo se identificaron las representaciones sociales de la practica odontologica en un grupo de estudiantes de postgrado en salud ambiental de Lima Peru. Se entrevistaron a 25 estudiantes de posgrado con la tecnica "focus group" y con una guia semi-estructurada. Se conformaron tres grupos con muestreo intencionado. Los datos se recolectaron durante los anos 2010-2011. La informacion se analizo con codificacion abierta, axial y selectiva mediante el software Atlas-ti. Se identificaron tres categorias sustantivas: practica dental, caracteristicas del profesional de odontologia y entorno de la practica dental. Las representaciones sociales que identificaron los estudiantes con la practica odontologica fueron miedo y dolor. Las representaciones sociales negativas de la practica odontologica pueden afectar la viabilidad y apego al tratamiento, por lo que es importante identificarlas oportunamente para intervenir con eficacia.

Relação entre ansiedade ao tratamento odontológico e fatores sociodemográficos: estudo com adultos em Santa Catarina (Brasil) / Relationship between anxiety to dentaltreatment and socidemographic factors:a study with adults in Santa Catarina(Brazil)

Introdução: O medo e a ansiedade são emoções preocupantes no consultório odontológico por desencadearem diferentes tipos de comportamento e causarem repercussões somáticas indesejáveis. A reversão do quadro de ansiedade ao tratamento odontológico requer intervenções de diferentes enfoques. Neste sentido, o papel do cirurgião-dentista no processo de redução dos efeitos negativos da ansiedade é essencial. Frente à importância da temática é desejável melhor se conhecer o fenômeno de ansiedade ao tratamento odontológico. Objetivo: identificar a influência de fatores sociodemográficos na determinação de ansiedade ao tratamento odontológico, junto a uma amostra de adultos residentes em Santa Catarina. Métodos: pesquisa descritiva, do tipo transversal, mediante levantamento de dados primários. A população-alvo foi constituída por adultos, residentes em três cidades da região oeste de Santa Catarina (Brasil) e uma cidade do litoral norte catarinense. O plano amostral foi não probabilístico e a obtenção da amostra deu-se por conveniência. A determinação do nível de ansiedade foi efetuada com base numa adaptação da escala de Corah - Dental Anxiety Scale (DAS). Resultados: a amostra constou de 1219 sujeitos, com idades variando de 18 a 87 anos. Os sujeitos classificados entre muito pouco a levemente ansioso (Grupo A - baixo nível) foram os mais frequentes (80 por cento) e 20 por cento eram portadores de moderada a extrema ansiedade (Grupo B - alto nível). A não efetivação de consultas de modo regular foi um pouco mais frequente entre os sujeitos do Grupo B. Conclusão: a maioria do grupo classificado com baixo nível de ansiedade (Grupo A) era de homens, da faixa etária de 50 ou mais anos e com grau de escolaridade superior.

Introduction: Fear and anxiety are disturbing emotions in the dental office for triggering different types of behavior and causing undesirable somatic repercussions. Reversal of anxiety disorders to dental treatment interventions requires different approaches. In this sense, the dentist's role in the reduction process of the negative effects of anxiety is essential. Considering the relevance of the theme it is desirable to understand clearly the anxiety phenomenon to dental treatment. Objective: to identify the influence of socio-demographic factors on the determination of anxiety related to dental treatment, in a sample of adults living in Santa Catarina. Methods: descriptive research, cross-sectional, through primary data collection. The target population consisted of adults living in two cities of the western region and one city of the north coast in Santa Catarina (Brazil). The sampling plan was not probabilistic and obtaining by convenience. To determine the level of anxiety was used an adaptation of Corah Scale - Dental Anxiety Scale (DAS). Results: The sample consisted of 1219 subjects, aged 18-87 years. The subjects rated between very little to look forward slightly (Group A - Low level) were the most common (80 per cent) and 20 per cent suffered from moderate to extreme anxiety (Group B - High level). The non-effective dental appointment was more frequent among subjects with high levels of anxiety (Group B). Conclusion: most in the group rated low anxiety (Group A) were men, older adults (50 or more years) and higher education. In the group with high levels of anxiety (Group B) the majority were women, young adults (18-24 years) and with higher education. The chi-square test revealed a significant association between anxiety and sexy and age.

Anterior composite restorations in clinical practice: findings from a survey with general dental practitioners

Objectives: The aim of this study was to assess technical preferences of general dental practitioners when restoring anterior composite restorations. How the level of clinical experience or post-graduate training infuenced their options was also tested. Material and Methods: A cross-sectional study was performed using a questionnaire with general dental practitioners (GDPs) (n=276) in Southern Brazil. Information regarding post graduation training (specialization, master's or PhD degree) and linical experience (years since completing graduation) were gathered. The options regarding anterior composite restorations (type of composite, adhesive system, light curing unit, polishing procedures and rubber dam use) were collected. Data were submitted to descriptive analysis and associations were tested. Results: Response rate was 68% (187). GDPs selected microhybrid composite (52%) and 2-step total etch adhesive system (77%). LED was the preferred method of activation for 72.8%. Immediate polishing was preferred by 75%, using a combination of techniques. Most of the respondents (74.3%) did not use rubber dam. More experienced clinicians used more halogen lights (p<0.022), performed more light monitoring (p<0.001) and were resistant to use rubber dam (p<0.012). Dentists with post-graduation training used 3-etch-and-rinse system more frequently (p<0.04), usually monitored light intensity (p<0.014) and placed rubber dam more frequently (p<0.044). Conclusions: Hybrid composite, simplifed adhesives, LED units and immediate polishing were preferred by Southern Brazilian dentists for anterior composite restorations. Few dentists used rubber dam to perform composite restorations in anterior teeth. Clinical experience and post-graduation training infuenced the dentists' choices. .

