Maternal Education Level as a Risk Factor for Early Childhood Caries / Maternal Education Level as a Risk Factor for Early Childhood Caries

ABSTRACT Objective: To determine the prevalence and risk factors associated with dental caries in Brazilian preschool children aged 2 to 5 years. Material and Methods: The following independent variables were evaluated: dental caries, dental trauma, and malocclusions. Data were analyzed using the Mann-Whitney test and Poisson regression (p<0.05). Results: The prevalence of dental caries in preschoolers was 55.1%. Child age, family income, maternal education, and tooth color alteration from trauma were significantly associated with dental caries (p<0.05). The final adjusted multivariate model showed a significant association between maternal education and dental caries; children of mothers with low education were 1.89 times more likely to have caries (PR: 1.89; 95%CI: 1.40-2.55) (p<0.01). Children with tooth color change from trauma were more likely to have dental caries (PR: 1.69; 95%CI: 1.22-2.34 (p=0.001). Conclusion: Child age, family income, maternal education, tooth discoloration and discoloration color are risk factors for the development of caries disease in children. Also, children of mothers with low educational levels have a higher chance of developing dental caries.

Differences in dental care for pregnant women in the public sector after the creation of Previne Brasil

Aim: To compare performance differences among dental surgeons in the public sector of the state of Minas Gerais regarding prenatal dental care before and after the establishment of Previne Brasil. Methods: A cross-sectional study was conducted, gathering data through a structured questionnaire. The sample consisted of dental surgeons working in the public sector of municipalities in MG and utilizing the snowball effect. Data analysis was performed using the IBM-SPSS® version 29.0, employing Pearson's Chi-square statistical test (P<0.05). Results: Out of the 28 State Health System (SRS) present in MG. A total of 1696 responses were collected, but after applying the exclusion criteria, 1001 responses remained, specifically related to dental surgeons working in MG public sector. 78.6% comprised professionals who graduated before 2019, while 20.1% graduated after that year. The morning and the second or other gestational trimesters were the most common periods considered optimal for caring for pregnant women. A significant portion of the professionals had not undergone any specific courses or training on this topic, reporting an average satisfaction level of 5.52 regarding the accessibility of information during their education aimed at this audience. Conclusion: Variances were observed in the care provided to pregnant women by dental surgeons working in the public sector of Minas Gerais, distinguishing those trained before and after the implementation of Previne Brasil. The debunking of myths and taboos stands as crucial for enhancing the acceptance of prenatal dentistry

Fatores associados à autoavaliação de saúde bucal por adultos em hemodiálise / Factors associated with self-rated oral health in adults with hemodialysis

Resumo Introdução Pacientes com insuficiência renal crônica podem apresentar prejuízos em sua saúde bucal em decorrência da própria doença, do tratamento e das alterações de estilo de vida associadas. Objetivo Avaliar os fatores associados à autoavaliação de saúde bucal ruim entre adultos com insuficiência renal crônica submetidos à hemodiálise. Método Estudo transversal com 243 adultos submetidos à hemodiálise em um hospital do sul de Minas Gerais nos anos de 2013 e 2014. O desfecho foi avaliado pelo autorrelato da condição bucal dicotomizada em boa (ótima/boa) e ruim (regular/ruim/péssima). As variáveis independentes incluíram condições sociodemográficas, saúde geral, saúde bucal e uso de serviços odontológicos, a partir de informações coletadas por meio de questionário. A associação entre o desfecho e as variáveis independentes foi testada por meio de modelos logísticos múltiplos com inclusão hierarquizada de variáveis. Resultados A prevalência de autoavaliação de saúde bucal ruim foi de 35,4%. Os mais jovens (p = 0,015), os que se submetem à hemodiálise há menos tempo (p = 0,016), têm halitose (p <0,001), necessitam de tratamento odontológico (p <0,001) e tiveram a última consulta odontológica por motivo diferente de dor (p = 0,027) expressaram maiores chances de autoavaliação de saúde bucal ruim, independentemente de condições sociodemográficas e de saúde. Conclusão Condições sociodemográficas, tempo em hemodiálise, agravos à saúde bucal e uso de serviços odontológicos influenciaram a autoavaliação da saúde bucal dos adultos submetidos à hemodiálise.

Abstract Background Patients with chronic renal failure may have their oral health impaired as a result of the disease itself, its treatment, and its associated lifestyle alterations. Objective To assess the factors associated with poor self-rated oral health among adults with chronic renal failure treated by hemodialysis. Method This is a cross-sectional study with 243 adults undergoing hemodialysis in a hospital in Minas Gerais, Brazil in 2013-2014. The outcome was assessed by the self-report of oral health categorized into good (excellent/good) and bad (fair/bad / very bad). The independent variables included sociodemographic conditions, general health, oral health, and the use of dental services were collected through a structured questionnaire. The association between the outcome and the independent variables was tested using multiple logistic models with hierarchical inclusion of variables. Results The prevalence of poor self-rated oral health was 35.4%. The youngest (p = 0.015), those who have undergone hemodialysis in the shortest time (p = 0.016), have halitosis (p <0.001), need dental treatment (p <0.001), and had their last dental appointment not for pain (p = 0.027) expressed higher odds of poor self-rated oral health, independently of sociodemographic and health conditions. Conclusion Sociodemographic conditions, time on hemodialysis, oral impairments, and use of dental services affected the oral health self-assessment among adults undergoing hemodialysis.

