Experiencia educativa de una estructura didáctica en la carrera de Estomatología para visitas domiciliarias / Educational experience of a didactic structure in the Dentistry career to visit the family

Fundamento: en el entorno educativo las investigaciones relacionadas con los modos de actuación de los estudiantes adquieren especial significación. Los estudiantes de cuarto año de la carrera de Estomatología del escenario docente del policlínico "Docente de Playa" de la Facultad de Ciencias Médicas "Victoria de Girón" necesitan formarse del modo más cercano posible a los modos de actuación del futuro egresado, al tener en consideración problemas teóricos y metodológicos objetos de la profesión. Objetivo: describir una experiencia educativa sobre la aplicación de una estructura didáctica para el desarrollo de la visita a la familia como modalidad de la educación en el trabajo con estudiantes de cuarto año de Estomatología. Métodos: la investigación se desarrolló durante los cursos comprendidos entre el año 2014 al 2019. Se utilizaron métodos del nivel teórico, empírico y estadístico. La estructura didáctica centrada en el desarrollo de la visita a la familia consta de cuatro etapas con los correspondientes objetivos y acciones. Resultados: se reconoce la educación en el trabajo como forma fundamental de organización de la enseñanza para la carrera de Estomatología y la visita a la familia como una de las modalidades, lo cual constituye una pauta a seguir en la estructura didáctica propuesta. Conclusiones: el análisis y valoración de los resultados obtenidos luego de la aplicación, permitió constatar cambios significativos y transformaciones cualitativas a partir de la estructura didáctica, lo cual constituye una alternativa para el mejoramiento de los modos de actuación de los estudiantes de cuarto año de la carrera de Estomatología.

Background: in the educational environment, research related to students' modes of action acquire special meaning. The fourth-year students of the Dentistry degree in the teaching setting of the Victoria de Girón "teachin polyclinic of the ""Playa Faculty of Medical Sciences need to be trained as closely as possible to the modes of action of the future graduate, by taking into consideration theoretical and methodological problems objects of the profession. Objective: to describe an educational experience on the application of a didactic structure for the development of family visits as a modality of the in-service training with fourth-year dentistry students. Methods: the research was developed during the courses from 2014 to 2019. Theoretical, empirical and statistical methods were used. The didactic structure focused on the development of the visit to the family consists of four stages with the corresponding objectives and actions. Results: education at work is recognized as a fundamental way of organizing teaching for the Dentistry career and visiting the family as one of the modalities, which constitutes a guideline to follow in the proposed didactic structure. Conclusions: the analysis and assessment of the results obtained after the application allowed us to verify significant changes and qualitative transformations from the didactic structure, which constitutes an alternative for the improvement of the modes of action of the fourth year students of the Dentistry career.

Comparación del desempeño técnico-asistencial en programas escolares con diferentes modalidades de implementación / Comparison of technical-assisstance performance in school programs with different implementation modalities

Se comparó el desempeño técnico-asistencial de 2 programas de atención odontológica con iguales protocolos de atención y diferente modalidad de implementación. Ambos programas se caracterizaron por un perfil preventivo-promocional; uso de protocolos validados según riesgo biológico, atención odontológica adaptada a sedes no convencionales, recursos asignados por método de necesidades; ejecución por recurso humano pre-profesional supervisado y modulación por altas. La modalidad de implementación difirió en la densidad/concentración de las actividades realizadas: en el Programa Extensivo (PE) las acciones se implementaron con frecuencia semanal; en el Programa Intensivo (PI) las acciones se concentraron en una semana en el año. Cobertura anual: PE = 120 escolares de 6 a 9 años de edad; PI = 180 escolares y preescolares de 3 a 12 años de edad. Se midió la cantidad de prestaciones, sesiones y tiempo -en minutos- hasta alcanzar el Alta Básica Operativa (ABO). Para comparar grupos (PI y PE) se utilizaron los tests: U de Mann Whitney, t de Student para mues-tras independientes, chi cuadrado y comparación de proporciones. La razón de prestaciones/sesión fue significativamente mayor (p=0,000) en el programa intensivo. El número de prestaciones hasta el alta (ABO) y la razón tiempo/sesión no mostraron diferencias entre programas (p=0,8 p=0,087), mientras que se evidenció una mayor razón tiempo/prestación y tiempo en alcanzar el alta (ABO) en la modalidad extensiva (p=0,000). La modalidad intensiva mostró mayor eficiencia en el desempeño técnico asistencial que la extensiva (AU)

