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

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

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

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

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