Utilização de serviços odontológicos por pacientes em tratamento oncológico / Use of dental services by patients in oncological treatment

Introdução: a busca por atendimento odontológico é um parâmetro importante para averiguar como os indivíduos compreendem a saúde bucal. Objetivo: avaliar a utilização de serviços odontológicos e fatores associados em pacientes oncológicos em Minas Gerais, Brasil. Material e método: estudo transversal, realizado com uma amostra de 441 pacientes adultos frequentadores de uma associação voluntária de apoio a pacientes oncológicos no Estado de Minas Gerais, Brasil. O desfecho foi avaliado por meio do autorrelato de consulta odontológica no último ano. As variáveis independentes incluíram condições socioeconômicas, saúde geral e relacionada ao câncer, saúde bucal e cuidados odontológicos. As associações entre o desfecho e as variáveis independentes foram testadas por meio de regressão logística bivariada e múltipla, sendo os resultados expressos por meio de odds ratio (OR) e intervalos de confiança de 95% (IC95%). Resultado: a prevalência de consulta odontológica no último ano foi de 33,3%. Os indivíduos que possuem entre quatro e sete (OR: 1,80; IC95%: 1,02-3,18) e aqueles com oito ou mais anos de estudo (OR: 3,20; IC95%: 1,07-9,60) apresentaram maiores, enquanto os edêntulos (OR: 0,44; IC95%: 0,21-0,92) apresentaram menores chances de consulta odontológica no último ano, independentemente de condições socioeconômicas, saúde geral e saúde bucal. Conclusão: foi baixa a procura por consulta odontológica no último ano entre os pacientes oncológicos. Além disso, houve desigualdades relacionadas à escolaridade e ao número de dentes remanescentes na utilização dos serviços. A identificação e priorização dos grupos com acesso desfavorável aos serviços são fundamentais no planejamento da prestação de cuidados odontológicos a essa população.

Introduction: the search for dental care is an important parameter to determine how individuals understand the oral health. Objective: to evaluate the use of dental services and associated factors in cancer patients in Minas Gerais, Brazil. Material and method: a cross-sectional study carried out with a sample of 441 adult patients attending a voluntary association to support cancer patients in the State of Minas Gerais, Brazil. The outcome was assessed through self-report of dental appointments in the last year. Independent variables included socioeconomic status, general and cancer-related health, oral health, and dental care. The associations between the outcome and the independent variables were tested using bivariate and multiple logistic regression, and the results were expressed as odds ratios (OR) and 95% confidence intervals (95%CI). Result: the prevalence of dental appointments in the last year was 33.3%. Individuals who have between four and seven (OR: 1.80; 95%CI: 1.02-3.18) and those who have eight or more years of schooling (OR: 3.20; 95%CI: 1.07-9 .60) had greater, whereas, the edentulous (OR: 0.44; 95%CI: 0.21-0.92) had less odds to have had a dental appointment in the last year, independently of socioeconomic status, general health and oral health conditions. Conclusion: recent dental care was uncommon among cancer patients. Furthermore, there were inequalities related to schooling and the number of remaining teeth in the use of services. The identification and prioritization of groups with unfavorable access to services are fundamental in planning the provision of dental care to this population.

Treatment of experimental periodontal disease by laser therapy in simvastatin-modified rats

Abstract Low intensity laser can be used as a promising alternative in the treatment of periodontal disease. Objective The aim of this study was to evaluate low-level laser therapy (LLLT) as an adjuvant treatment for scaling and root planing (SRP) for the treatment of induced periodontitis in simvastatin-modified rats. Material and Methods A total of 180 rats were evenly divided into two groups: Veh - receiving oral administration of polyethylene glycol (vehicle); S - receiving oral administration of Simvastatin. Periodontal disease was induced in both groups at the first mandibular molar. After seven days, the ligature was removed and the animals were divided into subgroups according to the following local treatments: NT - no treatment; SRP - scaling and root planing and irrigation with saline solution; and LLLT ¬- SRP and laser irradiation (660 nm; 0.03 W; 4 J). Ten animals in each subgroup/local treatment were euthanized at 7, 15 and 30 days. Samples of gingival tissue were processed to analyze the tissue oxidative damage and radiographic analysis. Levels of oxidative stress were analyzed by the expressions of Tripeptideglutathione (TG), Malondialdehyde (MDA) and Carbonylated Proteins (CP). Results The animals in S group had higher levels of TG and lower levels of MDA and CP compared with Veh group (p<0.05). Radiographically, in the intragroup analysis Veh and S, LLLT showed lower bone loss (BL) compared with NT and SRP, in all experimental periods (p<0.01). In addition, a lower BL was observed for the animals of Veh group treated with LLLT compared with treatment SRP in the S group, in all experimental periods. Conclusion Within the limits of this study, we can conclude that LLLT was effective as adjuvant treatment for SRP protecting against the occurrence of oxidative tissue damages as well as for reducing alveolar bone loss in experimentally induced periodontitis simvastatin-modified rats.

