Profile of Dental Caries in Eastern and Western Parakanã Children at Amazônia Paraense, Brazil

ABSTRACT Objective: To evaluate the prevalence of dental caries in children from 18 months to 5 years of age in eastern (near urban centers) and western (far from urban centers) Parakanã, verify the influence of proximity to non-indigenous cultures, and compare with other ethnicities and non-indigenous. Material and Methods: The universe of children was examined by one researcher in a cross-sectional study. Descriptive analysis and the Mann-Whitney test (p<0.05) were performed. Results: It was observed that 68.8% (N = 53) of children from 18 to 36 months of age presented dmft = 0 (without caries), while 12.5% (N = 6) of children of five years of age presented this condition. For children between 18 and 36 months, the average dmft values were 0.74 (SD=1.91) for eastern children and 1.25 (SD=1.65) for western children. At five years of age, the average dmft values were 4.35 (SD=3.29) and 3.75 (SD=2.05) for eastern and western, respectively. Mann-Whitney test (p<0.05) showed no difference between East and Western children. When compared with non-indigenous Brazilian children, the values behaved similarly. Conclusion: Knowledge of the epidemiological profile of dental caries in Indigenous Parakanã children is relevant both in planning oral health actions for this population and for aggregating information, which is still scarce for Indigenous.

Contextual and local determinants associated with the achievement of goals in the endodontics specialty in Brazilian dental speciality centres: A multilevel analysis.

OBJECTIVES: To assess which factors were associated with the achievement of endodontic goals. METHODS: Cross-sectional study using secondary data from the second cycle of the Program for the Improvement of Access and Quality in the dental speciality centres-in Portuguese PMAQ-CEO. The independent variables extracted from this database were related to dental speciality centres (CEO in Portuguese). In addition, variables referring to the CEO host city were incorporated into the model. The outcome variable was the number of endodontic goals achieved calculated from the production of the CEO available in the Ambulatory Health Information System in 2018. Descriptive analyses and multilevel Poisson regression were performed with the software SPSS 23.0 and STATA 14.0. RESULTS: CEOs with more than 20% of patients' absenteeism were 26% less likely to reach the goals of the endodontics specialty; CEOs with availability of endodontists for more than 40 hours a week were two times more likely to reach the goals than those with less than 40 hours in endodontics specialty. CEOs with a waiting time for endodontic procedures greater than 45 days achieved a number of goals 31% lower than those with a waiting time up to 45 days. CEO type I and CEO type II showed 2.10 and 1.20 higher likelihood to reach the number of goals of the endodontics specialty than CEO type III. The number of endodontic instruments in sufficient number was positively associated with the achievement of goals. CEOs located in municipalities that reached more than 5% in the supervised brushing indicator had 2.26 greater likelihood to achieve the goals than those that did not reach this percentage. CONCLUSION: Contextual and local determinants are associated with the achievement of goals in the endodontic specialty in the dental speciality centres in Brazil.

Contextual and individual determinants of the need for endodontic treatment in adults in Brazil: A multilevel analysis.

AIM: To examine the relationship between contextual and individual determinants with the need for endodontic treatment in Brazilian adults. METHODS: Individual-level data from 6897 adults aged 35-44 years living in the Brazilian state capitals who participated in the Brazilian Oral Health Survey (SBBrasil 2010 Project) were combined with city-level data. Individual- and city-level variables were selected to represent the structural and intermediate determinants of health according to the WHO model of social determinants of health. The association of independent variables with one or more teeth in need of endodontic treatment was evaluated using multilevel logistic regression to estimate the odds ratio (OR) and 95% confidence intervals (CI). RESULTS: The prevalence of the need for endodontic treatment was 7.7%. Adults living in cities with better contextual socioeconomic conditions (OR 0.82; 95% CI = 0.72-0.93) and better specialized dental services (OR 0.85; 95% CI = 0.77-0.95) were less likely to need endodontic treatment. Younger age, greater schooling and use of private dental services reduced the odds of need for endodontic treatment. Number of people per room, type of dental service and reason for the last dental visit were also associated with need of endodontic treatment. CONCLUSION: Contextual and individual factors were relevant determinants of endodontic treatment needs in adults.