Responsabilidade civil em odontologia - uma visão por profissionais da área jurídica / Dentist's civil liability - a forensic view

Introdução: atualmente, observa-se uma mudança na relação estabelecida entre o cirurgião-dentista e o seu paciente. A busca pela informação e a insatisfação com os resultados obtidos mediante os tratamentos odontológicos, fez com que as pessoas lutassem pelos seus direitos judicialmente. Objetivo: avaliar o conhecimento dos estudantes e profissionais do DIREITO relacionado à responsabilidade civil em ODONTOLOGIA. Metodologia: foram aplicados 37 questionários destinados a estudantes de Direito de faculdades privadas e públicas da cidade de Salvador, além de entrevista com um advogado da área cível e procuradores do Ministério Público Estadual. Conclusões: observou-se que não existe um consenso entre os profissionais sobre que tipo de responsabilidade cabe ao CD.

Introduction: Currently there is a change in the relationship established between the dentist and his patient. The search for information and dis satisfaction with the results obtained with the dental treatment, meant that people fight for their rights in court. Objective: To assess students' knowledge and professional liability related to the RIGHT of DENTISTRY. Methods: 37 questionnaires were pplied for the law students of public and private colleges in the city of Salvador in an interview with a lawyer for the civil and public prosecutors State. Conclusions: We observed that there is no consensus among professionals about what kind of responsibility lies with the CD.

Orientación empática en estudiantes de odontología de la Universidad Central del Este / Empathic orientation in dental students of Universidad Central del Este

Objetivo: determinar la orientación empática en estudiantes de odontología. Metodología: es una investigación no experimental, descriptiva, de corte transversal y ex post facto causa-efecto. La población estuvo constituida por 284 estudiantes de la carrera de odontología de la Universidad Central del Este (República Dominicana) y la muestra se conformó con 239 sujetos, quienes cursaban los niveles 1º, 2º, 3º, 4º y 5º (Años), durante 2012. Se utilizó la Escala de Empatía Médica de Jefferson (EEMJ), versión S, adaptada culturalmente para la República Dominicana. Resultados: se analizaron las variables año y género. Se encontró que el factor año fue altamente significativo (p<0,001), contrario a resultados del factor género (p>0,05), lo cual indica que existen diferencias entre los años estudiados, pero no entre los géneros. Conclusiones: es necesario realizar estudios que favorezcan la observación de las variables estudiadas y compararlas con modificaciones hechas a nivel de los programas académicos y mallas curriculares.

Purpose: To determine the empathetic orientation of dental school students. Methods: This is a non-experimental, descriptive, transversal and ex post facto cause and effect study. The population consisted of 284 dentistry students from the Universidad Central del Este (Dominican Republic). The sample size was of 239 subjects, who were enrolled in level 1º, 2º, 3º, 4º and 5º (years) during 2012. We applied a culturally adapted Spanish version of the Scale of Physician Empathy Jefferson (JSPE). Results: We analyzed variables year and gender, finding that year was highly significant (p <0.001), in contrast to gender (p> 0.05). This indicates that there are differences in empathetic orientation between years but not between genders. Conclusions: Further studies should be conducted that favor the observation of the variables studied. When possible, comparative analysis should be made to determine the impact of changes made at the academic programs and curricula.

Physician's knowledge about dental treatment during pregnancy / Visão médica do tratamento odontológico em gestantes

Objective: To guide pregnant patients, as regards their general and oral health, thus justifying the need to have regular prenatal and dental care, is an obligation of health professionals. Physicians, especially gynecologists and obstetricians play an important role, since they are the first professionals to take care of pregnant patients. Methods: The objective of present study was to evaluate physician's knowledge about dental treatment during pregnancy. Methods: Using questionnaires, 40 gynecologists and obstetricians were evaluated as regards their knowledge of dental care, and use of drugs and dental anesthetics in dental procedures during pregnancy. Results: Many myths referring to dental care in pregnant women were observed. Many physicians have knowledge about association between susceptibility to gingivitis/periodontitis and pregnancy. With reference to local anesthetics and vasoconstrictors used in dentistry, the physicians still have some doubts about their use, even with the literature supporting their safety in this period. It is intended to continue these contacts with the obstetricians, in order to extend their knowledge and seek multidisciplinary cooperation, which would promote adequate and complete prenatal care. Conclusion: It could be concluded that there are some divergences between obstetricians and dentists concerning dental care in pregnant women, which means losses for the patient.

Objetivo: Avaliar o conhecimento destes profissionais sobre o tratamento odontológico na gestação. Métodos: Por meio do emprego de questionários, 40 médicos ginecologistas/obstetras tiveram seus conhecimentos avaliados no que se refere ao atendimento odontológico em gestantes e utilização de medicamentos e anestésicos pelos dentistas.Resultados: Com este estudo pôde-se observar que ainda existem muitos mitos em relação ao atendimento odontológico no período gestacional. Muitos médicos estão cientes das possíveis associações entre gravidez e aumento da suscetibilidade de problemas periodontais, por atuação hormonal. Quanto ao emprego de anestésicos locais e vasoconstritores, os médicos ainda apresentam grande receio em indicá-los, mesmo a literatura suportando a segurança de sua utilização e indicando a necessidade de intervenção odontológica neste período. Pretende-se continuar estas avaliações e contatos com os médicos obstetras, estendendo o conhecimento dos mesmos e buscando a atuação multidisciplinar, o que promoveria um pré-natal adequado. Conclusão: Conclui-se que ainda há divergências entre médicos obstetras e dentistas no que se refere ao atendimento odontológico das gestantes, o que pode trazer prejuízos para a própria paciente.