Local application of statins in the treatment of experimental periodontal disease in rats

Abstract Objective The objective of this study was to evaluate the local effects of statins as adjuvants for treatment by scaling and root planing (SRP) of periodontal disease induced in rats. Material and Methods Ninety rats were used in the present experiment. Periodontal disease was induced in all animals using a cotton thread placed in the left first mandibular molar. After 7 days of induction, the bandage was removed and the animals were divided into three groups: 1) NT group (n=30), no treatment; 2) SRP group (n=30): SRP and irrigation with control gel; 3) S group (n=30) - SRP and irrigation with Simvastatin. Ten animals from each group were euthanized at 7, 15 and 30 days after treatment. Gingival biopsy specimens were processed to analyze the expression of matrix metalloproteinase 8 (MMP-8). The mandibles were removed and submitted to radiographic and laboratory processing for histometric analysis. Results The S group showed a significantly lower expression of MMP-8 compared to NT and SRP groups in all experimental periods. In the radiographic and histometric analyses between the groups, S group showed a significantly lower bone loss (BL) compared to NT and SRP groups in all experimental periods. Conclusions Within the limits of this study, it can be concluded that locally applied statin was effective as an adjuvant treatment for SRP in rats with induced periodontal disease.

Efeitos da Sinvastatina como coadjuvante no tratamento da doença periodontal induzida em ratos / Effects of Simvastatin as supporting in the treatment of periodontal disease induced in rats

O estudo avaliou a Sinvastatina no tratamento da doença periodontal (DP) em ratos. Trinta e seis animais foram divididos em Grupo Controle (C) que receberam oralmente soro fisiológico e Sinvastatina (S) que receberam oralmente Sinvastatina. Após 24 horas, a DP foi induzida utilizando-se um fio de algodão na região dento-gengival dos primeiros molares inferiores esquerdos. Após 7 dias, a ligadura foi removida e os animais receberam raspagem e alisamento radicular (RAR) e irrigação com soro fisiológico. Os animais foram eutanasiados aos 7, 15 e 30 dias. Radiograficamente, o tratamento com RAR mostrou uma menor perda óssea (PO) no Grupo S comparado ao C em todos os períodos. Concluiu-se que a Sinvastatina associada à RAR foi efetiva na redução da PO em ratos.

The study evaluated simvastatin in the treatment of periodontal disease (PD) in rats. 36 animals were divided into control group (C) receiving oral saline and Simvastatin (S) who received oral simvastatin. After 24 hours the PD was induced using a cotton yarn in the dento-gingival area of the first left molar. After 7 days the ligature was removed and animals received scaling and root planing (SRP) and irrigation with saline. The animals were sacrificed at 7, 15 and 30 days. Radiographically treatment with SRP showed less bone loss (BL) in the S group compared to C in all periods. It was concluded that SRP associated with simvastatin was effective in reducing the BL in rats.a

Drug addiction: self-perception of oral health / Drogadição: Autopercepção em Saúde Bucal / Adicción a las drogas: auto percepción de la salud bucal

Objective: To report the self-perception of substance-abusing individuals who were in a recovery process regarding sociodemographic conditions and general and oral health. Methods: Descriptive cross-sectional study conducted in a recovery center for drug addiction in Alfenas, Minas Gerais, Brazil, in 2015, with 39 men aged over 18 years old. Data were collected using a semi-structured questionnaire that addressed: socioeconomic status, selfperception of general and oral health, access to dental care, relationship with the dentist, and other issues. In order to assess the self-perception of oral health, the variable was dichotomized into "satisfactory" and "unsatisfactory", which refer to what the individual acknowledges as a good or poor condition of oral health, using Fisher's exact test with 5% significance level. Results: Most frequent diseases were depression, 35.90% (n=14), insomnia, 35.9%, (n=14) and recurring headache (23.1%; n=9); however, 61.50% (n=24) of the participants reported not getting sick easily, which contrasts with their self-perception. Regarding oral health, only 30.50% (n=12) of the participants reported brushing their teeth three times a day; 53.80% (n=21) had dentinal hypersensitivity; 41.00% (n=16) had dry mouth and bad breath; 30.80% (n=12) claimed to have bruxism and reported having one or more loose teeth; 28.20% (n=11) reported clenching the teeth in an exaggerated way, and 33.30% (n=13) reported feeling tooth pain. Conclusion: The self-perception of individuals ­ under 30 years old, single, white or mulattos ­ regarding their general health was contradictory, as they rated it as good but have reported depression, insomnia and weight loss; additionally, oral health was considered poor with unsatisfactory conditions, which highlights the harmful effects of substance abuse.

Objetivos: Relatar a autopercepção de indivíduos drogaditos que se encontravam em estágio recuperatório, quanto às condições sociodemográficas, de saúde geral e bucal. Métodos: Estudo descritivo e transversal realizado em 2015 em um centro de triagem de recuperação de dependentes químicos, em Alfenas, MG, Brasil, com 39 internos do sexo masculino e acima de 18 anos. Por meio de um questionário semi-estruturado, investigaram-se temas referentes à condição socioeconômica, percepção dos internos em relação à própria saúde geral e bucal, acesso ao tratamento odontológico, relacionamento com o cirurgião-dentista, entre outros. A variável autopercepção em saúde bucal foi dicotomizada em "satisfatória" e "insatisfatória" para aplicação do teste Exato de Fisher, com nível de significância de 5%. Resultados: As doenças mais frequentes foram depressão, 35,90% (n=14), insônia, 35,9%, (n=14) e dor de cabeça recorrente (23,1%; n=9), apesar de 61,50% (n=24) dos internos afirmarem não ficar doentes, indicando autopercepção conflitante. Ao serem questionados sobre a frequência de escovação diária, apenas 30,50% (n=12) mencionaram três vezes ao dia, 53,80% (n=21) com sensibilidade dentinária; 41,00% (n=16) com sensação de boca seca e mal hálito; 30,80% (n=12) bruxismo, 28,20% (n=11) apertamento dental e 33,30% (n=13) dor em algum dente. Conclusão: A autopercepção dos internos analisados com menos de 30 anos, solteiros, brancos ou mulatos, quanto ao seu estado geral de saúde era contraditória, já que classificaram como boa, mas relataram depressão, insônia e perda de peso; e saúde bucal foi considerada ruim com condições insatisfatórias, que destacam os efeitos nocivos do uso de drogas.