Aim: To compare technical-care performance of 2 dental care programs with the same care protocols and different implementation modalities. Both programs shared the following features: preventive-promotional profile; use of validated clinical protocols according to biological risk, dental care adapted to non-conventional settings, allocation of resources by needs method; supervised pre-professional human resource and modulation by discharges. The implementation mode differed in the density/concentration of the activities: in the extensive program (EP) the actions were implemented on a weekly basis along the year; in the intensive program (IP) the actions were concentrated in one week in the year. Annual coverage of the programs: 180 schoolchildren and preschoolers (3 -12 years old); EP = 120 schoolchildren (6 - 9 years old). We measured the following variables: the number of dental services performed, the number of sessions and the time, in minutes, to reach the basic operating discharge (BOD). We used the following tests to compare groups (IP and EP): Mann Whitney U; Student's t for independent samples, chi square and comparison of proportions test. The action per session ratio was significantly higher (p=0.000) in the intensive program. The number of actions performed until discharge (BOD) and the time per session ratio did not show differences between programs (p=0.8 p=0.087). In the extensive mode, compared to intensive mode, it took longer to reach discharge (BOD) (p=0.000) The program implemented with intensive modality (PI) showed greater efficiency regarding technical-care performance when compared to the extensive mode (AU)

Utilización de servicios de salud por la población de cuatro consultorios del médico de la familia / Use of health services by the population of four family doctor's offices

Introducción: La utilización de los servicios de salud es un proceso social, dinámico y complejo. Objetivo: Describir la utilización de los servicios de salud por la población de cuatro consultorios del médico y la enfermera de la familia. Métodos: Estudio descriptivo de corte transversal entre los meses de enero de 2019 a enero de 2020. Se aplicó una encuesta a 775 personas de 18 años y más. Los datos se procesaron con el paquete estadístico SPSS versión 20.0 para Windows. Se utilizaron estadísticas descriptivas, expresando los resultados en tablas de distribución de frecuencias. Resultados: El rango de edades de mayor representatividad fue el de 70-74. El sexo femenino representó el 10,2 por ciento (46) y el masculino el 12,7 por ciento (41). En relación con la iniciativa para solicitar actividades de promoción y prevención, las más solicitadas fueron toma de tensión arterial, chequeo médico y peso corporal. La solicitud habitual de receta médica (706; 87,3 por ciento) se realiza al médico del consultorio. El lugar a donde se dirige el paciente, fundamentalmente, en caso de necesitar atención médica no urgente es al consultorio médico de la familia (650; 83,9 por ciento). Los lugares a donde se dirige, esencialmente, en caso de necesitar atención médica urgente son al cuerpo de guardia del hospital (520; 67,5 por ciento) y al cuerpo de guardia del policlínico (208; 27,0 por ciento). Conclusiones: La población de los cuatro consultorios estudiados utiliza los servicios en los diferentes niveles según el problema de salud que necesita resolver. Sería importante poder identificar en otras investigaciones por qué las actividades menos solicitadas son el tacto rectal, el antígeno prostático y el examen físico de mama, en aras de trazar estrategias que permitan incrementar el empoderamiento para la salud individual(AU)

Introduction: The use of health services is a social, dynamic and complex process. Objective: Describe the use of health services by the population of four family doctor and nurse's offices. Methods: Descriptive cross-sectional study carried out from January 2019 to January 2020. A survey was applied to 775 people of 18 years and older. The data was processed using the SPSS statistical package version 20.0 for Windows. Descriptive statistics were used, expressing the results in frequency distribution tables. Results: The age range of greatest representativeness was 70-74. The female sex represented 10.2percent (46) and the male sex was 12.7percent (41). In relation to the initiative to request promotion and prevention activities, the most requested were blood pressure testing, medical check-up and body weight. The usual request of prescriptions (706; 87.3percent) is made to the doctor in the office. The place where the patient goes, fundamentally, in case of needing non-urgent medical attention is to the family doctor's office (650; 83.9percent). The places where the patient goes, essentially, in case of needing urgent medical attention are the emergeny service in the hospital (520; 67.5percent) and the emergency service of the polyclinic (208; 27.0percent). Conclusions: The population of the four family doctor's office studied uses the services at different levels according to the health problem they need to solve. It would be important to be able to identify in other research why the least requested activities are digital rectal examination, prostate antigen and breast physical examination, in order to draw strategies that allow increasing empowerment for individual health(AU)

Interprofissionalismo na Estratégia Saúde da Família: um olhar sobre as ações de promoção de saúde bucal / Interprofessionalism in the Family Health Strategy: a look on the actions of promotion of oral health

Resumo O trabalho interprofissional é necessário para a consolidação do modelo de atenção à saúde, porém o cirurgião-dentista encontra muitos desafios para trabalhar em equipe. Este estudo objetivou conhecer o interprofissionalismo, no âmbito da saúde bucal, entre os trabalhadores graduados da Estratégia Saúde da Família. Tratou-se de um estudo exploratório e transversal, com abordagem qualitativa, desenvolvido com 39 profissionais graduados da Atenção Básica do município de Icó, Ceará, Brasil. Os sujeitos pesquisados declararam uma deficiência na manutenção técnica nas unidades, a recorrente falta de insumos e a demanda excessiva de usuários como elementos que prejudicam o trabalho em equipe, assim como a inexistência de um plano de cargos, carreiras e salários, sendo um motivo de descontentamento entre os profissionais. Todos consideraram importante o trabalho interprofissional e sugeriram reuniões periódicas, atividades compartilhadas mais frequentes e capacitações como forma de intensificar essa ação. Apesar de o trabalho interprofissional ser reconhecido como fundamental para as ações de cuidado, é necessário mais comprometimento e apoio da gestão.