Factors associated with the needs of specialised dental treatment among adults aged 35-44 years old in the state of Minas Gerais, Brazil: a multilevel cross-sectional study.

This study evaluated the individual and contextual factors associated with the specialised dental treatment needs of a population of adults aged 35 to 44 years old in the state of Minas Gerais. The individual variables were obtained from the database of the SB Minas Gerais project - a survey of oral health status of the population of Minas Gerais, Brazil. The variables at the municipal level were derived from any available public databases related to oral health services. A multilevel analysis was performed to evaluate the association of independent individuals and contextual variables with or without dental treatment needs in the secondary care of the oral health network. Individuals with a higher income (OR 0.53; CI95% 0.31-0.93) and with greater access to oral health care (OR 0.94; CI95% 0.90-0.99) had less secondary care treatment needs. Income and access to oral health care are related to the needs of specialised dental treatment in Minas Gerais.

The Role of Organizational Factors and Human Resources in the Provision of Dental Prosthesis in Primary Dental Care in Brazil.

This study aimed to investigate factors associated with dental prosthesis procedures by oral health teams (OHTs) in the Brazilian primary health care in 2013-2014, who participated in the National Program for Improving Access and Quality of Primary Health Care (PMAQ-AB). This is an analytical cross-sectional study using a questionnaire with dichotomous questions applied in 18,114 OHTs. The dependent variable studied was making any type of prosthesis (removable or fixed). Independent variables involved issues related to human resources and health service management. Data were submitted to simple and multiple binary logistic regression with odds ratio calculation, 95% confidence intervals, and p-values. Most OHTs (57%) do not perform any dental prosthesis. The teams that are more likely to perform dental prostheses have human resources-related characteristics, such as professionals admitted through public examinations (OR 1.25, 95% CI 1.14-1.36) and those involved in permanent education (OR 1.13, 95% CI 1.02-1.26). Moreover, OHTs with a more organized work process and that receive more significant support from municipal management are more likely to perform dental prostheses (p < 0.05). The oral health teams which tended to provide the most dental prostheses to benefit patients were; hired as civil servants, had a municipal career plan, involved all members of the oral health team, and trained undergraduate dental students from outreach programs. Better organizational support and improved work incentives may be needed to get the majority of oral health teams to start providing dental prostheses to their patients.

Association Between Water Sanitation and Living Conditions and Dental Caries in Brazilian Schoolchildren

Abstract Objective: To analyze the association between water sanitation and living conditions and dental caries in Brazilian schoolchildren. Material and Methods: A list containing names of children enrolled in 18 urban public schools was obtained. Then, data registered by community health agents from the family health strategy were consulted, aiming to obtain information about socio-environmental variables such as house type, number of rooms in the house, water supply, water treatment, waste, feces and urine disposal. For sample calculation, 95% confidence level, 80% test power and 5% error rate were used A total of 199 5-year-old and 137 12-year-old schoolchildren participated in the research. For examinations, World Health Organization recommendations for epidemiological surveys of dental caries were followed. Results: For 5-year-old children, dental caries prevalence was related to municipality of origin, water supply system and sewage system. For 12-year-old children, untreated water and waste collection were related to higher dental caries rates. Conclusion: Dental caries was associated to house type and water sanitation.

Factors associated with the inclusion of oral health technicians into the public health service in Brazil.