Objetivo: Relatar la auto percepción de individuos drogadictos que estaban en proceso de recuperación, respecto las condiciones socio-demográficas y la salud general y bucal. Métodos: Estudio transversal y descriptivo realizado en un centro de recuperación para drogadicción en Alfenas, Minas Gerais, Brasil, en 2015, com 39 hombres con más de 18 años. Los datos fueron recogidos a través de un cuestionario semiestructurado que investigaba la posición socioeconómica, la auto percepción de la salud general y bucal, El acceso al cuidado dental, la relación con el dentista y otros temas. Para evaluar la auto percepción de la salud bucal la variable fue dividida en "satisfactoria" y "no satisfactoria" la cual refiere a los conocimientos del individuo sobre la buena o mala condición de salud bucal utilizando la prueba de Exacto de Fisher con El 5% de nivel de significancia. Resultados: Las enfermedades más frecuentes fueron la depresión con el 35,90% (n=14), el insomnio con el 35,9%, (n=14) y dolor de cabeza recurrente (23,1%; n=9); sin embargo, el 61,50% (n=24) de los participantes relataron no enfermarse con facilidad lo que contrasta con su auto percepción. Respecto a la salud bucal, solamente el 30,50% (n=12) de los participantes relataron cepillar los dientes tres veces al día; El 53,80% (n=21) tuvieron hipersensibilidad dental; el 41,00% (n=16) tuvieron la sensación de boca seca y mal aliento; El 30,80% (n=12) reclamaron de bruxismo y relataron tener uno o más dientes perdidos; el 28,20% (n=11) relataron apretar los dientes de manera exagerada y el 33,30% (n=13) relataron tener dolor de diente. Conclusión: La auto percepción de los individuos - por abajo de los 30 años, solteros, blancos o mulatos - respecto su salud general fue contradictoria ya que clasificaron como buena aunque reportaron la depresión, el insomnio y La pérdida de peso; además, la salud bucal fue considerada pobre con condiciones no satisfactorias, las cuales resalta los efectos nocivos de la substancia abusiva.

Conduta dos cirurgiões dentistas de Alfenas/MG frente ao tratamento emergencial de pacientes com avulsão dentária / Conduct of dentists from the University of Alfenas/MG regarding the emergency treatment of patients with tooth avulsions

Objetivo: Verificar a conduta dos cirurgiões dentistas de Alfenas/MG frente ao tratamento emergencialde dentes avulsionados. Materiais e Métodos: Foram entrevistados 72 profissionais, por meio de um questionário semiestruturado, analisando gênero, idade e período de experiência profissional e questõesespecíficas como conduta do dentista frente a uma lesão dentária do tipo avulsão, em diversas situaçõesclínicas. Resultados: Cinquenta cirurgiões dentistas (69,4%) atenderam algum caso de avulsão, mas apenas 8% relataram ser uma prática rotineira. Em relação ao tempo ideal para a realização de um reimplante dentário, 56 profissionais (77,8%) afirmaram ser imediatamente ou no máximo 30 minutos após o trauma. Quanto ao tratamento imediato do alvéolo, 52,8% dos pesquisados irrigariam o alvéolo com solução salina (NaCl 0,9%), sem remover o coágulo, e, quando tardiamente, 59,7% curetariam para a remoção do coágulo e irrigariam com solução salina. Além disso, 52,8% afirmaram realizar contenção com fio flexível. Quanto ao ajuste oclusal, 54,2% dos entrevistados responderam que deixariam o dente em infra-oclusão. Conclusão: Os resultadosobservados sugerem que os cirurgiões dentistas de Alfenas/MG realizam condutas adequadas com relação àavulsão dentária, quando comparados aos protocolos estabelecidos na literatura

A importância da saúde bucal na ótica de pacientes hospitalizados / The importance of oral health in the view of inpatients

A percepção da condição bucal é um importante indicador de saúde, pois sintetiza a condição real de saúde, as respostas subjetivas, os valores e as expectativas culturais. O estudo avaliou a importância da saúde bucal segundo a percepção de pacientes internados em um hospital da cidade de Araçatuba (SP). Foi aplicado um questionário semi-estruturado para a coleta de dados e utilizado para análise estatística o programa Epi Info 2000. Os resultados mostraram que metade dos pacientes haviam realizado a última visita ao cirurgião-dentista em um período compreendido entre seis a doze meses devido a problemas periodontais (35 por cento) e cárie dentária (20 por cento). Observou-se que, embora todos os pacientes considerassem ter uma "boa" higiene bucal, o tratamento periodontal foi identificado como o de maior necessidade entre os pacientes (67,93 por cento). A presença do cirurgião-dentista no corpo clínico hospitalar foi considerada por todos os entrevistados como fundamental para contribuir no cuidado integral à saúde dos pacientes hospitalizados. Quanto ao papel do dentista em um hospital, a grande maioria dos pacientes (90,63 por cento) afirmou ser o "cuidar dos dentes". Assim, conclui-se que todos os pacientes têm conhecimento do quão é importante a manutenção das condições adequadas de saúde bucal, principalmente em pacientes hospitalizados.

