Abordaje y Percepción de las y los Odontólogos Frente a Casos de Violencia Física contra la Mujer en Contexto Intrafamiliar/Compañero Íntimo en Chile / Chilean Dentist's Perception and Action Towards cases of Physical Violence Against Women in a Domestic/Intimate Partner Context

La violencia de género física y/o sexual afecta a más del 30 % de las mujeres del mundo y Chile, impactando la salud de todos. Tanto la Organización Mundial de la Salud, como la literatura, sugieren abordar esta problemática desde la salud pública, con énfasis en sus trabajadores. Los odontólogos tendrían un especial rol, debido a la ubicación de éste tipo de lesiones y mayor exposición. Mas, no consideran pertinencia frente a la problemática y su abordaje es deficiente. Nuestro objetivo es conocer cómo los odontólogos de Chile perciben y abordan este tipo de casos, mediante un estudio descriptivo y transversal a odontólogos suscritos a las redes sociales del Colegio de Cirujanos Dentistas de Chile, previa aprobación de su directiva 2021 y del Comité de Ética de la Facultad de Odontología UdeC (C.E.C. Nº19/21). Bajo consentimiento informado, se aplicó una encuesta sociodemográfica sobre la percepción y abordaje de los odontólogos frente a casos de violencia física contra la mujer en contexto de Violencia Intrafamiliar/ Compañero íntimo. Participaron 175 dentistas. El 53 % ha encontrado estos casos durante el ejercicio profesional y más del 80 % percibe un rol activo frente a la problemática. Sin embargo, el 74 % presenta dificultad en la detección de lesiones y el 78 % en la derivación a redes de apoyo. El 91 % no recibió formación al respecto durante el pregrado, pero les interesa adquirir mayores conocimientos. Los dentistas de Chile se encuentran expuestos a este tipo de casos y perciben un rol activo. Sin embargo, presentan dificultad en su detección y abordaje y podrían beneficiarse de formación adicional al respecto.

Physical and/or sexual gender violence affects more than 30 % of women in the world and in Chile, impacting everyone's health. Both, WHO and the literature, suggest addressing this problem from public health, with an emphasis on its workers. Dentists would have a special role, due to the location of this type of injury and greater exposure. But, they do not consider relevance and their approach is deficient. Our objective is to know how dentists in Chile perceive and approach this type of case. Descriptive and cross-sectional study of dentists subscribed to College of Dental Surgeons of Chile´s social networks, prior approval of its 2021 directive and the Ethics Committee of the UdeC School of Dentistry (C.E.C. Nº19/21). Under informed consent, a sociodemographic survey was applied on the perception and approach of dentists in cases of physical violence against women in the context of Domestic Violence/ Intimate Partner. 175 dentists participated. 53 % have encountered these cases during professional practice and more than 80 % perceive an active role in dealing with the problem. However, 74 % have difficulty in detecting injuries and 78 % in referral to support networks. 91 % did not receive training in this regard during undergraduate studies, but are interested in acquiring more knowledge. Chilean dentists are exposed to this type of cases and perceive an active role. However, they are difficult to detect and treat and could benefit from additional training in this regard.

Knowledge and attitudes of Mexican dentists regarding COVID-19 / Conocimiento y actitudes de dentistas mexicanos sobre la COVID-19

Dentists have a high risk of contracting COVID-19, they needed to be aware of the major challenge that represents the dental practice and COVID-19. Accordingly, this study aimed: 1) to investigate the knowledge of dentists regarding COVID-19, 2) to investigate the attitudes of dentists concerning the use of personal protective equipment and, 3) to investigate the attitudes of dentists on stopping their dental practices in the framework of a contingency plan for the COVID-19 outbreak. An online cross-sectional survey was applied to dentists (n=822). Dentists in Mexico answered the survey, which was administered before the contingency plan for the COVID-19 outbreak. Results were analyzed with descriptive statistics and with a Chi-square test (P≤0.05). Of the respondents, 99% of dentists indicated knowing what COVID-19 is, knowing most, but not all, of its signs and symptoms and knowing its mode of transmission. The 89% of dentists indicated that they always used personal protective equipment. But they did not use always wear face masks, protective eyewear, face shields, disposable gowns, and caps. Dentists were aware of the risk of performing dental procedures during the COVID-19 outbreak. The 90% of dentists indicated that they would treat only patients requiring emergency treatment, and 10% indicated that they would not treat any patients. The dentists had limited knowledge about the COVID-19 disease. They did not use personal protective equipment consistently, and they indicated that they might continue working during the COVID-19 outbreak.

Durante la pandemia por COVID-19, los dentistas han tenido un alto riesgo de contraer COVID-19. Los dentistas mexicanos tuvieron la necesidad de enfrentarse a la COVID-19 en la práctica dental con un posible conocimiento limitado sobre la enfermedad. De acuerdo con esa problemática, los objetivos de este estudio fueron: 1) investigar el conocimiento de los dentistas sobre la COVID-19, 2) investigar las actitudes de los dentistas sobre el uso de equipo de protección personal, 3) investigar las actitudes de los dentistas para detener la práctica laboral frente a la pandemia. Una encuesta fue aplicada a dentistas mexicanos en el inicio de la contingencia por COVID-19 (n=822). Se analizaron los resultados de con una prueba de Chi cuadrada (P≤0.05). El 99% de los participantes conocieron qué es la COVID-19, pero no todos los signos y síntomas de la enfermedad ni los modos de transmisión. El 89% de los dentistas indicaron que siempre usan equipo de protección personal. Pero no usan siempre careta, lentes de protección, cubreboca, guantes deshechables y gorro. Los participantes tenían conocimiento del riesgo de contraer COVID-19. El 90% indicó que sólo atenderían urgencias dentales y el resto indicó que no atendería pacientes. Los dentistas tuvieron un conocimiento limitado sobre la COVID-19. No usaron equipo de protección personal de forma consistente. Además indicaron que estarían dispuestos a seguir trabajando durante la pandemia.