BACKGROUND: The number of oral health technicians (OHT) in the public health service in Brazil is lower than the number of training school graduates. Thus, the objective of this study was to investigate possible factors associated with the inclusion of OHT in the public health service in Minas Gerais, Brazil, and its implications on oral health indicators. METHODS: This cross-sectional ecological study used a database (Excel) composed of 122 municipalities that participated in an OHT training course that took place between 2012 and 2013. Municipal contextual variables, including oral health indicators and sociodemographic indicators, related to the organization of health services were incorporated before and after the course. The dependent variable was the entry of graduates into the public health service according to a self-report survey conducted in 2015. A descriptive analysis of the variables was carried out, followed by bivariate analyses between the independent variables and the dependent variable using Pearson's chi-square test. The independent variables selected for multivariate logistic regression were statistically significant at p <  0.20. In the final model, significant effects were identified for variables with p <  0.05. The statistical software SPSS 18.0 for Windows was used. RESULTS: After the course, the variable of the public service organization and the two variables of oral health indicators were associated with the outcome. The organization services variable "presence of oral health team modality II" and the variable "indicator of coverage of first dental programmatic consultation" presented an association tendency with the entry of OHT in the multivariate logistic regression model, but these associations were not statistically significant because they had significance levels of p = 0.075 and p = 0.191, respectively. The variable "collective action indicator supervised dental brushing" was associated with the entry of egress (p = 0.045) remaining in the final model. CONCLUSION: The model of organization of the oral health service formed through the implementation of modality II oral health teams positively influenced the inclusion of OHT in the public health service in Minas Gerais, with improvement in the oral health indicators of the municipalities.

Sentinel event in oral health: experience with children with up to six years of age, users of the Unified Health System / Evento sentinela em saúde bucal: experiência com crianças até seis anos de idade usuárias do Sistema Único De Saúde

ABSTRACT Objective: The aim of this study was to find out the children's profile identified as Sentinel Event in oral health by the Municipal Health Department of the city of Belo Horizonte, State of Minas Gerais, Brazil. Methods: A quantitative, analytical, exploratory and documentary analysis study was developed in the city of Belo Horizonte, State of Minas Gerais, Brazil, involving 545 children, age ranging from zero to six years old. Sentinel event data were collected through an electronic form created in the Unified Health System and filled out by the municipal oral health teams. Information systems of the city council were consulted. The variables studied were as follows: Health Vulnerability Index, race/color, age, sex, to be beneficiary of the Bolsa Família Program (a social program sponsored by the government), to be monitored by the Strategy of the Family Health Program, to reside in the Belo Horizonte Citizenship Program area, nature of the school and region of residence. Statistical analysis was performed in the SPSS software, 20th version. Results: The results showed that the majority of children live in areas of medium and high social risk, they are five to six years old, male, dark-skinned, do not benefit from the Bolsa Família program, are not under the Strategy of the Family Health Program, do not reside in the territory of the Belo Horizonte Citizenship Program, and study in institutions of the municipal education network. The sentinel event is present in the nine regions of Belo Horizonte, with a higher prevalence in the regions of Venda Nova, Northeast, West, East and Barreiro. Conclusion: The study demonstrates the crucial importance of comprehensive social policies in order to influence oral health.

RESUMO Objetivo: Conhecer o perfil das crianças identificadas como evento sentinela em saúde bucal pela Secretaria Municipal de Saúde de Belo Horizonte. Métodos: Um estudo quantitativo, analítico, exploratório e de análise documental, foi desenvolvido em Belo Horizonte, Brasil, envolvendo 545 crianças de zero a seis anos de idade. Os dados dos eventos sentinela foram coletados por meio de um formulário eletrônico criado no Formulário do Sistema Único de Saúde e preenchido pelas equipes de saúde bucal municipais. Também foram consultados sistemas de informação da Prefeitura Municipal de Belo Horizonte. As variáveis estudadas foram: Índice de Vulnerabilidade à Saúde, raça/cor, idade, sexo, ser beneficiário do Programa Bolsa Família, ser acompanhado pela Estratégia da Saúde da Família, residir na área do Belo Horizonte Cidadania, natureza da instituição escolar e regional de residência. A análise estatística foi realizada no programa SPSS versão 20.0. Resultados: A maior parte das crianças reside em áreas de média e elevada vulnerabilidade à saúde, são pardas, têm de cinco a seis anos de idade, são do sexo masculino, não beneficiárias do Programa Bolsa família, não são acompanhadas pela Estratégia Saúde da Família, não residem em território do Programa BH cidadania e estudam em instituições próprias da rede municipal de ensino. O evento sentinela está presente em toda a cidade de Belo Horizonte, com maiores prevalências nas regionais Venda Nova, Nordeste, Oeste, Leste e Barreiro. Conclusão: O estudo demonstra como a adoção de políticas sociais abrangentes pode influenciar a situação de saúde bucal.