The perception of oral condition is an important health indicator as it synthesizes the condition of objective health, subjective answers, cultural values and expectative. The study evaluated the importance of oral health according to the perception of inpatients of a hospital unit at Araçatuba city, São Paulo State. A partially structured questionnaire was used to collect data. The program Epi Info 2000 was used to statistics analysis. The results show that half of patients affirmed that visited a dental surgeon on a period between 6 and 12 months due to periodontal problems (35 percent) and dental caries (20 percent). It was observed that although all patients consider to have a good oral hygiene, the periodontal treatment was identified like the more necessary among them (67.93 percent). The presence of a dental surgeon at the hospital clinical group was considered by all the patients essential to collaborate with the integral care of health of inpatients. About the role of dental surgeon in a hospital, the majority of patients (90.63 percent) affirmed to be the act of "caring on the teeth". So, it is possible to conclude that all the patients know the importance of the maintenance of oral health appropriated conditions specially of inpatients.

Traumatismo alvéolo-dentário: prevalência em crianças e conhecimento de educadores do ensino fundamental / Dentoalveolar trauma: prevalence in children and knowledge of elementary school educator

As lesões traumáticas dentárias são consideradas em certas partes do mundo um importante problema de saúde pública, não somente porque a sua prevalência é elevada, mas também porque resulta em impacto substancial na qualidade de vida das crianças. O presente estudo avaliou o conhecimento e a atitude dos educadores do ensino fundamental da rede pública de Alfenas/MG, Brasil, sobre as Lesões Traumáticas Dentárias (LTDs) e ainda a prevalência e os fatores de risco entre crianças de 6 a 12 anos. Para tanto foram entrevistados 212 educadores na faixa etária de 23 a 64 anos, sendo que 93,4% apresentavam formação universitária e 25,5% tinham até cinco anos de experiência profissional. Quanto ao treinamento de primeiros-socorros, 34% o haviam realizado durante sua formação acadêmica ou por vontade própria (22,6%). Entre esses, apenas 7,1% haviam recebido treinamento envolvendo o conteúdo das LTDs. Apenas 7,5% estavam satisfeitos com o conhecimento sobre trauma dental e somente 12,3% sentiam-se preparados para atuar frente a essa intercorrência. Somente 10,8% haviam presenciado algum tipo de LTDs. Em relação à busca de auxílio dentro da escola, em caso de trauma dental, 53,3% se direcionariam a diretora e 8% ao cirurgião-dentista da escola. A primeira conduta dos professores frente à fratura e avulsão dentária seria o contato com os pais da criança (63,2% e 58,5%, respectivamente). Frente a um dente avulsionado, 47,2% realizariam a conduta adequada manuseando o dente pela coroa. A maioria dos professores (90,1%) faria um reimplante dental de dentes permanentes, sendo isto feito imediatamente (71,2%). Quanto ao meio de armazenamento do dente avulsionado, 36,3% dos professores acondicionariam o elemento em um líquido, sendo o leite (46,7%) e o soro (24,7%) os mais mencionados. Os meios secos mais citados foram o papel (18,9%) e gaze ou algodão (15,1%). A maioria (96,2%) afirmou que gostaria de receber informações sobre trauma dental. Quanto a ocorrência das LTDs e...

Dental traumatic lesions are considered a relevant public health problem in certain parts of the world, not only because their prevalence is high, but also because it results in a substantial impact on children’s life quality. The present study evaluated the knowledge and attitude of public elementary school educators about Dental Traumatic Lesions (DTLs) in Alfenas/MG, Brazil, as well as the prevalence and risk factors among children from 6 to 12 years of age. To achieve this aim 212 educators, ranging from 23 to 64 years of age were interviewed; they had college education (93.4%) and those with up to five years of professional experience (25.5%). With regard to first-aid training, 34% had taken it during their college course or even voluntarily (22.6%). Among those, only 7.1% had taken training involving DTLs content. Only 7.5% were satisfied with the knowledge about dental trauma and only 12.3% felt prepared to take an attitude towards this emergency. Only 10.8% had actually seen some kind of DTL. Regarding aid search inside the school in case of dental trauma, 53.3% would call the headmaster and 8% would seek for the school’s dentist. The first attitude of the teachers towards dental fracture and avulsion would be contact child’s parents (63.2% and 58.5%, respectively). When facing an avulsed tooth, 47.2% would take the appropriate attitude handling the tooth by the crown. Most of the teachers 90.1% would perform permanent teeth reimplant, most of them immediately (71.2%). Concerning the storage medium of the avulsed tooth, 36.3% of the teachers would store the element in a liquid, being milk (46.7%) and saline solution (24.7%) the most prevalent. The most mentioned dry media were paper (18.9%) and gauze or cotton (15.1%). Most of the teachers (96.2%) stated that they would like to receive information on dental trauma. Considering the occurrence of DTLs and risk factors related, 1,635 children were examined with mean age of 8.82 years, adopting the criteria…

Traumatismo alvéolo-dentário: prevalência em crianças e conhecimento de educadores do ensino fundamental / Dentoalveolar trauma: prevalence in children and knowledge of elementary school educator

