Ecologia parasitária de isópodos e biologia reprodutiva em tibiro, Oligoplites spp (OSTEICHTHYES: CARANGIDAE) das águas costeiras de Natal, Rio Grande do norte

Oligoplites palometa (Cuvier) and Oligoplites saurus (Bloch & Schneider) (Osteichthyes: Carangidae) are coastal pelagic fish species. The objective of this study was to investigate the effect of parasitism by isopods and the reproductive biology of the leather jack, Oligoplites spp. A total of 113 individuals of Oligoplites spp (35 of O. saurus and 78 of O. palometa) were captured during the period between January, 2005 and July, 2007 from the coastal waters of Natal, RN. The morphometric and meristic characters were registered; macroscopic analyses were done to collect the isopod parasites and the gonads were observed to verify the reproductive aspects. The crustacean isopod parasite, Cymothoa spinipalpa (Isopoda: Cymothidae) was encountered on the tongue in the oral cavity in both fish hosts. The parasitic indices of C. spinipalpa showed high values of prevalance of 51,4% for O. saurus and 64,1% for O. palometa. The host presented significant correlations between body mass and body length of O. palometa and the number of parasites. Body lengths of female C. spinipalpa were small due to the limited space available in the oral cavity of the host. There was a significant difference in the sex ratio of O. palometa, males outnumbered the females. The isopod parasites showed specificity to the oral cavity of hosts. Macroscopic analyses of gonads showed four stages of gonadal development for both sex of O. palometa: immature, maturing, mature and spent

Acesso aos serviços odontológicos e incidência de cárie em adolescentes e fatores de risco em município do Nordeste Brasileiro, 2006

The aims of this study were to analyze the access of dental services by child population, to determine the prevalence of dental caries, gingivitis and malocclusion in resident children from the municipal district of Sobral Ceará and to evaluate the incidence of the dental decay in adolescents associated with the factors related to socioeconomic condition, access to health services and self-perception. This study had as main factor the multidisciplinary represented by the participation of health professional (doctors, dentists, nurses) in the development of the survey's initial reference; student from Human Sciences area to apply the structured questionnaire in domiciliary visits; statistics professionals in the orientation of the analysis to be held and family health team (community health agents, dentists and dental clinic assistants) in the scheduling of domiciliary visits and the accomplishment of oral exam. The sample was determined from the domicile record that included children born between 1990 and 1994 to develop the research Children health conditions in the municipal district of Sobral Ceará . The first sample comprised 3425 parents of children from 5 to 9 years old, living in the urban area at the municipal district of Sobral Ceará, aiming at identifying the most important factors associated to the access to dental service. From this sample, 1021 children were selected in a systematic way, for the accomplishment to the epidemiological study of decay, gingivitis and malocclusion. In the study's third phase, in order to arrange the group to be followed, 688 adolescents were examined and interviewed, by means of the active search from the 1021 individuals that had been previously examined. It was observed that 50.9% of the children had access to dental service at least once in a lifetime. Of this total, 65.3% accomplished it during the last year, and 85.4% of these did in public services, what allows to identify the importance of this sector in the access to dental services. It was observed that the factors that most affected the access to dental 129 services were related to socioeconomic condition, such as the access to health plan, the possession of toothbrush, garbage collecting, mother s schooling, sewerage treatment and malnutrition. In relation to oral diseases, an increase in the DMF-T index according the age was observed, from 0.10 in five years old to 1.66 in the nine years old, while with the dmf-t index, the inverse happened, since the index decreased from 3.59 in five years old to 2.69 in nine years old. In relation to gingivitis, an average 32.7% of the children presented gum bleeding. In what concerns malocclusion, it was observed that 60.3% of the children didn't present any problem, 30.17% had light malocclusion and 9.5% severe malocclusion. The average incidence of dental caries was 1.86 teeth per youngster. Among the studied variables, tooth pain in the last six months, mother's income and school snack, adjusted by the perception about the need of treatment, the mother's schooling and the dentist's appointment at least once in a lifetime, were the variables that presented positive relationship with the high incidence of dental caries on this population by logistic regression. Variables of socioeconomic nature, related to the access to health services and behavior and biological variables presented a relationship with the high caries incidence. The study point out to the need of developing health actions in a humanized way, by an oral health team effectively bound to the population's interest, with the great objective to provide, with the public health services managers, adequate conditions to improve oral health

A representação social do cuidado no Programa Saúde da Família na cidade do Natal