Availability of Dental Prosthesis Procedures in Brazilian Primary Health Care.

OBJECTIVES: To describe dental prosthesis provision in the Brazilian public health service and report the performance of dental prosthesis procedures according to the Brazilian macroregions. METHODS: A structured interview was conducted with senior-level health professionals from each of the 18,114 oral health teams (OHT). The dependent variables were performance of removable prostheses and prosthesis procedures, including provision of fixed prostheses by OHT. Descriptive statistics were produced together with performing a cluster analysis using SPSS version 19.0. RESULTS: The manufacture of any type of prosthesis was done by a minority of OHT (43%). The most commonly provided types of dental prosthesis were removable full and partial dentures. Cluster 1 (teams that performed prosthesis procedures the most) was composed of a smaller number of teams (n = 5,531), and Cluster 2 (composed of teams that do not perform prosthetics or that perform them in small amounts) consisted of 12,583 teams. The geographic distribution of clusters reveals that the largest proportion of Cluster 1 teams is located in the Northeast (33.9%) and Southeast (33.6%). CONCLUSIONS: A minority of OHT produce dental prostheses. There is an unequal geographical distribution of clusters.

Filling process of the Child Health Record in health care services of Belo Horizonte, Minas Gerais, Brazil. / Preenchimento da Caderneta de Saúde da Criança nos serviços de saúde em Belo Horizonte, Minas Gerais, Brasil.

OBJECTIVE: to describe the filling process of the Child Health Record (CHR) in health care services. METHODS: descriptive study held in Belo Horizonte, Minas Gerais, Brazil; an interview was conducted with parents/guardians of children aged 3-5 years old; 21 essential items to child monitoring were observed in the CHR during the 2014 Multi-vaccination Day; fields that should be filled in maternity wards, Primary Health Care (PHC), and other services were assessed separately. RESULTS: 367 children (96.1%) were included; 44.5% of CHR presented ≥60% of completeness; among the items that should be recorded in maternity wards, birth weight showed the highest proportion of completeness (64.5%); for those that should be filled in PHC/other services, records of vaccines (94.0%) presented the highest completeness; there was more filling in maternity wards than in PHC and other services (p<0.001). CONCLUSION: a low proportion of filling was observed, especially in PHC and other services.

Preenchimento da Caderneta de Saúde da Criança nos serviços de saúde em Belo Horizonte, Minas Gerais, Brasil / Llenado del Libro de Salud del Niño en los servicios de salud en Belo Horizonte, Minas Gerais, Brasil / Filling process of the Child Health Record in health care services of Belo Horizonte, Minas Gerais, Brazil