As lesões traumáticas dentárias são consideradas em certas partes do mundo um importante problema de saúde pública, não somente porque a sua prevalência é elevada, mas também porque resulta em impacto substancial na qualidade de vida das crianças. O presente estudo avaliou o conhecimento e a atitude dos educadores do ensino fundamental da rede pública de Alfenas/MG, Brasil, sobre as Lesões Traumáticas Dentárias (LTDs) e ainda a prevalência e os fatores de risco entre crianças de 6 a 12 anos. Para tanto foram entrevistados 212 educadores na faixa etária de 23 a 64 anos, sendo que 93,4% apresentavam formação universitária e 25,5% tinham até cinco anos de experiência profissional. Quanto ao treinamento de primeiros-socorros, 34% o haviam realizado durante sua formação acadêmica ou por vontade própria (22,6%). Entre esses, apenas 7,1% haviam recebido treinamento envolvendo o conteúdo das LTDs. Apenas 7,5% estavam satisfeitos com o conhecimento sobre trauma dental e somente 12,3% sentiam-se preparados para atuar frente a essa intercorrência. Somente 10,8% haviam presenciado algum tipo de LTDs. Em relação à busca de auxílio dentro da escola, em caso de trauma dental, 53,3% se direcionariam a diretora e 8% ao cirurgião-dentista da escola. A primeira conduta dos professores frente à fratura e avulsão dentária seria o contato com os pais da criança (63,2% e 58,5%, respectivamente). Frente a um dente avulsionado, 47,2% realizariam a conduta adequada manuseando o dente pela coroa. A maioria dos professores (90,1%) faria um reimplante dental de dentes permanentes, sendo isto feito imediatamente (71,2%). Quanto ao meio de armazenamento do dente avulsionado, 36,3% dos professores acondicionariam o elemento em um líquido, sendo o leite (46,7%) e o soro (24,7%) os mais mencionados. Os meios secos mais citados foram o papel (18,9%) e gaze ou algodão (15,1%). A maioria (96,2%) afirmou que gostaria de receber informações sobre trauma dental. Quanto a ocorrência das LTDs e...

Dental traumatic lesions are considered a relevant public health problem in certain parts of the world, not only because their prevalence is high, but also because it results in a substantial impact on children’s life quality. The present study evaluated the knowledge and attitude of public elementary school educators about Dental Traumatic Lesions (DTLs) in Alfenas/MG, Brazil, as well as the prevalence and risk factors among children from 6 to 12 years of age. To achieve this aim 212 educators, ranging from 23 to 64 years of age were interviewed; they had college education (93.4%) and those with up to five years of professional experience (25.5%). With regard to first-aid training, 34% had taken it during their college course or even voluntarily (22.6%). Among those, only 7.1% had taken training involving DTLs content. Only 7.5% were satisfied with the knowledge about dental trauma and only 12.3% felt prepared to take an attitude towards this emergency. Only 10.8% had actually seen some kind of DTL. Regarding aid search inside the school in case of dental trauma, 53.3% would call the headmaster and 8% would seek for the school’s dentist. The first attitude of the teachers towards dental fracture and avulsion would be contact child’s parents (63.2% and 58.5%, respectively). When facing an avulsed tooth, 47.2% would take the appropriate attitude handling the tooth by the crown. Most of the teachers 90.1% would perform permanent teeth reimplant, most of them immediately (71.2%). Concerning the storage medium of the avulsed tooth, 36.3% of the teachers would store the element in a liquid, being milk (46.7%) and saline solution (24.7%) the most prevalent. The most mentioned dry media were paper (18.9%) and gauze or cotton (15.1%). Most of the teachers (96.2%) stated that they would like to receive information on dental trauma. Considering the occurrence of DTLs and risk factors related, 1,635 children were examined with mean age of 8.82 years, adopting the criteria…

Percepção dos coordenadores de saúde bucal e cirurgiões-dentistas do serviço público sobre o Sistema Único de Saúde (SUS) / Perception of oral health coordinators and dental surgeons who work in the public service about the National Health System (SUS)

O profissional de saúde é um ponto-chave para a implementação do Sistema Único de Saúde (SUS). À medida que exerce sua função, o sistema passa do aspecto teórico-conceitual para a prática da atenção. Objetivou-se neste estudo verificar o nível de conhecimento sobre o Sistema Único de Saúde (SUS) dos coordenadores de saúde bucal e cirurgiões-dentistas do serviço público dos 40 municípios da região noroeste do Estado de São Paulo. Utilizou-se um questionário estruturado, autoaplicável, composto de questões referentes aos princípios doutrinários e organizativos do SUS, controle social, financiamento, formação de recursos humanos, atenção e assistência em saúde. Dos entrevistados, 77 (89,5 por cento) não sabiam quem era o responsável pelo planejamento e execução da assistência, 53 (61,6 por cento) não tinham conhecimento de equidade, 46 (53,5 por cento) de fundo de saúde e 45 (52,3 por cento) de controle social. Conclui-se que existe deficiência no conhecimento de determinados assuntos, havendo necessidade de promoção de cursos a respeito da filosofia do SUS.