COVID-19: ¿una oportunidad para la toma de conciencia sobre el cuidado integral del odontólogo? / COVID-19: An opportunity to raise awareness about dentists' holistic wellbeing?

La pandemia de COVID-19 generó en la comunidad odon- tológica argentina un profundo desconcierto e incertidumbre frente a su práctica profesional, su economía y su cuidado. Mediante un cuestionario difundido a través de redes so- ciales en octubre de 2020, se formularon preguntas vinculadas al ejercicio profesional en ese contexto y otras en las que se incluyeron variables referidas a signos de ansiedad, depresión y resiliencia. Los odontólogos presentaron signos de estrés, ansiedad, tensión emocional, dificultad para conciliar el sueño, senti- mientos de culpa y sensación de soledad. Manifestaron casi en su totalidad que su esfuerzo y el cuidado de su persona frente a este nuevo paradigma no son valorados por el sistema de salud y que se evidencia en la escasa retribución que perciben por sus prestaciones. Las conclusiones tienen el mandato del cambio pues los datos arrojados por la encuesta y el sentir manifestado con vehemencia y desolación ponen sobre la mesa la necesidad de iniciar una nueva etapa (AU)

The COVID-19 pandemic created a profound state of be- wilderment and uncertainty among dentists regarding their professional practice, economy and personal care. An online survey posted on social media in October 2020 asked ques- tions about professional practice in this context and other variables such as signs of anxiety, depression and resilience. Dentists reported signs of stress, anxiety, emotional tension, difficulty to get to sleep, and feelings of guilt and loneliness. Most of them felt that the efforts they made to do their job and ensure their personal care in this new paradigm were not valued by the healthcare system, as reflected by the low compensation for their services. From the data obtained through the survey and the feelings of vehemence and grief expressed by respondents, it is concluded there is a need for action and change (AU)

Estudio exploratorio-descriptivo sobre las actitudes de los odontólogos costarricenses hacia la aplicación interdisciplinaria de los principios psicológicos en la consulta bucodental / Exploratory-descriptive study on the attitudes of Costa Rican dentists towards the interdisciplinary application of psychological principles in oral consultation

Resumen Introducción: Actualmente, resulta necesario el acercamiento interdisciplinario entre la odontología y la psicología, el cual permita aplicar el componente psicológico al entorno bucodental. Objetivo: Conocer y explorar las actitudes del odontólogo costarricense acerca de la psicología, su importancia y potenciales contribuciones en la dinámica y el desempeño profesional. Materiales y métodos: Se empleó una metodología cuantitativa con diseño transeccional descriptivo-exploratorio; donde, se aplicó una encuesta de 10 preguntas de selección simple abarcando los datos sociodemográficos y los componentes actitudinales (adaptación cuestionario Gómez y Gómez, 2007) a una muestra de 334 odontólogos, miembros del Colegio de Cirujanos Dentistas de Costa Rica. Resultados: Los hallazgos reflejan que un 88,32% de los participantes considera "bastante importantes" los aspectos psicosociales de sus pacientes, mientras que el 79,94% indicó que la colaboración entre ambas ciencias produce beneficios tangibles en la prestación de servicios odontológicos; asimismo, un 82,04% de los encuestados mencionaron que es "bastante importante" que se reciba capacitación especializada en el área psicológica con un enfoque integral-preventivo. Conclusión: Los profesionales demuestran actitudes favorables/positivas sobre el accionar interdisciplinario del componente psicológico en el quehacer diario del odontólogo y su equipo, por lo cual deben continuarse las investigaciones para profundizar en variables concurrentes y otros determinantes asociados.

Abstract Introduction: At present times, an interdisciplinary approach between dentistry and psychology is necessary, to allow applying the psychological component to the oral environment. Objective: To know and explore the attitudes of the Costa Rican dentists about psychology, it´s importance and potential contributions in the dynamics and professional performance. Materials and methods: A quantitative methodology with descriptive-exploratory transectional design was used; in which, a survey of 10 multiple choice questions was applied, covering the sociodemographic data and the components (adaptation of the Gómez and Gómez questionnaire, 2007) to a sample of 334 dentists, members of the Association of Dental Surgeons of Costa Rica. Results: The findings reflect that 88.32% of the participants consider the psychosocial aspects of their patients "quite important", while 79.94% indicated that the collaboration between both sciences produces tangible benefits in the provision of dental services; likewise, 82.04% of those surveyed mentioned that it is "quite important" to receive specialized training in the psychological area with a comprehensive-preventive approach. Conclusion: Professionals demonstrate favorable / positive attitudes about the interdisciplinary action of the psychological component in the daily work of the dentist and his team, for which research should be continued to delve into concurrent variables and other associated determinants.