Objetivo: descrever o preenchimento da Caderneta de Saúde da Criança (CSC) nos serviços de saúde. MÉTODOS: estudo descritivo, desenvolvido em Belo Horizonte, Minas Gerais, Brasil; realizou-se entrevista com os pais/responsáveis de crianças de 3 a 5 anos de idade e observaram-se 21 itens essenciais ao acompanhamento infantil na CSC, no Dia de Multivacinação de 2014; considerou-se separadamente os campos a serem preenchidos nas maternidades e na Atenção Primária à Saúde (APS) e outros serviços. Resultados: foram incluídas 367 crianças (96,1%); 44,5% das CSC apresentaram ≥60% dos itens preenchidos; dos itens a serem registrados nas maternidades, o peso ao nascer apresentou maior proporção de preenchimento (64,5%); daqueles a serem registrados na APS e outros serviços, os campos das vacinas foram os mais preenchidos (94,0%); houve maior preenchimento na maternidade do que na APS e outros serviços (p<0,001). Conclusão: observou-se baixa proporção de preenchimento, especialmente na APS e outros serviços.

Objetivo: describir el llenado del Libro de Salud del Niño (LSN) en los servicios de salud. Métodos: estudio descriptivo con niños de 3 a 5 años de Belo Horizonte, Minas Gerais, Brasil; se entrevistó a los padres y fueron analizados 21 partes esenciales del acompañamiento infantil en la LSN, en el Día de Multivacunación de 2014; se consideró por separado los campos que debían ser llenados en las maternidades y en la Atención Primaria de Salud (APS)/otros servicios. Resultados: se incluyeron 367 niños (96,1%); 44,5% del LSN presentaron ≥60% de las partes llenadas; en las maternidades, el peso al nacer presentó mayor proporción de llenado (64,5%); ya en las APS/otros el registro de vacunas fue el mayor (94,0%); el llenado fue mayor en maternidades que en las APS y otros servicios (p<0,001). Conclusión: se observó baja proporción de llenado, especialmente en los servicios de APS y otros.

Objective: to describe the filling process of the Child Health Record (CHR) in health care services. Methods: descriptive study held in Belo Horizonte, Minas Gerais, Brazil; an interview was conducted with parents/guardians of children aged 3-5 years old; 21 essential items to child monitoring were observed in the CHR during the 2014 Multi-vaccination Day; fields that should be filled in maternity wards, Primary Health Care (PHC), and other services were assessed separately. Results: 367 children (96.1%) were included; 44.5% of CHR presented ≥60% of completeness; among the items that should be recorded in maternity wards, birth weight showed the highest proportion of completeness (64.5%); for those that should be filled in PHC/other services, records of vaccines (94.0%) presented the highest completeness; there was more filling in maternity wards than in PHC and other services (p<0.001). Conclusion: a low proportion of filling was observed, especially in PHC and other services.

Conditions and Perceptions of Oral Health in Brazilian Pregnant Women

Objective: To identify the prevalence of caries and periodontal diseases, and factors associated with caries and perceptions of dental care by pregnant women, before and after the educational intervention. Material and Methods: 121 pregnant women from the municipality of Matozinhos (Minas Gerais State, Brazil) participated in this study. Caries and periodontal diseases, sociodemographic characteristics, and access to dental service were evaluated. Perceptions were analyzed before and after the action of operative groups. In addition to descriptive statistical analysis, the DMFT index, dichotomized by the median value, was associated with family income and perceptions of treatment need and health, using the Pearson's and linear trend chi-square tests. The McNemar's chi-square test was used for comparisons before and after educational interventions. A significance level of p<0.05 was used. Results: The DMFT was equal to 12.00 (±6.33), with 52.2% of carious teeth. Most of the pregnant women showed some level of periodontal disease or dental calculus. Caries was neither associated with family income (p=0.469) and need for dental treatment (p=0.161) nor with health perception (p=0.506). There was an improvement regarding the perception of dental care during pregnancy after educational intervention (p<0.001). Conclusion: The conditions of oral health and oral health care in pregnant women are worrisome. Educational interventions improved the perceptions of dental care, and they pointed out the need dentists have as effective members of the prenatal team.

A 15-Year Time-series Study of Tooth Extraction in Brazil.