The health professional is a key element for the implementation of Sistema Único de Saúde (SUS - National Health System). As it executes its function, this system goes from the theoretical and conceptual aspect to the care practice. The aim of this study was to verify the knowledge level about the National Health System (SUS) of the oral health coordinators and dental surgeons working in the public service of the forty cities located in the northwest region of the State of São Paulo. The study used a structured, self-administered questionnaire with questions about the National Health System's doctrinal and organizational principles, social control, financing, human resources education, health care and assistance. Among the interviewees, 77 (89.5 percent) did not know who was responsible for the planning and execution of assistance, 53 (61.6 percent) did not have knowledge about equity, 46 (53.5 percent) about health capital and 45 (52.3 percent) about social control. The conclusion was that there is lack of knowledge regarding some subjects; therefore, it is necessary to offer courses about the philosophy of the National Health System (SUS).

El certificado odontológico, para justificar al trabajador, ¿es un derecho asegurado? / Is dental sick leave a guaranteed right?

Se tuvo como objetivo verificar en este trabajo la validación (aceptación) de los certificados odontológicos por las industrias asociadas al CIESP (Centro de las Industrias del Estado de São Paulo) de la región noroeste del Estado de São Paulo, Brasil. Se utilizó como instrumento de recolección de datos un cuestionario semi-estructurado, auto-aplicable, compuesto por preguntas abiertas y cerradas, referentes a la actividad y tamaño de la industria, realización de exámenes obligatorios, aceptación y validación de los certificados odontológicos y tipo de asistencia odontológica proporcionada por la industria. La mayor parte, 58 de ellas (92%), de las industrias aceptaba certificado odontológico; sin embargo, 24 (41,4%) aceptaban solamente en el caso de cirugías y extracciones dentarias y 4 (6,8%) después de la homologación del médico del trabajo. Además, para que el certificado odontológico tuviera validez era exigida la presencia de la Clasificación Internacional de Enfermedades (CIE) por la mayor parte, 46 (79,3%), de las industrias. La aceptación del certificado odontológico por las industrias investigadas es alta, a pesar de existir la dependencia del tipo de procedimiento y presencia de la CIE.

The aim of the this work was to verify the validation (acceptance) of odontological clean bill of health by industries associated to CIESP (Centre of Industries of São Paulo state) of the Northeast region of São Paulo state, Brazil. A questionnaire was used as an instrument of data collecting, which was semi- structured, self applying, composed by open and closed questions, referring to activity and size of the industry, carrying out the obliged exams, acceptance and validation of the odontological clean bill of health and type of odontological assistance offered by the industry. The majority 58 (92%) of the industries accepted odontological clean bill of health, however, 24 (41,4%) took them only in cases of surgeries and exodonty and 4 (6,8%) after homologation of the job´s doctor. Moreover, for the validity of the odontological clean bill of health, was asked the presence of the International Classification of Diseases by great part of the industries – 46 (79,3%) . The acceptance of the odontological clean bill of health by the researched industries is high, although, there is the dependence of the type of procedure and presence of the International Classification of Diseases.

Tratamento restaurador atraumático e sua utilização em saúde pública / Atraumatic restorative treatment and its use in public health dentistry

Em muitos países, inclusive no Brasil, a Odontologia tradicional estritamente curativista não consegue estabelecer melhores índices de Saúde Bucal, pois além da prevalência elevada de cárie dentária encontram-se as barreiras econômicas por parte do paciente e doprofissional, o qual muitas vezes não consegue obter equipamentos necessários para a realização de assistência odontológica. O Tratamento Restaurador Atraumático foi proposto como uma nova abordagem para o tratamento da cárie, pois visou atender as populações carentes desprovidas de energia elétrica e reduzir custos. Este tipo de tratamento busca também respeitar um dos principais conceitos atuais da prática odontológica que é criar um ambiente favorável que detenha o processo da doença cárie através da mínima intervenção e máxima preservação das estruturas dentárias. Além do aspecto curativista dos preparos cavitários e restaurações, somam-se as vantagens da preocupação voltada para a promoção de saúde, educação e motivação dos pacientes. Frente ao exposto, este artigo tema finalidade de expor e discutir os principais aspectos relacionados com esse tipo de tratamento restaurador vinculado à Saúde Públicapor meio de uma revisão de literatura.

In many countries, including Brazil, strictly curative traditional dentistry was unable to establish improved Oral Health indices, because in addition to the high prevalence of dental caries, both patients and professionals encounter economic barriers; the latter are frequently unable to obtain the equipment required for providing dental assistance. Atraumatic Restorative Treatment was proposed as a new approach to caries treatment, as the goal was to attend needy populations that lived under conditions without electrical power supply, as well as to reduce costs. This type of treatment also seeks to respect one of the main current concepts of dental practice, which is to create a favorable environment that halts the caries disease process by means of minimum intervention and maximum preservation of dental structures. In addition to the curative aspect of cavity preparations and restorations, there are the added advantages of concern focusedon health promotion, education and patient motivation. In view of the above explanation, the purpose of this article is to expound and discuss the main aspect related to this type of restorative treatment linked to Public Health, by means of a literature review.

