Analysis of hospital dental care for patients with special needs in Brazil.

This analytical cross-sectional study aimed to analyze the access of patients with special needs (PSN) in Brazilian municipalities to hospital dental care of the Unified Health System (Sistema Único de Saúde - SUS), based on data from the Hospital Information System of the Unified Health System (Sistema de Informações Hospitalares do SUS- SIH/SUS - SIH), from 2010 to 2018. The Kolmogorov-Smirnov normality test was performed; the Poisson regression was used to verify factors associated with the variable total number of hospitalization authorizations with the main procedure of dental treatment for PSN ("Total de Autorizações de Internação Hospitalar" - AIH), the Spearman correlation test with a significance level of 5% was used to characterize the relationships between the Municipal Human Development Index per municipality - (Índice de Desenvolvimento Humano Municipal - HDI) and the Oral Health Coverage in the Family Health Strategy by municipality (Cobertura de saúde bucal na estratégia saúde da família por município - SBSF Coverage), and the relationship of the AIH with SBSF Coverage. A total of 127,691 procedures were performed, of which 71,517 (56%) were clinical procedures, such as restorations, endodontic treatments, supra and subgingival scaling, among others. Municipalities in the Midwest (PR=5.117) and Southeast (RP = 4.443) regions had more precedures than the others. A weak correlation was found between AIH and SBSF Coverage (r = -0.2, p < 0.001) and HDI and SBSF Coverage (r = -0.074, p < 0.001). Population size, region, health coverage, oral hygiene, and number of dentists in hospitals affected the availability of dental procedures in PSN.

How different attributes are weighted in professionals' decision-making in Pediatric Dentistry-a protocol for guiding discrete choice experiment focused on shortening the evidence-based practice implementation for dental care.

BACKGROUND: Important evidence has been constantly produced and needs to be converted into practice. Professional consumption of such evidence may be a barrier to its implementation. Then, effective implementation of evidence-based interventions in clinical practice leans on the understanding of how professionals value attributes when choosing between options for dental care, permitting to guide this implementation process by maximizing strengthens and minimizing barriers related to that. METHODS: This is part of a broader project investigating the potential of incorporating scientific evidence into clinical practice and public policy recommendations and guidelines, identifying strengths and barriers in such an implementation process. The present research protocol comprises a Discrete Choice Experiment (DCE) from the Brazilian oral health professionals' perspective, aiming to assess how different factors are associated with professional decision-making in dental care, including the role of scientific evidence. Different choice sets will be developed, either focusing on understanding the role of scientific evidence in the professional decision-making process or on understanding specific attributes associated with different interventions recently tested in randomized clinical trials and available as newly produced scientific evidence to be used in clinical practice. DISCUSSION: Translating research into practice usually requires time and effort. Shortening this process may be useful for faster incorporation into clinical practice and beneficial to the population. Understanding the context and professionals' decision-making preferences is crucial to designing more effective implementation and/or educational initiatives. Ultimately, we expect to design an efficient implementation strategy that overcomes threats and potential opportunities identified during the DCEs, creating a customized structure for dental professionals. TRIAL REGISTRATION: https://osf.io/bhncv .

Orthodontics in the oral health care network of the Unified Health System (SUS).

This observational study aimed to describe and analyze data from two external evaluations of the National Program for Improving Access to and Quality of Dental Specialty Centers (PMAQ CEO), held in 2014 and 2018 in Brazil, which evaluated Dental Specialty Centers (CEO) using a national and census approach. We selected questions through a search in the microdata of the first and second evaluations. The groups were analyzed independently. To compare the groups, nonparametric tests were performed (Mann Whitney U). The formulated hypotheses were: there would be no differences between the data of these groups (h0) and there would be differences between the data of these groups (h1). For qualitative nominal variables, frequency distribution was verified and association tests were performed (chi-square test). The significance level for this study was set at 5%. We observed that orthodontic treatments were found in about 13% of the CEO. Regarding human resources, most professionals were specialists or had MSc or PhD degrees; were civil servants; had been hired by direct administration; or had been hired via public tender. Regarding the work process and inclusion of the CEO in the health care network, we observed a greater number of services that use single and electronic medical records, greater presence of services monitoring and analyzing goals, greater knowledge about monthly average of absenteeism (for 2018); and larger number of services with referrals from primary health care centers (for 2014). Expanding the view on orthodontics and including preventive, interceptive, and corrective treatments at different points in health care networks are essential strategies for achieving comprehensive care in universal health systems.

Orthodontics in the oral health care network of the Unified Health System (SUS)

Abstract This observational study aimed to describe and analyze data from two external evaluations of the National Program for Improving Access to and Quality of Dental Specialty Centers (PMAQ CEO), held in 2014 and 2018 in Brazil, which evaluated Dental Specialty Centers (CEO) using a national and census approach. We selected questions through a search in the microdata of the first and second evaluations. The groups were analyzed independently. To compare the groups, nonparametric tests were performed (Mann Whitney U). The formulated hypotheses were: there would be no differences between the data of these groups (h0) and there would be differences between the data of these groups (h1). For qualitative nominal variables, frequency distribution was verified and association tests were performed (chi-square test). The significance level for this study was set at 5%. We observed that orthodontic treatments were found in about 13% of the CEO. Regarding human resources, most professionals were specialists or had MSc or PhD degrees; were civil servants; had been hired by direct administration; or had been hired via public tender. Regarding the work process and inclusion of the CEO in the health care network, we observed a greater number of services that use single and electronic medical records, greater presence of services monitoring and analyzing goals, greater knowledge about monthly average of absenteeism (for 2018); and larger number of services with referrals from primary health care centers (for 2014). Expanding the view on orthodontics and including preventive, interceptive, and corrective treatments at different points in health care networks are essential strategies for achieving comprehensive care in universal health systems.