Tooth loss is considered to be a public health problem. Time-series studies that assess the influence of social conditions and access to health services on tooth loss are scarce.This study aimed to examine the time-series of permanent tooth extraction in Brazil between 1998 and 2012 and to compare these series in municipalities with different Human Development Index (HDI) scores and with different access to distinct primary and secondary care.The time-series study was performed between 1998 and 2012, using data from the Brazilian National Health Information System. Time-series study was performed between 1998 and 2012. Two annual rates of tooth extraction were calculated and evaluated separately according to 3 parameters: the HDI, the presence of a Dental Specialty Center, and coverage by Oral Health Teams. The time-series was analyzed using a linear regression model.An overall decrease in the tooth-loss tendencies during this period was observed, particularly in the tooth-extraction rate during primary care procedures. In the municipalities with an HDI that was lower than the median, the average tooth-loss rates were higher than in the municipalities with a higher HDI. The municipalities with lower rates of Oral Health Team coverage also showed lower extraction rates than the municipalities with higher coverage rates.In general, Brazil has shown a decrease in the trend to extract permanent teeth during these 15 years. Increased human development and access to dental services have influenced tooth-extraction rates.

Who did not appear? First dental visit absences in secondary care in a major Brazilian city: a cross-sectional study.

The study sought to identify possible factors associated with non-attendance at first dental appointments scheduled in 2011 of users living in Belo Horizonte, Minas Gerais, who were referred from primary care to different dental specialties in secondary care within the public health services of the city. A cross-sectional study was conducted based on research in secondary data bases of the public health regulatory system. The dependent variable was "no shows" for scheduled appointments, and the independent variables were age, time on the waiting list, gender, health district, and the specialty to which the individual was referred. Among the 6,428 first dental visits scheduled for 2011 in the specialties selected for analysis, 32.9 % were not performed due to the absence of the user. Bivariate analysis revealed a statistically significant association between non-attendance of the user and the five independent variables. Young adults, male, and resident in given districts who were referred to the specialties of surgery and endodontics and who waited longer on the waiting list exhibited a higher frequency of no-shows.

Measuring social capital through multivariate analyses for the IQ-SC.

BACKGROUND: Social capital can be viewed as a societal process that works toward the common good as well as toward the good of the collective based on trust, reciprocity, and solidarity. Our study aimed to present two multivariate statistical analyses to examine the formation of latent classes of social capital using the IQ-SC and to identify the most important factors in building an indicator of individual social capital. FINDINGS: A cross-sectional study was conducted in 2009 among working adolescents supported by a Brazilian NGO. The sample consisted of 363 individuals, and data were collected using the World Bank Questionnaire for measuring social capital. First, the participants were grouped by a segmentation analysis using the Two Step Cluster method based on the Euclidian distance and the centroid criteria as the criteria for aggregate answers. Using specific weights for each item, discriminant analysis was used to validate the cluster analysis in an attempt to maximize the variance among the groups with respect to the variance within the clusters. "Community participation" and "trust in one's neighbors" contributed significantly to the development of the model with two distinct discriminant functions (p < 0.001). The majority of cases (95.0%) and non-cases (93.1%) were correctly classified by discriminant analysis. CONCLUSIONS: The two multivariate analyses (segmentation analysis and canonical discriminant analysis), used together, can be considered good choices for measuring social capital. Our results indicate that it is possible to form three social capital groups (low, medium and high) using the IQ-SC.

Who did not appear? First dental visit absences in secondary care in a major Brazilian city: a cross-sectional study / Quem não compareceu? Ausências às primeiras consultas odontológicas na atenção secundária em um município brasileiro de grande porte: um estudo transversal

The study sought to identify possible factors associated with non-attendance at first dental appointments scheduled in 2011 of users living in Belo Horizonte, Minas Gerais, who were referred from primary care to different dental specialties in secondary care within the public health services of the city. A cross-sectional study was conducted based on research in secondary data bases of the public health regulatory system. The dependent variable was "no shows" for scheduled appointments, and the independent variables were age, time on the waiting list, gender, health district, and the specialty to which the individual was referred. Among the 6,428 first dental visits scheduled for 2011 in the specialties selected for analysis, 32.9 % were not performed due to the absence of the user. Bivariate analysis revealed a statistically significant association between non-attendance of the user and the five independent variables. Young adults, male, and resident in given districts who were referred to the specialties of surgery and endodontics and who waited longer on the waiting list exhibited a higher frequency of no-shows.