Abstract Interprofessional work is necessary for the consolidation of this healthcare model; however, the dental surgeon meet many challenges while working in a team. The objective of this study was to get to know interprofessionalism in the oral health field among the graduated workers of the Family Health Strategy. It was an exploratory and cross-sectional study, with qualitative approach, developed with 39 primary care graduated professionals from the municipality of Icó, state of Ceará, Brazil. The individuals surveyed declared a deficiency in the technical maintenance in the units, the recurring lack of inputs and excessive demand from users as elements that hinder teamwork, as well as the lack of a position, career and salary plan are a reason for discontent among the professionals. All of the participants considered interprofessional work important and suggested periodic meetings, more frequent shared activities and training as a way to intensify this action. Although interprofessional work is recognized as fundamental to care actions, more commitment and management support is needed.

Population Knowledge and Attitude Toward Emergency Management of Avulsed Permanent Teeth

Abstract Objective: To evaluate the knowledge of patients treated in a public University concerning dental avulsion and its emergency first-aid management. Material and Methods: Three hundred patients were invited to answer a questionnaire about demographic characteristics, attitude and knowledge of first-aid management of dental avulsion. Chi-square test was used to assess the association between knowledge about dental replantation and education level. Results: Female gender (66.7%) aged from 31 to 40 years (31.3%) with high school education (50.3%) predominated among all the participants. It was not found a difference between education level and management of avulsed permanent teeth (p=0.076), and 66% of the respondents were not able to do the replantation. In relation to the management of avulsed tooth, 42.7% of the respondents would brush the tooth and if the replantation was not possible, most of them would choose inappropriate media for storage. The association between the storage medium and educational level showed to be statistically significant (p=0.043). Conclusion: It was possible to notice the lack of knowledge about this subject, and it could result in the worst prognosis. In avulsion cases, the subsequent root resorptions may lead to the loss of the child's tooth. It is important to implement educational campaigns to spread knowledge and improve success rates of permanent avulsed teeth

Programa de Salud Bucodental en escolares de la Comunidad del Bajo Boulogne / Oral Health Program in children from Bajo Boulogne Community

Las afecciones bucodentales constituyen un problema de salud pública por su alta prevalencia y su fuerte impacto individual y colectivo en términos de dolor, malestar y discapacidad social y funcional. El Centro de Medicina Familiar y Comunitaria San Pantaleón, ubicado en la provincia de Buenos Aires, brinda asistencia sanitaria gratuita a la comunidad. Un relevamiento documentó que el 97% de los concurrentes presentaba caries y no se lavaban los dientes por falta de cepillo y pasta dental. Se decidió llevar adelante un programa de promoción de la salud bucodental. El objetivo fue evaluar su implementación; que incluyó: a) rastreo de caries y problemas odontológicos; b) coordinación interinstitucional; c) entrega de cepillos y pasta dental; d) intervención educativa; e) extensión comunitaria. Participaron en forma irregular 120 niñas, niños y adolescentes entre 5 y 18 años del Centro de Apoyo Escolar Fundación Bajo Boulogne. Se realizaron dos encuentros educativos y entrega de cepillos y pasta dental. En la revisión odontológica inicial sobre 60 participantes se detectaron caries en 43 (71,6%), que fueron derivados para tratamiento odontológico, pero concurrieron solo 26 (60,4%). El conocimiento sobre salud bucodental mostró cambios entre los más pequeños luego de las intervenciones educativas. Se logró implementar el programa, cumplimentando las actividades propuestas. Pero surgieron barreras que dificultaron la cobertura. En cuanto a la eficacia de la intervención educativa, no se logró mostrar cambios en el conocimiento. Se consiguió la detección oportuna, la incorporación de hábitos como el cepillado dentro de la institución educativa, la articulación para mejorar el acceso a la atención y la vinculación entre los diferentes actores comunitarios. (AU)

Oral disorders are a public health problem due to their high prevalence and their strong individual and collective impact in terms of pain, discomfort, and social and functional disability. The San Pantaleón Family and Community Medicine Center, located in the province of Buenos Aires, provides free healthcare to the community. A survey documented that 97% of those present had cavities and did not brush their teeth due to a lack of brush and toothpaste. It was decided to carry out an oral health promotion program. The objective was to evaluate its implementation; which included: a) tracking of caries and dental problems; b) inter-institutional coordination; c) delivery of brushes and toothpaste; d) educational intervention; e) community extension. 120 girls and boys and adolescents between 5 and 18 years of age from the Bajo Boulogne Foundation School Support Center irregularly participated. Two educational meetings were held, handing out brushes and toothpaste. In the initial dental review of 60 participants, caries was detected in 43 (71.6%), who were referred for dental treatment, with only 26 (60.4%) concurring. Oral health knowledge showed changes among the youngest after educational interventions. It was possible to implement the program, completing the proposed activities. Barriers arose that made coverage difficult. Regarding the effectiveness of the educational intervention, it was not possible to show changes in knowledge. Timely detection was achieved, the incorporation of habits such as brushing within the educational institution, articulation to improve access to care and the link between the different community actors. (AU)