Depression, anxiety, and stress in dentists in times of covid-19 in northern Peru / Depresión, ansiedad y estrés en cirujanos dentistas en tiempos de covid-19 en el norte del Perú

Objective: To determine the levels of depression, anxiety, and stress in dentists working in the northern region of Peru in times of COV ID -19. Material and Methods: 310 dentists working in the northern region of Peru in times of COVID-19 were evaluated by means of an observational and cross-sectional study. Subjects were asked to give their informed consent and answer a virtual questionnaire containing 21 items based on the DASS-21 Scale that assesses depression, anxiety, and stress. A descriptive analysis was carried out with frequencies; for the variables of gender and years of work experience the Chi square test (p<0.05) was used. Results: It was found that 291 (93.87%) of the dentists suffered from some type of psychological disorder: stress (35.74%), anxiety (35.05%), depression (29.21%). Mild stress was the most prevalent accounting for 49.04% (51); mild depression with 45.88% (39), and moderate anxiety with 40.20% (41). A higher prevalence was found in females and in those dentists who had less than 5 years of work experience. Conclusion: 93.87% of dentists working in the northern region of Peru in times of COVID-19 presented some type of psychological disorder, a higher frequency of mild stress was found, followed by mild depression, and moderate anxiety.

Objetivo: Determinar los niveles de depresión, ansiedad y estrés en cirujanos dentistas que laboran en la región norte del Perú en tiempos de COVID-19. Material y Métodos: Se realizó un estudio observacional de corte transversal, evaluando a 310 cirujanos dentistas que laboran en la región norte del Perú en tiempos de COVID-19 y que respondieron un cuestionario virtual sobre la base de la Escala de Dass-21 que evalúa depresión, ansiedad y estrés y que contiene 21 ítems, previo consentimiento informado. Se realizó un análisis descriptivo con frecuencias y para las variables género y tiempo de servicio se empleó la Prueba Chi cuadrado (p<0.05). Resultados: Se encontró que 291 (93.87%) de cirujanos dentistas presentaron algún trastorno psicológico, de los cuales el 35.74% presentaron estrés; ansiedad el 35.05% o depresión el 29.21%; siendo mayor el estrés leve con el 49.04% (51); depresión leve el 45.88% (39) y ansiedad moderada el 40.20% (41), presentando un porcentaje mayor en mujeres y en aquellos cirujanos dentistas que laboran menos de 5 años. Conclusión: El 93.87% de los cirujanos dentistas que laboran en la región norte del Perú en tiempos de COVID-19, presentaron algún tipo de trastorno psicológico, se encontró mayor frecuencia de estrés leve, seguido de depresión leve y ansiedad moderada.

Brazilian dentists' perceptions of using bone grafts: an inland survey / Uso de enxertos ósseos na percepção de cirurgiòes-dentistas do interior do Brasil

ABSTRACT Pre-clinical assessments of bone substitute materials are frequent in the literature, but research papers about the clinical situation of bone graft use and consumer market acceptance are rare. The aim of this study was to evaluate the dental use of bone grafts according to the perception of dentists in the city of Sobral, Brazil. We interviewed 183 professionals and analyzed their professional data, knowledge of the subject, specific use, and opinions on cost-effectiveness and biosafety. Most of the respondents had 10 years ' or less experience in the profession, and lacked specialization though they had been familiar with the subject since they graduated. The most frequently mentioned compositions were ceramics, followed by composites. Only a quarter of the respondents had performed bone grafts, generally with up to 50 cases, with the most frequent applications being using simultaneously with a dental implant, fresh dental sockets and maxillary sinus lifting. Autogenous and xenogeneic grafts were more frequent than alloplastic and allogeneic; ceramics were the most frequently used composition, and the association of bone graft with membrane was more frequent than bone graft alone or associated with autologous fibrin. Professional and patient satisfaction was high, cost was considered moderate, and differences were found regarding patient participation in the choice and country of origin of the product. Bone grafts were used more often in the private than public service. Dentists stated that they follow the instructions. Inflammatory or infectious complications were found to be related to the frequency of the procedure performed and safety regarding the origin. Opinions were favorable regarding the use of grafts derived from animals and unfavorable to grafts derived from cadavers. Very few respondents were registered in human bone tissue banks. The good level of acceptance for dental use of bone grafts in a Brazilian inland city provides a promising scenario for the development of the sector.

RESUMO Avaliações pré-clínicas sobre materiais osseosubstitutos sao frequentes na literatura, mas sao raras pesquisas sobre o panorama clínico de uso de enxertos ósseos e aceitação do mercado consumidor. O objetivo deste estudo foi avaliar o uso odontológico de enxertos ósseos na percepção de dentistas da cidade de Sobral, Brasil. Foram entrevistados 183 profissionais e analisados dados profissionais, conhecimento temático, uso específico, relação custo-efetividade e biosseguranga. A maioria dos cirurgioes-dentistas exibiu até 10 anos na profissao, ausencia de especialização, porém familiaridade com a temática desde a graduação. As cerámicas, seguidas de compósitos, compu-seram as composições mais citadas. Apenas um quarto dos ci-rurgioes-dentistas já realizaram enxertos ósseos, em geral com realização de até 50 casos, com maior tendencia de aplicação em alvéolo dentário fresco, simultánea a implante dentário e para levantamento de seio maxilar. As origens autógena e xenó-gena tiveram maior destaque do que aloplástica e alógena, as cerámicas foram a composição mais usada e a associação do enxerto ósseo com membrana foi mais frequente do que enxerto ósseo sozinho ou associado á fibrina autóloga. A satisfação do profissional e paciente foi alta, o custo considerado moderado, havendo diferengas quanto a participação do paciente na escol-ha e no país de origem do produto, com maior uso no servigo privado do que no público. Os dentistas afirmaram seguirem a bula, que as complicações inflamatórias ou infecciosas estao relacionadas com a frequencia de procedimento realizado e se-guranga quanto á origem. Houve opiniao favorável ao uso de enxertos derivados de animais e desfavorável ao de cadáveres, havendo raros profissionais cadastrados em bancos de tecidos ósseos humanos. A boa aceitação para uso odontológico de enxertos ósseos em cidade do interior do Brasil configura um cenário promissor para o desenvolvimento do setor.