O estudo teve como objetivo identificar possíveis fatores associados ao não comparecimento à primeira consulta agendada em 2011, de usuários residentes em Belo Horizonte, Minas Gerais, referenciados, a partir da atenção primária, para diferentes especialidades odontológicas da atenção secundária da Secretaria Municipal de Saúde (SMSA). Foi realizado um estudo transversal utilizando-se pesquisa em base de dados secundários do Sistema de Regulação da SMSA. A variável dependente foi "não comparecimento" à consulta agendada e as variáveis independentes analisadas foram: idade, tempo na fila de espera, sexo, distrito sanitário de origem e especialidade para a qual o usuário foi referenciado. Entre as 6.428 primeiras consultas odontológicas agendadas para 2011 nas especialidades selecionadas para análise, 32,9% não foram realizadas em função da ausência do usuário. A partir da análise bivariada foi verificada associação estatisticamente significante entre o não comparecimento do usuário e as cinco variáveis independentes. Adultos jovens, do sexo masculino, residentes em determinados distritos, referenciados para as especialidades de cirurgia e endodontia e que ficaram mais tempo na fila de espera, apresentaram maior frequência de não comparecimentos.

Procedimentos de ensino adotados no curso de graduação em Odontologia da Universidade Federal de Minas Gerais: uma análise documental / Educational procedures employed in the undergraduate course in Dentistry of the Federal University of Minas Gerais: a document analysis

Objetivo: Analisar os procedimentos de ensino citados pelos professores nos planos de ensino. Material e Métodos: Trata-se de um estudo documental cujos dados foram coletados de abril a maio de 2015. Foram analisados 30 planos representando 53,6% das disciplinas obrigatórias, cuja seleção se deu por meio de sorteio. Os procedimentos de ensino foram agrupados em individuais e interativos, de acordo com a literatura da área de didática. Resultados: Verificou-se que em 24 planos (80,0%) foram citados procedimentos de ensino individuais e interativos, destacando-se a aula expositiva com 96,7% e a discussão (53,3%), respectivamente. Observa-se uma pequena diversificação de procedimentos de ensino com uma concentração em procedimentos tradicionalmente já adotados no ensino superior. Conclusão: A pouca diversidade das metodologias encontradas pode significar dificuldades dos professores no conhecimento das dinâmicas de diferentes estratégias de ensino e aprendizagem. Os resultados apontam que o planejamento didático deve se configurar como uma atividade permanente, pois implica em ação refletida do professor, de reelaboração de sua prática educativa. Descritores: Ensino. Odontologia. Currículo. Metodologia.

[Analysis of secondary care in oral health in the state of Minas Gerais, Brazil]. / Análise da atenção secundária em saúde bucal no estado de Minas Gerais, Brasil.

The scope of this study was to describe and analyze specialized outpatient procedures in periodontics, endodontics and oral surgery performed in the State of Minas Gerais in 2010. Secondary data for the procedures performed in healthcare facilities and registered in the Information System of the Unified Health System were used. Descriptive and bivariate analysis was performed, considering p <0.05. 707,559 procedures were performed in 2,547 health units distributed in 693 (81%) counties in the State. Of these procedures, 55% are in the area of surgery, 28% in periodontics and 17% in endodontics. The units are predominantly public under municipal administration, 52.5% of which have an oral health team (OHT) and 96.9% have no qualification as Dental Specialty Centers (DSCs). DSCs are more efficient than the other units (p <0.001), but there is a significant percentage that fails to comply with the goals of the Ministry of Health. Municipalities that have DSCs have higher population, more OHTs, lower potential coverage and better HDI. A significant number of specialized procedures are performed in the State of Minas Gerais, especially in primary care settings. DSC establishments are more efficient than non-DSC, considering the average number of procedures. The minimum production goals are met by a minority of DSCs.