Intervención comunitaria en salud bucal en la población de San Pablo de Pillao, Perú, 2018 / Community oral health intervention in the population of San Pablo de Pillao, Peru, 2018

RESUMEN Introducción. Las intervenciones comunitarias permiten promover la salud y prevenir enfermedades en el poblador. Objetivo. Describir los diagnósticos y tratamientos realizados por estudiantes de odontología en el Campamento Universitario Multidisciplinario de Investigación y Servicio. Métodos. Se diseñó un estudio epidemiológico, con el enfoque cuantitativo en el distrito de San Pablo de Pillao, provincia Huánuco, Perú. Participaron docentes y estudiantes de la Facultad de Medicina, Humana, Odontología, Nutrición y Psicología. De un total de 250 asistentes a las sesiones, 95 adultos fueron atendidos en la consulta odontológica. Se realizaron sesiones educativas referidas a "anemia y desnutrición", "enfermedades diarreicas", "infecciones respiratorias", "alcoholismo y violencia", "crecimiento y desarrollo", "lactancia materna" y "salud bucal", así como una campaña de diagnóstico y tratamiento de efecciones bucodentales. Se utilizó el programa Excel para el análisis de datos. Resultados. Se atendieron 95 pobladores adultos. El 6,3 por ciento correspondió a edéntulos totales y el 40 por ciento a edéntulos parciales. De los dentados, el 97,3 por ciento presentó caries dental con un promedio de índice CPOD (suma de los dientes cariados + dientes perdidos + dientes obturados, en la dentición pemanente) de 2,08 ± 1,56. Con respecto al estado periodontal, el 38,9 por ciento presentó inflamación gingival severa. En los adultos se realizó 35 restauraciones, 28 exodoncia y 8 ajustes de prótesis. En adultos y niños se realizaron fluorizaciones y cinco actividades educativas de promoción de la salud. Conclusiones. La presencia de caries y enfermedad gingival fue altamente prevalente; las principales actividades terapéuticas realizadas en el campamento fueron las restauraciones y exodoncia(AU)

ABSTRACT Introduction: Community interventions make it possible to promote health and prevent disease in the population. Objective: Describe the diagnoses and treatments made by dental students at the Multidisciplinary Research and Service University Camp. Methods: A qualitative epidemiological study was designed for the district of San Pablo de Pillao, Huánuco province, Peru. The participants were teachers and students from the School of Human Medicine, Dentistry, Nutrition and Psychology. Of the total 250 subjects attending the sessions, 95 adults were cared for at the dental service. The educational sessions conducted dealt with the topics of "anemia and malnutrition", "diarrheal diseases", "respiratory infections", "alcoholism and violence", "growth and development", "breastfeeding" and "oral health", as well as a campaign about diagnosis and treatment of oral disorders. Data analysis was performed on Microsoft Excel. Results: Of the total 95 adult residents cared for, 6.3 percent were totally edentulous and 40 percent were partially edentulous. Of the dentate subjects, 97.3 percent had dental caries with a mean DLRP index (sum total of decayed + lost + restored permanent teeth) of 2.08 ± 1.56. As to periodontal status, 38.9 percent had severe gingival inflammation. A total 35 restorations, 28 exodontias and 8 prosthesis adjustments were performed on adult patients. Adults and children alike received fluoridation and attended five educational health promotion sessions. Conclusions: Dental caries and gingival disease were highly prevalent. The main therapeutic actions performed in the camp were restorations and exodontia(AU)

Teledentistry and the Unified Health System: An Important Tool for the Resumption of Primary Health Care in the Context of the COVID-19 Pandemic

Abstract This paper describes the possibilities of using Teledentistry to expand and qualify health care in oral health care networks. WHO already recommended to its member countries, even before the pandemic, Telehealth as a strategy to improve the quality of services, especially in universal systems, as the Unified Health System (SUS). Teledentistry opens opportunities for oral health to resume the provision of various services, remotely, such as: 1) Tracking, active search, monitoring of priority users, those at risk and with systemic problems, suspicions of COVID-19 and contacts, through Telemonitation; 2) Initial listening, individual or collective educational activities, through Teleorientation; 3) Discussion of clinical cases for the definition of the opportunity / need for operative procedures, matrix support, sharing, solution of doubts among professionals and between these and teaching and research institutions, by Teleconsulting, among others. In addition to a review of Teledentistry in the context of the pandemic, we conceptualized the terms used and possibilities offered to SUS professionals, in addition to specifying the possible protocols for recording these activities to provide safe data for their monitoring and evaluation. Besides, we bring a brief discussion with promising experiences, carried out in the pre- and trans-pandemic contexts, which can be important strategies for the resumption of oral health in the post-pandemic scenario.