Precarização do trabalho odontológico na saúde suplementar: uma análise bioética / Precarisation of dentistry in private healthcare: bioethical analysis

Resumo O presente trabalho evidenciou o processo de trabalho do cirurgião-dentista (CD) no setor de saúde suplementar a partir da visão do profissional, sob a luz da Bioética de Intervenção. Foi realizado um estudo observacional-seccional do tipo inquérito circunscrito à região do Distrito Federal. Os dados foram coletados por meio de 108 questionários respondidos por CDs credenciados à duas modalidades de operadora: autogestão e odontologia de grupo, com a finalidade de conhecer a percepção e o grau de satisfação profissional diante do mercado de trabalho odontológico. A insatisfação maior por parte dos profissionais foi relacionada à remuneração dos trabalhos odontológicos pelas operadoras. Para a operadora de autogestão 1, 38,1% dos profissionais responderam que a remuneração era satisfatória, enquanto para a de autogestão 2 e odontologia de grupo, houve 100% de insatisfação. Outro dado encontrado foi que a operadora de odontologia de grupo restringiu os tratamentos selecionados aos pacientes de forma expressiva. Conclui-se que existe a perda de autonomia profissional, desvalorização dos ressarcimentos e precarização do trabalho odontológico na saúde suplementar, demonstrando conflitos éticos nessa relação de trabalho.

Abstract The present study highlighted the labour process of the dental surgeon (DS) in the private healthcare sector from the healthcare professional's perspective based on intervention bioethics. An observational, cross-sectional survey study was performed within the Federal District (Distrito Federal) region. Data were collected from 108 questionnaires completed by DSs affiliated with two types of private health insurers, self-insurance and group insurance, to assess job perception and the degree of job satisfaction in the dentistry market. The main source of dissatisfaction for healthcare professionals was related to the pay for dental procedures by insurers. For self-insurer 1, 38.1% healthcare professionals replied that the pay was satisfactory, whereas in self-insurance 2 and in the group insurance, 100% of healthcare professionals were dissatisfied. Another finding was that the group insurer considerably restricted elective treatments. In conclusion, loss of professional autonomy, depreciation of insurance claims and precarisation of dentistry occurs in the private healthcare sector, thus demonstrating the ethical conflicts in this relationship.

Percepção das precauções padrão, prática do reencape de agulhas e condutas frente a acidente com material biológico de equipes de saúde bucal do serviço público odontológico / Perception of the standard precautions, practice of re-capping of needles and practices when facing an accident involving biological material of dental health teams at dental public service

Resumo: O presente estudo objetivou verificar o conhecimento e adesão às precauções padrão (PP), em especial a prática de não reencapar agu lhas; as ações a serem tomadas diante acidentes e aspectos relativos à prevenção de infecções, pelas equipes de saúde bucal da rede públi ca de um município do Estado de São Paulo, Brasil. Também observar os materiais descartados nos recipientes do grupo E em todas as unidades de atendimento odontológico do município. Aplicou-se um questionário semiestruturado, com perguntas direcionadas ao tema. Dos 79 pesquisados, 60 responderam ao questionário, onde 33 (55%) eram cirurgiões-dentistas. 34 (56,6%) profissionais não sabiam o que eram as PP e 43 (71,6%) afirmaram reencapar agulhas. 27 (44,9%) já sofreram algum tipo de acidente com material perfurocortante, contaminado ou sangue e 44 (73,3%) desconheciam ou se equivocaram sobre quais os cuidados imediatos em caso de exposição cutânea ou percutânea. Em relação à análise dos recipientes de descarte, observaram-se 5.193 agulhas descartadas, sendo 3.790 (73%) reencapadas em um, ou ambos os lados. Também o descarte incorreto de materiais não perfurocortantes. Conclui-se que existe falha no conhecimento sobre precauções padrão e condutas em casos de acidentes com mate rial biológico, além do incorreto descarte de materiais nos recipientes do grupo E.

Abstract: This study aimed to verify the knowledge and adoption of the stan dard precautions (PP), especially in the practice of not re-capping needles; the actions to be taken in relation to accidents and aspects related to the prevention of infections, by the dental health teams of the public service of a city in the State of São Paulo, Brazil. We also assessed the materials discarded in the containers of group E in all dental care units of the city. A semi-structured questionnaire was applied, with questions about the theme. Of the 79 subjects surveyed, 60 answered the questionnaire, where 33 (55%) were dental surgeons. 34 (56.6%) professionals did not know what PP were and 43 (71.6%) reported re-capping needles. 27 (44.9%) had already suffered some kind of accident with sharp tools or contaminated material with blood and 44 (73.3%) were unaware or made mistakes about the immediate care in case of skin or percutaneous exposure. Regarding the analysis of the disposal containers, 5,193 discarded needles were observed, of which 3,790 (73%) were re-capped on one or both sides. Also, we observed the improper disposal of non- sharps material. We concluded that there is a lack of knowledge about standard precautions and conducts in cases of accidents with biological material, besides the incorrect disposal of materials in the containers of group E.