Analysis of the ethical aspects of professional confidentiality in dental practice

From the point of view of deontological ethics, privacy is a moral right that patients are entitled to and it is bound to professional confidentiality. Otherwise, the information given by patients to health professionals would not be reliable and a trustable relationship could not be established. The aim of the present study was to assess, by means of questionnaires with open and closed questions, the awareness and attitudes of 100 dentists working in the city of Andradina, São Paulo State, Brazil, with respect to professional confidentiality in dental practice. Most dentists (91.43 percent) reported to have instructed their assistants on professional confidentiality. However, 44.29 percent of the interviewees showed to act contradictorily as reported talking about the clinical cases of their patients to their friends or spouses. The great majority of professionals (98.57 percent) believed that it is important to have classes on Ethics and Bioethics during graduation and, when asked about their knowledge of the penalties imposed for breach of professional confidentiality, only 48.57 percent of them declared to be aware of it. Only 28.57 percent of the interviewees affirmed to have exclusive access to the files; 67.14 percent reported that that files were also accessed by their secretary; 1.43 percent answered that their spouses also had access, and 2.86 percent did not answer. From the results of the present survey, it could be observed that, although dentists affirmed to be aware of professional confidentiality, their attitudes did not adhere to ethical and legal requirements. This stand of health professionals has contributed to violate professional ethics and the law itself, bringing problems both to the professional and to the patient.

Análisis de los criterios establecidos por el cirujano dentista ante la fijación de honorarios y la forma de pago / Analysis of the criteria established by the dental surgeon for the application of fees and payment modalities

Toda actividad humana que se convierte en utilidad se debe pagar de alguna manera. Se denominan honorarios la forma de remuneración a aquellos que ejercen una profesión liberal, es decir, que poseen un acopio técnico-científico y cultural propio. En la odontología es muy difícil el estandarizarse honorarios, puesto que, principalmente en el ejercicio privado, es grande el número de las variables del profesional, del paciente, de la comunidad y del caso en sí mismo que condicionan los costes. El código de ética odontológica no conceptúa honorarios, sólo establece criterios, sin obligar, autorizar o prohibir al profesional que estipule honorarios. El objetivo del presente trabajo fue verificar junto a los cirujanos-dentistas de las ciudades de Jales y Santa Fé do Sul, Estado de São Paulo, Brasil, cómo se hacen los análisis de los criterios establecidos por el cirujano-dentista ante a la fijación de honorarios y a la forma de pago. Se ha aplicado un cuestionario conteniendo preguntas abiertas y cerradas a 100 cirujanos-dentistas registrados en el Consejo Regional de Odontología. Evaluándose los resultados, observamos que la mayoría, o sea, el 46,5 por ciento de los entrevistados afirmó que recibe sus honorarios en cheque y se lleva en cuenta la complejidad del caso para establecerlos (25,6 por ciento); el 54,6 por ciento fija sus honorarios basados en alguna tabla; el 19,8 por ciento no considera justo lo que recibe y el 60,5 por ciento ya ha tenido problemas con incumplimiento. A través de los resultados se puede verificar que gran parte de los cirujanos-dentistas sienten dificultades en establecer sus honorarios y además se encuentran insatisfechos con lo que reciben.

Every human service that is transformed into utility must be paid by certain way. It is known as honorarium the remuneration paid to those who exert a liberal profession, that is, those that have a technical-scientific and cultural heap of their own. In dentistry, it is very difficult to standardize the honorarium due to the great amount of professional variables, derived from patients, from the community and from the individuality of each clinical case, which condition the costs. According to dental ethics code, honorarium is not conceptualized, but criteria are established without obliging, authorizing or prohibiting the professional to estimate the honorarium. The aim of this study was to verify the criteria applied by dental surgeons from Jales and Santa Fe do Sul - SP, to establish their honorarium, as well as the way of payment. A questionnaire containing dissertative and multiple - choice tests was applied to 100 members of the Regional Dentistry Council of this cities. The results indicated most of the subjects, that is, 46,5% received their honorarium by checks and the values were established according to the complexity of clinical case ( 25,6% ); 54,6% determined their honorarium based upon some tables, for 19,8% of the subjects, their honorarium was not considered to be fair and 60% had problems with debtor patients. Through these result one can conclude most of the dentists felt difficulty in establishing their honorarium and considered that their remuneration was not fair.

Toda atividade humana que se transforma em utilidade deve ser paga de alguma forma. Denominam-se honorários a forma de remuneração àqueles que exercem uma profissão liberal, isto é, que possuem um acervo técnico-científico e cultural próprio. Em odontologia é muito difícil se padronizar honorários, pois, principalmente entre autônomos, é grande o número de variáveis do profissional, do paciente, da comunidade e do caso em si que condicionam os custos. O Código de ética odontológico não conceitua honorários, apenas estabelece critérios, sem obrigar, autorizar ou proibir o profissional de estipular honorários. O objetivo do presente trabalho foi verificar, junto aos cirurgiões-dentistas das cidades de Jales e Santa Fé do Sul - SP, como são feitas as análises dos critérios estabelecidos pelo cirurgião-dentista frente à fixação de honorários e ao tipo de pagamento. Foi aplicado um questionário contendo questões abertas e fechadas à 100 cirurgiões-dentistas cadastrados no CRO dessas regiões. Analisando-se os resultados observamos que a maioria, ou seja, 46,5% dos entrevistados afirmaram receber seus honorários em cheque e levam em consideração a complexidade do caso para estabelecê-los (25,6%); 54,6% fixa seus honorários baseados em alguma tabela; 19,8% não acha justo o que recebem e 60,5% já tiveram problemas com inadimplência. A partir dos resultados pode-se verificar que grande parte dos cirurgiões-dentistas sentem dificuldades de estabelecer seus honorários além de estarem insatisfeitos com o que recebem.