Avaliação do desempenho e satisfação dos usuários de próteses totais mucossuportadas fornecidas pelo Sistema Único de Saúde em município catarinense / Evaluation of performance and users satisfaction of complete denture prosthesis provided by the Unified Health System in Santa Catarina municipality

O edentulismo ainda e considerado um grande problema para a saúde publica, no Brasil. Acomete parte da população, em regiões distintas e diferentes faixas etárias. Alguns municípios brasileiros aderiram aos Laboratórios Regionais de Próteses Dentarias para minimizar essa condição; assim, buscou-se avaliar o desempenho e a satisfação dos usuários de próteses totais mucossuportadas fornecidas pelo Sistema Único de Saúde. Estudo transversal, de analise descritiva e abordagem quali-quantitativa, com amostra censitária de 115 usuários que receberam próteses totais superiores e/ou inferiores no período de julho de 2013 até julho de 2014. Foram aplicados os questionários OHIP-14 e a Escala Visual Analógica para avaliar a satisfação e desempenho. A idade mediana foi 59,0 (53,0-68,0) anos. Renda mensal prevalente foi de até um salário mínimo (60,0%; n=69). O grau de alfabetização mais comum foi ensino fundamental incompleto (68,7%; n=79). O desempenho mediano associado aos diferentes tipos de próteses foi de 99,0 para a superior, 95,0 para a inferior e 97,0 para ambas as próteses, resultados considerados estatisticamente significativos (p=0,047). Usuários do SUS que receberam próteses totais mucossuportadas estão satisfeitos com a reabilitação. Quanto ao desempenho das próteses avaliadas, constatou-se diferença estatisticamente significativa para reabilitação com prótese superior, inferior ou para ambas.

Edentulism is still considered a great problem for public health in Brazil. Affect the population in different regions and different ages. Some cities have joined the Regional Laboratories of Dental Prosthetics to minimize this condition, so it has been intended to evaluate the performance and user satisfaction of complete denture prosthesis provided by the Unified Health System. Cross-sectional study of descriptive analysis and qualitative and quantitative approach, with census sample of 115 users who have received upper and/ or lower complete dentures from July 2013 to July 2014. We applied the OHIP-14 questionnaire and Visual Analog Scale to assess satisfaction and performance. The median age was 59.0 (53.0 to 68.0) years. Prevalent monthly income was up to one minimum wage (60.0%; n = 69). The most common grade literacy was incomplete primary education (68.7%; n = 79). Average performance associated with different types of prosthesis was 99.0 for higher, 95.0 was lower and 97.0 for both prostheses, results were considered statistically significant (p = 0.047). SUS users who have received complete dentures prosthesis are satisfied with the rehabilitation. As for the performance of prosthesis assessed, there was no statistically significant difference for rehabilitation with upper dentures, lower or both.

Formas de presentación de los terceros molares mandibulares incluidos e impactados. Hospital General Provincial Docente Riobamba / Forms of presentation of mandibular third molars included and impacted. General Hospital of Riobamba

La diversidad de posibles posiciones que pueden adoptar los terceros molares durante el proceso de erupción, hacen que estos se muestren como piezas incluidas, retenidas o impacta-das, problemática asociada a trastornos mecánicos como la obstrucción de tejidos blandos o duros o por motivos embriológicos. Se realizó un estudio descriptivo, transversal, con enfo-que mixto; con el objetivo de caracterizar las formas de presentación de este tipo de dientes en los individuos que conformaron la población de estudio, la que quedó determinada por la totalidad de pacientes atendidos por sintomatología relacionada a la presencia de terceros molares mandibulares incluidos e impactados (164) en el Servicio de Odontología del Hospi-tal General Provincial Docente Riobamba entre enero y diciembre del 2015; de los cuales, mediante un muestreo no probabilístico del tipo intencional, se seleccionaron 103 enfermos con edades comprendidas entre los 15 a 60 años de edad, con óptimo estado de salud mental y diagnóstico radiológico en historia clínica de tercer molar retenido. Las características mor-fológicas de los terceros molares observados se acercan a las descripciones anatómicas referi-das por la ciencia, predominando la inclinación vertical del eje longitudinal respecto al segun-do molar. La presencia de esta anomalía se observó de forma mayoritaria en el sexo masculi-no y en el grupo etario conformado por individuos adolescentes y adultos jóvenes, los que no refirieron poseer antecedentes patológicos familiares relacionados a este padecimiento.

The third molars can adopt a diversity of possible positions during the process of eruption. These positions make them appear as pieces included, retained or impacted, problematic associated with mechanical disorders such as obstruction of soft or hard tissues, or embryolo-gical reasons. A descriptive, cross-sectional study with a mixed approach was carried out in order to characterize the ways of presenting this type of teeth in the subjects of the study. The population was determined by the totality of patients treated for symptoms related to the presence of included and impacted third mandibular molars (164) in the Dental Service of the General Hospital of Riobamba between January and December 2015. 103 patients aged between 15 and 60 years were selected through a non-probabilistic sampling of the intentio-nal type, considering some aspects like optimal mental health status and radiological diagno-sis in retained third molar clinical history. The morphological characteristics of the observed third molars are close to the anatomical descriptions given by science, predominantly the vertical inclination of the longitudinal axis with respect to the second molar. The presence of this anomaly was observed mainly in the male sex and in the age group formed by adoles-cents and young adults who did not report having a family history of pathologies related to this condition.