A qualitative analysis of perceptions of orthodontists in Concepción about removable orthodontic appliances

Objective: to determine the utilization, attitudes and perceptions about removable orthodontic appliances (ROA) among a sample of Chilean orthodontists. Materials and methods: Data collection was performed using semi-structured interviews with 10 orthodontists from diverse professional backgrounds. The analysis was performed using the “Grounded Theory” methodology, using Atlas.ti v.6.0.15. Results: We interviewed four men and six women (31 to 75 years old), with 7 to 53 years of experience as dentists, and 1 to 10 years of experience as orthodontists. All orthodontists have experience in private practice, five in public service, and one in a military institution. One-hundred and thirty-three codes were grouped into seven categories identified as follows: perception of orthodontists, control over treatment, ROA characteristics, ROA indications and contraindications, patients’ attitude to ROA, selection of treatment, and ROA utilization. Conclusion: In the selection of ROA, different factors are involved, including the characteristics of the dentist, of the patient, and the social context. The key factor in the utilization of ROA is the perception of control over treatment.

Cáncer oral y dentistas: conocimientos, actitudes y prácticas en Chile / Oral cancer and dentists: knowledge, attitudes and practices in Chile

El objetivo de este estudio fue describir los conocimientos, actitudes y prácticas en relación al cáncer oral de Cirujano ­ Dentistas de la comuna Las Condes, Santiago de Chile. Se realizó un estudio descriptivo, transversal. Se aplicó una encuesta de autollenado a 264 Cirujano ­ Dentistas de la comuna Las Condes, Santiago de Chile en el período junio ­ julio 2014. Se informó previamente a los participantes el carácter voluntario, anónimo y confidencial de la encuesta. La muestra final fue de 205 (Tasa de pérdida: 22,3 %).Se realizó estadística descriptiva con tabulación y distribución de frecuencias. La mayoría de los participantes identificó los principales factores de riesgo decáncer oral: tabaquismo (99,5 %) y consumo de alcohol (83,4 %). Menos de dos tercios identificó las dos lesiones cancerizables más frecuentes (leucoplasia y eritroplasia) y al carcinoma espinocelular como la forma más común de cáncer oral. El 25,4 % reportó presentar conocimientos actualizados sobre el cáncer oral y el 35,6 % reportó practicar habitualmente un examen clínico para detectar cáncer oral. Se observaron carencias en los conocimientos, actitudes y prácticas en relación al cáncer oral de Cirujano ­ Dentistas de la comuna Las Condes, Santiago de Chile. Estas carencias son susceptibles a ser mejoradas mediante intervenciones educacionales dirigidas a Cirujano ­ Dentistas que permitan mejorar sus conocimientos, actitudes preventivas y competencias procedimentales en la prevención y diagnóstico precoz del cáncer oral.

The aim of this survey was to describe the knowledge, attitudes and practices regarding oral cancer in a sample of dentists from Las Condes, Santiago de Chile. A descriptive, cross-sectional study was conducted. A self-filling survey was applied to 264 dentists of Las Condes, Santiago de Chile during june ­ july 2014. Participants were previously informed that the survey was voluntary, anonymous and confidential. The final sample included 205 dentists (Loss Rate: 22.3 %). Descriptive statistic was applied using tabulation and frequency distribution. Most participants identified the main risk factors for oral cancer: tobacco (99.5 %) and alcohol usage (83.4 %). Less than two thirds of the participants identified the two most common precancerous lesions (leukoplakia and erythroplakia) and squamous cell carcinoma as the most common type of oral cancer. 25.4 % of the participants reported to have updated knowledge regarding oral cancer and 35.6 % reported to routinely perform clinical examination to detect oral cancer. Deficiencies in knowledge, attitudes and practices regarding oral cancer of dentists from Las Condes, Santiago de Chile were observed. These deficiencies are likely to be enhanced through educational interventions which would improve their knowledge, attitudes and strengthen their role in the prevention and early diagnosis of oral cancer.

Profissional da saúde frente a situação de ter um familiar em cuidados paliativos por câncer / Profesional de la salud ante la situación de tener un familiar en cuidados paliativos por cancer / Health workers coping with having a relative in palliative care for cancer

RESUMO Objetivo conhecer a vivência do profissional de saúde na situação de ter um familiar em cuidados paliativos por câncer. Metodologia Qualitativa, desenvolvido com quatro familiares de pacientes oncológicos em cuidados paliativos, por meio de entrevistas semiestruturadas, no período de novembro a dezembro de 2014, no domicílio dos participantes. Para a análise dos dados foi utilizada a proposta operativa de Minayo. Resultados surgiram duas temáticas, Profissional da saúde e ser familiar frente ao diagnóstico de câncer e Profissional da saúde e Ser familiar no confronto com a proximidade com a morte. Conclusões Ser familiar na condição de profissional de saúde demandou maior comprometimento no cuidado, tornando-os angustiados por terem que lidar com seus sentimentos de ver seu familiar em sofrimento pela doença e terminalidade, ao mesmo tempo em que seus conhecimentos profissionais contribuíram na tomada de decisões durante este processo.

RESUMEN Objetivo conocer la vivencia del profesional de la salud en la situación de tener un familiar en cuidados paliativos por cancer. Metodología cualitativa, desarrollada con cuatro familiares de pacientes oncológicos en cuidados paliativos, por medio de entrevistas semiestructuradas, en el periodo de noviembre a diciembre de 2014. Para el análisis de los datos fue utilizada la propuesta operactiva de Minayo. Resultados surgieron dos temáticas, Profesional de la salud y ser familiar ante el diagnóstico del cáncer y Profesional de la salud y ser familiar en la confrontación con la proximidad de la muerte. Conclusiones ser familiar en la condición de profesional de salud demandó mejor comprensión en el cuidado, poniéndolos angustiados por tener que tratar con sus sentimientos al ver su familia en sufrimiento por la enfermedad o terminalidad, al mismo tiempo que sus conocimientos profesionales contribuyeron en la tomada de decisiones durante este proceso.