O processo de trabalho em saúde bucal coletiva em tempos de pandemia: a contribuição da teleducação com a teleodontologia / The work process in collective oral health in times of a pandemic: the contribution of tele-education with teledentistry

A pandemia da COVID-19 impôs ações assertivas em todos os níveis da sociedade. Aqui se relata o apoio emergencial na Resposta Rápida do Núcleo de Evidências e Análises Econômicas da Faculdade de Odontologia da Universidade de São Paulo (EvipOralHealth) para a coordenadoria estadual de saúde bucal de São Paulo, em prol da tomada de decisão e ressignificação do processo de trabalho. Foram implementadas duas estratégias de teleodontologia para a educação permanente (EP) dos trabalhadores de saúde bucal: 1. Lives com pesquisadores, estudantes, gestores e trabalhadores das diversas áreas da saúde pública e da Odontologia para estabelecer marcos teóricos; 2. Ambulatórios virtuais - via webconferência. Reuniu-se gestores e trabalhadores para a condução de diálogos de políticas sobre o dia a dia do enfrentamento e de adaptações e condições de trabalho de cada região. A experiência revela a importância da relação ensino-serviço-comunidade efetiva, pautada na tradução do conhecimento e na construção de espaços de troca possibilitando a implementação de práticas, programas e políticas. Precisamos repensar as estratégias de EP, sermos mais ágeis, mais flexíveis, menos acadêmicos e capazes de adaptar conteúdos e formatos às necessidades. A teleodontologia e a teleducação podem conferir escala e fazer chegar mais facilmente o conhecimento aos que necessitam.

Teledentistry and the Unified Health System: an important tool for the resumption of Primary Health Care in the context of the COVID-19 pandemic / Teleodontologia e SUS: uma importante ferramenta para a retomada da Atenção Primária à Saúde no contexto da pandemia de COVID-19

This "short communication" describes the possibilities of using Teleodontology to expand and qualify health care in oral health care networks. WHO already recommended to its member countries, including Brazil, even before the pandemic, the use of Telehealth as a strategy to improve the quality of its services, especially in the context of universal health systems, as the Unified Health System In the current context, Teleodontology opens opportunities for oral health to resume the offer of various services, remotely, such as: 1. tracking, active search, monitoring users of priority groups, at risk and with systemic problems, monitoring of suspected cases of COVID-19 and its contacts, via telemonitoration; 2. initial listening, individual and collective educational activities, among others, through teleorientation; 3. discussion of clinical cases to define the opportune moment to perform operative procedures among professionals of different levels of care, matrix support, sharing and soluting doubts between professionals or between professionals and teaching and research institutions, through teleconsulting, among others . In addition to a literature review on Teleodontology in the context of the pandemic, an important contribution of this "short communication" is the conceptualization of the terms used and possibilities they offer to SUS professionals, in addition to specifying the possible protocols for recording these activities, in order to provide service managers with secure data for monitoring and evaluating the work process. In addition, we bring a brief discussion with some promising experiences, carried out in the pre- and trans-pandemic context, which can consolidate themselves as important strategies for the resumption of oral health in the post-pandemic scenario.

Este "short communication" descreve as possibilidades de utilização da Teleodontologia para ampliação e qualificação do cuidado em saúde nas redes de atenção à saúde bucal. A OMS já recomendava aos seus países membros, mesmo antes da pandemia, o Telessaúde como estratégia para melhorar a qualidade dos serviços, especialmente nos sistemas universais, como é o caso do Sistema Único de Saúde. A Teleodontologia abre oportunidades para que a saúde bucal retome a oferta de diversos serviços, de forma remota, como: 1. rastreamento, busca ativa, monitoramento de usuários prioritários, de risco e com problemas sistêmicos, de suspeitas de COVID-19 e contactantes, através do Telemonitamento; 2. escuta inicial, atividades educativas individuais ou coletivas, através da Teleorientação; 3. discussão de casos clínicos para a definição da oportunidade/necessidade de procedimentos operatórios, matriciamento, compartilhamento, solução de dúvidas entre profissionais e entre estes e instituições de ensino e pesquisa, por Teleconsultorias, entre outros. Além de uma revisão sobre a Teleodontologia no contexto da pandemia, conceituamos os termos utilizados e possibilidades que oferecem aos profissionais do SUS, além de especificar os protocolos possíveis para registro dessas atividades, a fim de fornecer dados seguros para seu monitoramento e avaliação. Ademais, trazemos uma breve discussão com experiências promissoras, realizadas nos contextos pré e trans pandemia, que podem ser importantes estratégias para a retomada da saúde bucal no cenário pós pandemia.

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.