Implementation of dental specialty centers: a descriptive analysis of the current status in the Brazilian territory

ABSTRACT This study aimed to assess the current implementation status of Dental Specialty Centers (Centros de Especialidades Odontológicas - CEO) in Brazil. The sample included CEOs implemented up to November 2015 in the 27 Brazilian federative units. Data were obtained directly from the database of the Informatics Department of the Brazilian Unified Health System, according to the National Registry of Health Facilities (NRHF) of Dental Specialty Centers of all Brazilian regions. Primary care data were also collected from the cities with implemented CEOs, including coverage status of the Family Health Strategy (FHS) and number of Oral Health Teams (OHT) I and II, at 2 collection periods (January 2006 and November 2015). There were 1019 CEOs implemented in Brazil, which were unequally distributed among the Brazilian states, with prevalence of implementation of CEOs type II (n=503, 49.4%). The statistical analysis showed significant difference between the three types of CEO (I, II, and III) and the variables of coverage rate (FHS) and number of teams (OHT I, OHT II) at both data collection periods. Although presenting an evolutionary aspect in the implementation of CEOs, the implementation of medium-complexity care in Brazil is disorganized.

Índice de higiene oral comunitario en escolares de 12 años / Oral hygiene index in students of 12 years old

Objetivos: El objetivo de esta investigación fue determinar el índice de higiene oral en escolares de 12 años de la parroquia El Vecino en la ciudad de Cuenca - Ecuador, 2016. Material y Métodos: Se realizó un estudio descriptivo, documental, retrospectivo, cuantitativo a partir de los datos epidemiológicos de 185 escolares de 12 años, de la parroquia El Vecino, aplicando el IHO-S de Greene y Vermillion. Se utilizaron fichas epidemiológicas que cuentan con consentimientos y asentimientos debidamente firmados, las cuales reposan en el archivo del departamento de investigación de la carrera de Odontología de la UCACUE. Los valores pesquisados fueron vertidos en fichas digitales, que se almacenaron en una base de datos en el programa EPI INFO ver 7.2 y posteriormente se tabularon en el programa Excel. Resultados: El IHO-S parroquial promedio se estableció en 1,09, donde el 61,62% (114 escolares) mostró un nivel bueno, no existiendo diferencia estadísticamente significativa entre los géneros. El 84,32% (156 escolares) presentó un nivel bueno de placa bacteriana blanda, mientras que el 61,08% (113 escolares) mostró ausencia de placa bacteriana calcificada. Las unidades educativas presentaron un IHO-S promedio entre 0,93 ­ 1,29. Conclusiones: La mayoría de los escolares presentan un buen nivel de higiene oral, no encontrándose diferencia estadísticamente significativa entre los géneros. El nivel bueno predominó en el índice de placa bacteriana blanda, mientras que en la placa bacteriana calcificada prevaleció su ausencia. Casi la totalidad de las unidades educativas presentaron un nivel bueno de Índice de Higiene Oral. (AU)

Objetives: The aim of this study was to determine the Oral Hygiene Index in students of 12 years old at parish El Vecino in Cuenca, Ecuador, 2016. Material and Methods: A descriptive, documentary, retrospective, quantitative study was done from epidemiological data of 185 students of 12 years old at parish El Vecino, applying the IHO-S Greene and Vermillion. Epidemiological records with duly signed consents and approvals by legal representative and students respectively were used, which are stored on the Research Department files of the career of Dentistry, UCACUE. The obtain data were typed into digital files, which were stored in a database in the EPI INFO program, version 7.2 and tabulated in Excel program. Results: The community's average of OHI-S was established in 1.09, where 61.62% (114 students) showed a good level, there was no statistically significant difference between sexes. The 84.32% (156 students) presented a good level of dental plaque, while 61.08% (113 students) showed no calcified plaque. The educational unit's average of OHI-S was determinate between 0,93­1,29. Conclusions: Most of the students have a good level of oral hygiene, not found statistically significant difference between gender. The good level predominated in the dental plaque index, while in the calcified plaque prevailed absence. Almost all of the schools showed a good level of Oral Hygiene Index. (AU)

MICROCEFALIA E A ODONTOLOGIA BRASILEIRA / MICROCEFALIA AND THE BRAZILIAN DENTISTRY / LA MICROCEFALIA Y ODONTOLOGÍA BRASILEÑA

Objetivos: alertar os cirugiões-dentistas para os problemas bucais das crianças com microcefalia no Brasil. Métodos: estudo reflexivo, realizado em setembro de 2016, tendo como alvo crianças com microcefalia, suas alterações sistêmicas e bucais e a complexidade no atendimento odontológico a partir de dados adquiridos através de referências bibliográficas. Resultados: os últimos estudos apontam que as crianças com microcefalia no Brasil possuem inúmeras alterações bucais englobando desde doenças periodontais a traumatismos dentais, impondo novos desafios para a assistência odontológica. Considerações finais: diante do surgimento de novos casos de crianças com Microcefalia, faz-se necessário chamar a atenção dos cirurgiões-dentistas e demais membros da equipe de saúde sobre os cuidados com essas crianças, quanto aos problemas bucais mais frequentes e quanto a necessidade de um correto manuseio de técnica e condução adequada de cada caso, que inclui não somente a criança, mas também seus familiares.