ABSTRACT Objective To know the experience of health workers who are coping with having a relative in palliative care for cancer. Methodology A qualitative study conducted with four family members of cancer patients in palliative care. Data were collected by means of semi-structured interviews from November to December, 2014, at the home of the participants. The data were analysed using the operative proposal of Minayo. Results Two themes emerged, Health worker and family member coping with a cancer diagnosis and Health worker and family member coping with the proximity of death. Conclusions Being a family member and a health professional at the same time demanded greater involvement in care and caused distress since these workers witnessed the suffering of a family member with a terminal disease. However, their professional knowledge supported decision-making during the care process.

Desgaste profesional: síndrome de burnout / Professional burnout syndrome

La actividad profesional odontológica contiene ciertas ventajas en su ejercicio (en general, es independiente, de primera necesidad en la sociedad, etc.), pero otras pueden llevar al profesional a padecerlas. Dentro de éstas, veremos el agotamiento psico-físico, la pérdida de una óptima calidad de vida, una serie de síntomas que van desarrollando un proceso de deterioro que se denomina síndrome de burnout (del quemado o fundido). La dificultad principal radica en que se va instalando en forma larvada, es decir, sin conciencia del sujeto, que generalmente se da cuenta cuando ya es demasiado tarde. El planteo que nos indica que el incipiente profesional, sostenido por el ideal que representa la carrera que eligió puede ir, en el transcurso de su clínica, desilusionándose a través de diversas complicaciones que se le van presentando. Dicha problemática no es excluyente de los odontólogos, sino que involucra a todos los profesionales que atienden la salud de las personas, tanto orgánica como psíquica. Por lo expuesto, diremos que ésta no es una situación exclusivamente individual, sino que afecta a las instituciones, a los equipos de trabajo, a los pacientes y a la comunidad en general. Contrapuesta a la creencia de la profesión de salud como apostolado, advertiremos que debe tenerse en cuenta la prevención del síndrome y su desnaturalización, para poder evitar sus efectos deletéreos. Ocuparse de la salud de los que curan debería ser prioritario en toda sociedad.

Influence of occlusal plane inclination and mandibular deviation on esthetics

Objective:The aim of this study was to assess the degree of perception of occlusal plane inclination and mandibular deviation in facial esthetics, assessed by laypeople, dentists and orthodontists.Methods:A woman with 5.88° of inclination and 5.54 mm of mandibular deviation was selected and, based on her original photograph, four new images were created correcting the deviations and creating more symmetric faces and smiles. Examiners assessed the images by means of a questionnaire. Their opinions were compared by qualitative and quantitative analyses.Results:A total of 45 laypeople, 27 dentists and 31 orthodontists filled out the questionnaires. All groups were able to perceive the asymmetry; however, orthodontists were more sensitive, identifying asymmetries as from 4.32° of occlusal plane inclination and 4.155 mm of mandibular deviation (p< 0.05). The other categories of evaluators identified asymmetries and assigned significantly lower grades, starting from 5.88° of occlusal plane inclination and 5.54 mm of mandibular deviation (p< 0.05).Conclusion:Occlusal plane inclination and mandibular deviation were perceived by all groups, but orthodontists presented higher perception of deviations.

Objetivo: o objetivo do presente estudo foi avaliar o grau de percepção, de leigos, dentistas e ortodontistas, quanto à influência das inclinações do plano oclusal e dos desvios mandibulares na estética facial.Métodos:uma mulher com 5,88o de desvio do plano oclusal e 5,54mm de desvio mandibular foi selecionada. A partir de sua fotografia original, quatro novas imagens foram criadas, corrigindo os desvios e criando rostos e sorrisos mais simétricos. Os examinadores avaliaram as imagens por meio de um questionário, sendo realizadas análises qualitativas e quantitativas.Resultados:45 leigos, 27 dentistas e 31 ortodontistas preencheram os questionários. Todos os grupos foram capazes de perceber a assimetria, no entanto, os ortodontistas foram mais sensíveis, sendo capazes de perceber a assimetria de 4,32o de inclinação do plano oclusal e 4,155mm de desvio mandibular (p > 0,05). Os demais avaliadores perceberam a assimetria apenas a partir de 5,88o de desvio do plano oclusal e 5,54mm de desvio mandibular (p > 0,05).Conclusão:inclinações do plano oclusal e desvios mandibulares foram percebidos por todos os grupos, mas os ortodontistas apresentaram maior sensibilidade aos desvios.

Avaliação estética e condutas terapêuticas relacionadas aos principais perfis faciais / Aesthetic evaluation and therapeutic procedures related to main facial profiles

Introdução: A cirurgia ortognática para correções de deformidades dentofaciais proporciona uma face mais harmoniosa, funcional e estética. O objetivo desse estudo foi avaliar a percepção dos cirurgiões bucomaxilofaciais quanto à estética dos perfis faciais padrões I, II e III, relacionada ao sexo, etnia e às principais condutas terapêuticas. Métodos: Foram entrevistados 18 cirurgiões especialistas ou em formação em Cirurgia e Traumatologia Bucomaxilofacial, utilizando uma ficha clínica padronizada para avaliação estética e condutas terapêuticas de 12 imagens manipuladas simulando os perfis faciais, sexo e raças. Resultados: Quanto à estética, destacaram-se os perfis faciais tipo I, que apresentaram as melhores médias, enquanto os perfis faciais tipo III as menores; entretanto, não houve diferenças significativas entre as médias obtidas nos diferentes perfis faciais em relação ao sexo e à raça. As condutas terapêuticas foram homogêneas nos perfis II e III, com maiores percentuais para condutas clássicas no tratamento ortocirúrgico destas deformidades dentofaciais. Conclusão: O perfil facial I foi o considerado mais estético; então, houve influência do sexo e do tipo racial na estética para a amostra estudada. Os perfis faciais I foram os mais difíceis de avaliar quanto às condutas terapêuticas, o que resultou em grande variedade de opções em relação aos perfis II e III.