Análise da atenção secundária em saúde bucal no estado de Minas Gerais, Brasil / Analysis of secondary care in oral health in the state of Minas Gerais, Brazil

Este estudo descreveu e analisou os procedimentos especializados ambulatoriais nas áreas de periodontia, endodontia e cirurgia bucal em Minas Gerais, 2010. Utilizou-se dados secundários dos procedimentos realizados nos estabelecimentos de saúde e registrados no Sistema de Informação do Sistema Único de Saúde. A análise descritiva e bivariada foi realizada, considerando p < 0,05. Foram executados 707.559 procedimentos em 2.547 unidades de saúde distribuídas em 693 (81%) municípios. Destes procedimentos, 55% são da área de cirurgia, 28% da periodontia e 17% são da endodontia. As unidades são predominante públicas, sob administração municipal, 52,5% possuem alguma equipe de saúde bucal (ESB), 96,9% não tem habilitação como Centros de Especialidades Odontológicas (CEO). Os CEO são mais eficientes que as demais unidades (p < 0,001), mas há importante percentual que não cumpre as metas do Ministério da Saúde. Os municípios com CEO possuem maior população, mais ESB, menor cobertura potencial por estas e melhores IDH. Um significativo número de procedimentos especializados é realizado, especialmente em estabelecimentos de atenção básica. CEO são mais eficientes do que os não CEO, considerandose a média de procedimentos realizados. As metas de produção mínima são cumpridas por uma minoria de CEO.

The scope of this study was to describe and analyze specialized outpatient procedures in periodontics, endodontics and oral surgery performed in the State of Minas Gerais in 2010. Secondary data for the procedures performed in healthcare facilities and registered in the Information System of the Unified Health System were used. Descriptive and bivariate analysis was performed, considering p <0.05. 707,559 procedures were performed in 2,547 health units distributed in 693 (81%) counties in the State. Of these procedures, 55% are in the area of surgery, 28% in periodontics and 17% in endodontics. The units are predominantly public under municipal administration, 52.5% of which have an oral health team (OHT) and 96.9% have no qualification as Dental Specialty Centers (DSCs). DSCs are more efficient than the other units (p <0.001), but there is a significant percentage that fails to comply with the goals of the Ministry of Health. Municipalities that have DSCs have higher population, more OHTs, lower potential coverage and better HDI. A significant number of specialized procedures are performed in the State of Minas Gerais, especially in primary care settings. DSC establishments are more efficient than non-DSC, considering the average number of procedures. The minimum production goals are met by a minority of DSCs.

[The use of metaphors to express toothache: a study in the field of the anthropology of health]. / Uso de metáforas para expressar a dor de dente: um estudo na área de antropologia da saúde.

This research was conducted with patients who sought emergency care at a Comprehensive Primary Care Clinic (CIAP IV) at the Dental School of Minas Gerais Federal University and at the Dental Center of a medium-sized city in the state of Minas Gerais. The scope of this article is to identify how the social representations of this issue are generated through the metaphors used by patients to express toothache. A total of 35 individuals of both genders who sought emergency care for toothache participated in the study. Content theme analysis was used. Social representations of toothache are generated as people resort to their life experiences to find words to express the problem. Prior sensations and feelings, and even imaginary situations, generate metaphors to attempt to explain the suffering. Toothache is often compared with the worst feelings ever experienced by individuals. Toothache represents great suffering for people seeking emergency dental care. This fact may help to develop further public oral health policies, bearing in mind that a socially deprived population is more often afflicted by toothache.