Objective: to alert professionals to the oral problems of children with microcephaly in Brazil. Method: reflective study, conducted in September 2016, targeting children with microcephaly, their oral changes and complexity in dental care from data acquired through bibliographic references. Results: the latest studies indicate that children with microcephaly in Brazil have numerous oral alterations ranging from periodontal diseases to dental traumatisms, imposing new challenges for dental care. Final considerations: in the face of the emergence of new cases of children with Microcephaly, it is necessary to draw the attention of dentists and other members of the health team about the care with these children, the most frequent oral problems and the need for a correct handling of technique And appropriate handling of each case, which includes not only the child, but also their families.

Objetivo: alertar a los profesionales a los problemas dentales de los niños con microcefalia en Brasil. Método: estudio reflexivo, realizado en septiembre de 2016, dirigida a los niños con microcefalia, los cambios en la boca y la complejidad en la atención dental de los datos adquiridos a través de referencias. Resultados: los últimos estudios muestran que los niños con microcefalia en Brasil tienen varias enmiendas orales que abarcan desde los traumatismos dentales enfermedad periodontal, imponiendo nuevos retos para cuidado dental. Consideraciones finales: antes de la aparición de nuevos casos de niños con microcefalia, es necesario llamar la atención de los dentistas y otros miembros del equipo de salud sobre el cuidado de estos niños, ya que los problemas dentales más frecuentes y, como la necesidad de un manejo técnico correcto y adecuado desarrollo de las actuaciones, que incluye no sólo al niño sino también a sus familias.

Necesidad de tratamiento periodontal en embarazadas, Frutillar, Chile, 2015 / Periodontal treatment needs in pregnant women, Frutillar-Chile 2015

Objetivo Determinar la necesidad de tratamiento periodontal de embarazadas de la ciudad de Frutillar, Chile, durante el año 2015. Material y método Se realizó un estudio observacional descriptivo de corte transversal durante los meses de julio a octubre del año 2015. Se evaluó a 66 embarazadas, las cuales cumplieron con los criterios de inclusión. Fueron evaluadas mediante un examen clínico por 2 examinadores calibrados (kappa 0,86). Para determinar la necesidad de tratamiento, se utilizó el índice de necesidad de tratamiento periodontal de la comunidad. Se aplicó el test de la chi al cuadrado, asumiendo un nivel de significación estadística p < 0,05. Este estudio contó con la aprobación del Comité de Ética del Centro de Salud Familiar de Frutillar. Resultados Del total de las embarazadas evaluadas, el 97% presentó necesidad de tratamiento periodontal. El valor promedio ± desviación estándar del índice de necesidad de tratamiento periodontal de la comunidad fue 2,51 ± 1,48), no teniendo diferencias estadísticamente significativas entre grupo etario (p > 0,05). Conclusión La necesidad de tratamiento periodontal de embarazadas de la ciudad de Frutillar es alta. La detección de enfermedad periodontal debe ser una parte fundamental del examen dental integral de las embarazadas, para mantener un estado de salud y prevenir futuras complicaciones en su condición de embarazo.

Aim To determine the periodontal treatment needs of pregnant women in 2015 in the city of Frutillar, Chile. Material and method A descriptive observational cross-sectional study was conducted from July 2015 to October 2015 on a total of 66 pregnant women that satisfied the inclusion criteria. They were evaluated by a clinical examination by two trained examiners (Kappa 0.86). The Community Periodontal Index of Treatment Needs (CPITN) was used to determine their periodontal treatment needs. The Chi-squared statistic was used, assuming a statistical significance level of P<.05. This study was approved by the Ethics Committee of the Frutillar Family Health Centre. Results Of the total of pregnant woman evaluated, 97% need periodontal treatment. The mean value using the CPITN was 2.51 (SD 1.48), with no statistically significant differences between the age. Conclusion The periodontal treatment needs of pregnant women in the city of Frutillar are high. The detection of periodontal disease must be an essential part of the comprehensive dental examination of the pregnant woman, in order to maintain health and prevent further complications in their pregnancy condition.

Instrumentos de visita domiciliar: abordagem da odontologia na estratégia saúde da família / Instruments for home visits: the family health strategy dental care approach

Este artigo discute instrumentos de visita domiciliar de um membro da equipe da Estratégia Saúde da Família, o cirurgião-dentista, enquanto importantes protocolos de trabalho que permitem um atendimento mais individualizado, e melhor conhecimento das condições de saúde e de vida do usuário, em termos socioeconômicos e familiares. Na organização do serviço da Equipe de Saúde Bucal, surgiu a necessidade de elaboração desses protocolos, que servissem como referência e padronização de condutas clínicas no atendimento domiciliar ao usuário, além da reunião de informações sobre a ação desenvolvida. Evidenciou-se a necessidade de sistematização da visita domiciliar por parte do cirurgião-dentista, para o estabelecimento de um diagnóstico mais preciso da situação de saúde bucal da população da área de cobertura da Unidade de Atenção Primária à Saúde e, consequentemente, para reduzir o estoque de necessidades acumuladas em agravos bucais desses usuários.