Introduction: Orthognathic surgery for correction of dentofacial deformities provides a more-symmetrical face, and functional and aesthetic benefits. The aim of this study was to evaluate the perception of buccomaxillofacial surgeons regarding the aesthetics of facial profiles patterns I, II, and III in related to sex, ethnicity, and the main therapeutic procedures. Methods: We interviewed 18 specialist surgeons or surgeons in training in buccomaxillofacial surgery by using a standardized clinical report form for aesthetic evaluation and therapeutic procedures of 12 manipulated images simulating facial profiles, sex, and race. Results: As for aesthetics, the highlights were that facial profile type I had the highest mean values, whereas facial profile type III had the lowest mean values. However, no significant differences were found between the mean values obtained in different facial profiles in relation to sex and race. The therapeutic procedures were homogeneous in profiles II and III, with higher percentages for classical procedures in the orthosurgical treatment of these dentofacial deformities. Conclusion: Facial profile I was considered more aesthetic. Furthermore, sex and racial type effects on aesthetics for the studied sample. Facial profiles I were the most difficult to assess as to therapeutic procedures, which resulted in a wide range of options in relation to profiles II and III.

Factores que explican la satisfacción laboral de odontólogos en Chile / Factors explaining the job satisfaction of dentists in Chile

OBJETIVO Determinar factores que influyen en la satisfacción laboral de odontólogos de Chile, en las ciudades de Puerto Montt y Valdivia. MÉTODO Estudio observacional de corte transversal realizado entre abril-agosto 2013. Dos investigadoras (JI, VC) visitaron a dentistas trabajando en las ciudades de Valdivia y Puerto Montt pidiéndoles que contestasen un cuestionario acerca de su nivel de satisfacción laboral (1: muy insatisfecho a 7: muy satisfecho) según factores internos y externos relacionados mediante la escala de Warr-Cook-Wall. Los datos fueron analizados mediante regresión múltiple lineal simultánea, en la cual la variable respuesta fue satisfacción laboral, y las predictoras los factores internos/externos, para detectar aquellas asociadas significativamente (p < 0,05). RESULTADOS Obtuvimos 171 encuestas de 91 odontólogas mujeres y 80 hombres, con un promedio ± desviación estándar de edad de 35,6 ± 10,7 años y una antigüedad laboral de 7,6 ± 8,0 años. Trabajan 22 ± 19 h en el sector público (51,5%), 10 ± 13 h contratado en clínicas privadas (26,3%) y 10 ± 12 h en clínicas propias (22,2%). El nivel de satisfacción laboral general fue 5,6 ± 1,1, de 7, con diferencia significativa para quienes trabajan en clínica propia (6,05 ± 0,84). Este modelo explica el 75% de la satisfacción laboral, y las variables predictoras asociadas de manera significativa son: responsabilidad asignada, remuneración, compañeros de trabajo, horarios, condiciones físicas de trabajo y posibilidad de usar habilidades, esta última solo en odontólogos de consulta privada. CONCLUSIÓN Los odontólogos encuestados presentan un alto nivel de satisfacción profesional, y este nivel se asocia en mayor medida a factores externos. Esta información debería ser considerada por futuros empleadores interesados en la satisfacción laboral de los odontólogos.

OBJECTIVE To determine the factors that influence job satisfaction of dentists in Chile, in the cities of Puerto Montt and Valdivia. METHOD A cross-sectional study was conducted between April and August 2013. Two researchers (JI, VC) visited dentists working in the cities of Valdivia and Puerto Montt and asked them to answer a questionnaire about their level of job satisfaction (1-very dissatisfied to 7-very satisfied) as well as related intrinsic and extrinsic using the scale of Warr-Cook-Wall. Data were analyzed by simultaneous multiple-regression in which the linear response variable was job satisfaction and predictors were intrinsic/extrinsic factors, in order to detect those significantly associated (P < .05). RESULTS A total of 171 questionnaires were completed by the dentists (91 female - 80 male), with a mean ± standard deviation age of 35.6 ± 10.7 years and seniority of 7.6 ± 8.0 years. They worked 22 ± 19 hours work in the public sector (51.5%), 10 ± 13 hours in contracted private practice (26.3%), and 10 ± 12 hours in private practice (22.2%). Overall job satisfaction level was 5.6 ± 1.1, with a significant difference for those working in their private practice (6.05 ± 0.84). This model explains 75% of job satisfaction, and the predictors were significantly associated with the amount of responsibility given, income, colleagues and fellow workers, physical working conditions, and opportunity to use abilities, the last one only in dentists from private clinics. CONCLUSION The dentists surveyed have a high level of job satisfaction, and this level was associated mostly by extrinsic factors. This information should be considered by prospective employers interested in job satisfaction of dentists.

Validation of an instrument to assess factors associated with adherence to standard precautions among dentists in primary healthcare

Accidents with biological material are a reality in dental practice.The use of preventive measures such as the adoption ofStandard Precautions (SP) is essential, thus this study aims tovalidate an instrument to check factors associated with adherenceto SP among dentists. The scales of psychosocial andorganizational factors that influence adherence to SP were thestarting point. These scales have already been nationally validatedfor doctors and nurses. The instrument consisted of 49items divided into five dimensions. The process of instrumentvalidation involved the following steps: its adaptation for situationsthat pose risks to dentists; content and semantic analysisby a committee of judges, and application to dentists. Theadapted instrument was applied to 224 dentists who providedprimary healthcare in the north region of Paraná State. Afterthe application of scales, the psychometric properties wereanalyzed using the factor analysis technique and a reliabilitytest. The factor analysis confirmed three domains: Obstaclesto following standard precautions; Knowledge of occupationaltransmission of HIV and Safety climate. The reliability of thedomains was considered adequate (Cronbach’s alpha between0.73 and 0.88.). The instrument demonstrated adequate psychometricproperties to assess factors that influence adherenceto SP among dentists...

Os acidentes com presença de material biológico são umarealidade na prática odontológica. A utilização de medidaspreventivas como a adoção das Precauções Padrão (PP) éessencial, desta maneira este estudo tem como objetivo validarum instrumento para verificação de fatores associadosà adesão às PP, entre dentistas. Partiram-se das Escalas deFatores Psicossociais e Organizacionais que Influenciam aAdesão às Precauções-Padrão, já validadas nacionalmentepara enfermeiros e médicos. O instrumento compôs-se de49 itens distribuídos em 5 dimensões. O processo de validaçãodo instrumento seguiu as seguintes etapas: adaptaçãodo instrumento para as situações que envolvem riscos aosdentistas por meio da análise semântica e análise de conteúdo,as quais foram realizadas por um comitê de juízes. Oinstrumento adaptado foi para 224 dentistas que atuavamna Rede Básica de Saúde na região Norte do Estado doParaná. Após aplicação das escalas foram analisadas aspropriedades psicométricas através das técnicas de análisefatorial e teste de confiabilidade. A análise fatorial confirmoutrês domínios: Obstáculo para seguir às PrecauçõesPadrão; Conhecimento da transmissão ocupacional do HIVe Clima de segurança. A confiabilidade dos domínios foiconsiderada adequada (alfa de Cronbach entre 0,73 e 0,88).O instrumento demonstrou propriedades psicométricas adequadaspara avaliar fatores de influência na adesão as PP,entre dentistas...

Brazilian orthodontists and the legal issues involving their professional activity: a legal and behavioral proposal

OBJECTIVE: The aim of this study was to review the use of orthodontic records (OTR's) by Brazilian orthodontists and propose a behavioral approach from a legal point of view, drawing on their interpersonal relationship with their patients. METHODS: A statistical cross-analysis was performed to compare five groups. A sixth group was created comprising the intersection of the responses provided by the five aforementioned groups. RESULTS: The results demonstrate that 42.2% of orthodontists require initial and final records and keep orthodontic records throughout their professional career; 13.9% duplicate the initial records and consider patients as the lawful owners of these documents; 19.5% make use of a medical history questionnaire, to be duly signed by all patients; 5.4% acknowledge that the decision to undergo treatment is ultimately the patient's, and, therefore, an alternative response "not perform the treatment" should be included in the questionnaire; 24% recognize the importance of the Consumer Protection Code (CPC), regard the provision of orthodontic services as an obligation of means; and explain to the patient the risks involved in orthodontic practice. Among the 1,469 orthodontists researched, 0% simultaneously took into account all aspects of this study. CONCLUSION: It was concluded that Brazilian orthodontists adopt a mistaken legal, professional and behavioral attitude, neglecting to build patient's orthodontic record with due care and in accordance with the law, which makes them vulnerable to patient disputes, contentious or otherwise.

OBJETIVO: a proposta desse trabalho foi analisar a prática do prontuário ortodôntico e as atitudes comportamentais sob o ponto de vista jurídico entre os ortodontistas do Brasil, mediante seu relacionamento interpessoal com seus pacientes. MÉTODOS: um questionário composto por 35 perguntas foi enviado para 5.355 ortodontistas. Após a devolução de 27% das correspondências, foi realizado um cruzamento informatizado estatístico em cinco grupos. Um sexto grupo criado foi a intersecção de todas as respostas dos cinco grupos anteriores. RESULTADOS: constatou-se que 42,2% dos ortodontistas solicitam as documentações iniciais ou finais, e guardam o prontuário ortodôntico por toda a carreira profissional; 13,9% duplicam a documentação inicial e consideram que o prontuário ortodôntico pertence ao paciente; 19,5% aplicam questionário de anamnese para todos os pacientes, que é assinado ao final; 5,4% consideram que a decisão pela opção terapêutica é do paciente, incluem a opção "não realizar o tratamento" e afirmam que o contrato é fundamental para o início do tratamento; 24,0% reconhecem a importância do Código de Defesa do Consumidor na profissão, consideram obrigação de meio (obrigação de diligência) os serviços ortodônticos prestados e esclarecem sobre os riscos envolvidos na prática da especialidade; 0% dos ortodontistas realizam simultaneamente todas essas considerações. CONCLUSÃO: o ortodontista brasileiro mantém uma atitude comportamental equivocada, mediante seus pacientes, pois, sob o ponto de vista jurídico-profissional, negligencia a elaboração cautelosa do prontuário dentro dos fundamentos legais conforme o estágio atual da especialidade. Sob o aspecto legal de seu exercício profissional, o ortodontista brasileiro está vulnerável diante questionamentos de seus pacientes, sejam eles litigiosos ou não, justos ou injustos.