This article discusses the home visit instruments of a Family Health Strategy team member, the dentist, as important medical protocols that allow for more individualized care and better knowledge of the patient's health and living conditions, in socioeconomic and familial terms. In the organization of the Oral Health Team service, the need arose to compile these protocols to serve as a reference and standardization of clinical practices for providing patient care at home, in addition to gathering information on the actions developed. There was a conclusive need for systematization of home visits by the dentist to establish a more accurate diagnosis of the oral health status of the population in the coverage area of the Primary Health Care Unit, and consequently, to reduce the backlog in attending to these patients' dental problems.

Inserção do cirurgião-dentista na estratégia de saúde da família: revisão de literatura / Dentist´s inserting in the family health team: literature review

Com a finalidade de contemplar o princípio da integralidade, em 2000, a Equipe de Saúde Bucal (ESB) foi inserida na Estratégia de Saúde da Família (ESF). Assim, este estudo tem por objetivo principal revisar a importância do cirurgião-dentista e o seu papel na ESF. Para isso, foi realizada uma revisão de literatura, utilizando a Biblioteca Virtual de Saúde (BVS) e bancos de dados do Ministério da Saúde, nos quais foram encontrados 18 artigos entre os anos de 2003 e 2011. Também foram pesquisadas as fontes do Pubmed e Cochrane, mas não foram encontrados artigos relacionados ao tema deste trabalho. Diante disso, os critérios de inclusão utilizados no estudo foram artigos científicos relacionados aos objetivos dessa revisão, sendo, portanto, excluídos aqueles não relacionados. Concluiu-se que são necessárias contratações de profissionais especializados em saúde coletiva capazes de desenvolver um trabalho, segundo os princípios do Sistema Único de Saúde, inseridos no trabalho em equipe e comunidade.

In order to contemplate the principle of integrality, in 2000, Oral Health Team was inserted into the Family Health Team (FHT). The aim of this study was to review the importance and role of the dentist in the FHT. Literature review was made using the Virtual Health Library (VHL) and databases of the Brazilian Ministry of Health in which 18 articles were found between the years 2003 and 2011 related to the topic of this work. It was concluded that signings are needed for public health professionals, adequately remunerated, able to develop a working according to the principles of the Health System, inserted into the FHT.

Complicaciones intra y postquirúrgicas de exodoncias en un programa de atención comunitaria de la FOUBA en Junín de los Andes / Intra and postsurgical tooth extraction complications at a FOUBA community dentistry program in Junin de los Andes

El objetivo de este estudio fue analizar la incidencia de complicaciones intra y postquirúrgicas de extracciones simples en 5 días de atención comunitaria en Junín de los Andes, provincia de Neuquén, Argentina. Se realizaron 109 extracciones dentales en 74 de los pacientes que concurrieron al centro único de atención, entre el 27 y 31 de octubre de 2014, presentando piezas dentarias con indicación de extracción. Las complicaciones más frecuentemente encontradas fueron la fractura de la tabla ósea vestibular, la fractura de la corona de la pieza dentaria y el dolor posoperatorio. Complicaciones de frecuencia intermedia fueron el trismus, la alveolitis, la laceración de los tejidos blandos y la fractura de la raíz de la pieza dentaria. Se registró un caso de hemorragia primaria y una inyección accidental dentro de un vaso sanguíneo. Cuando se comparó estadísticamente la presencia de complicaciones pre y posquirúrgicas entre cirugías que duraron menos de 30 minutos y 30 minutos más, se encontró una asociación significativa; para ambas complicaciones, el porcentaje fue mayor en el segundo grupo. La práctica de extracciones simples ocasionalmente conlleva tener que manejar complicaciones. Es importante que el odontólogo general sea capaz de prevenirlas, diagnosticarlas y tratarlas. Reducir los tiempos operatorios parecería ser una medida clave para disminuir las probabilidades de aparición de complicaciones intra y posquirúrgicas.

The objective of this study was to analyze the incidence of intra and postoperative complications of simple extractions in 5 days of community care in Junín de los Andes, province of Neuquén, Argentina. A total of 109 dental extractions were performed in 74 patients who attended the single care center between October 27 and 31, 2014, presenting teeth with indication of extraction. The most frequent complications were the fracture of the buccal bone table, the fracture of the crown of the tooth and the postoperative pain. Complications of intermediate frequency were trismus, alveolitis, laceration of the soft tissues and fracture of the root of the tooth. There was a case of primary haemorrhage and an accidental injection into a blood vessel. When statistically comparing the presence of pre and postsurgical complications between surgeries that lasted less than 30 minutes and 30 minutes more, a significant association was found; for both complications, the percentage was higher in the second group. The practice of simple extractions occasionally entails having to handle complications. It is important that the general dentist be able to prevent, diagnose and treat them. Reducing operative times seems to be a key measure to decrease the chances of intraoperative and postoperative complications.