The aim of this study was to learn about the social representations of the care provided by the Family Health Program (FHP) in the city of Natal, Brazil and determine how these representations guide the daily actions of doctors, dentists, nurses, nurse s assistants and oral health assistants during the work process. In this sense, we used the theoreticalmethodological approach to the Theory of Social Representations. For data collection, we used the following instruments: a two-part questionnaire, where the first part recorded sociodemographic data and the second part was adapted to the free word association technique (FWAT), which was applied to 90 professionals belonging to 18 FHP units. Interviews were also used as collection instruments. These were based on inductive stimuli and on direct observations of 30 of these professionals. After a superficial reading of the material, we constructed a corpus from which ten categories emerged. To analyze FWAT we used lexicographic analysis, combining frequency and the mean order of responses. The interviews and sociodemographic variables were analyzed using content analysis and descriptive statistical analysis, respectively. The study showed that the central nucleus of the social representation in question is composed of the elements attention, receptivity and love, revealing that the subjects have different understandings of the FHP care process and that the knowledge accumulated in this respect is supported by an approximate vision of the meaning of care. However, traditional elements with trivializing connotations about care predominate, which compromises the development of strategies to overcome traditional practices. In the set of analyses, we were able to capture the invariance of a contradiction: on one hand, professionals know and affirm the importance of providing care for FHP patients; on the other, the experience of daily practice translates into the negation of this concept. In this contradictory context, professionals build gradual and successive syntheses that allow them to act and affirm themselves by associating information from their academic formation, structured knowledge acquired in other experiences, values and symbols of their daily routine. Thus, they shape and reshape themselves, according to what is concretely and specifically required, at the same time both plural and multiple. The composition of the central nucleus indicates that any measure that intends to modify attitudes that is, the daily actions of FHP professionals with respect to care must take into account and give priority to the debate about the redefining of the semantic fields of the central nucleus (love/attention/receptivity and humanization), especially those of love and attention

Avaliação in vitro da atividade antimicrobiana de diferentes soluções a base de hidróxido de cálcio

The science of Dentistry wishes obtains the ideal solution for the dental plaque chemical control. This research evaluated antimicrobial action capacity in calcium hydroxide and tergentol various solutions starting for the CHD 20, a root canals irrigating solution with a reason of 80% calcium hydroxide saturated solution and 20% tergentol detergent with the aim of evaluate this drug mouth rinse indication with prevention or combat objective for dental caries and periodontal diseases. Antibiogram disks and biofilm tests were accomplished for the microorganisms: Streptococcus mutans, Streptococcus sanguis, Streptococcus sobrinus and Lactobacillus casei. Different reasons of detergent for the calcium hydroxide saturated solution, tergentol and distillated water solution, 0,12% clorhexydine digluconate solution was positive control and distillated water was negative control. The results showed better performance of clorhexydine in relation to calcium hydroxide directing to not accept this (CHD20) as mouth rinse solution

Efetividade do uso tópico de fluoreto e da escovação no controle de cáries produzidas "in vivo"

The objective of this clinical study was to evaluate the effectiveness of the toothbrushing with and without fluoride and the daily fluoride rinse (NaF 0.05%) on produced white spot, in vivo. This was a clinical study, controlled, randomized and triple blind. Thirty patients were selected for orthodontics reasons from Orthodontics Specialization Course at the Brazilian Dental Association - Section of Rio Grande do Norte. In this study it was used 4 bicuspid upper and lower. They had orthodontic reason for extractions, in 35 days, at least. The sample had one hundred and twenty teeth that received orthodontic bands. The bands were fixed with polycarboxylate cement, and there was a space standardized between bands and one surface of teeth. The four bicuspid of each patients were randomized and nominated as A, B, C and D. These nominations determinated the sequence of the extractions and what was done in each tooth. All the patients had been submitted to the toothbrushing with or without fluoride for 35 days. After this period, the A tooth of each patient was extracted to serve as control. The others teeth (B, C and D) were extracted one by each week. The entire sample was analyzed through the clinical examination and by laser fluorescence (DIAGNOdent®) in three different times: before orthodontic bands, 28 days after fixed and then removed the bands and, the last one, 07 days after one of the three treatments (toothbrushing with or without fluoride, tooth paste with fluoride and mouth rinse with fluoride). At the beginning all groups (A, B, C and D) had the same conditions, no significant difference was found. The same situation was found in a clinical examination. The results of the DIAGNOdent® for the groups that used tooth paste without fluoride, with fluoride and mouth rinse with fluoride, after 28 days, there was no significant difference. Clinically, the white spot was formed in all teeth after 28 days. When it was compared the three treated groups, the group without fluoride in tooth paste had worst result than the others groups. But there was no significant association between the number of active and inactive white spots and the type of treatment that the teeth had received. The demineralization of the enamel surface, under the orthodontic bands, it happened in a few weeks. The exposition of the white spots in oral environmental resulted in an improvement, but it was not enough to return to the values from the base line, either for the toothbrushing and/or the use of fluorite mouth rinse. Mouth rinse and toothpaste with fluoride have showed to reduce the incidence of demineralization in the enamel, but none seems to be superior to another one in an in vivo study

A influência do tempo de diálise e do paratormônio sobre as condições clínico-radiográficas bucais de indivíduos com insuficiência renal crônica em diálise

Universidade Estadual do Rio Grande do Norte

Estudo psicossocial das perdas dentárias na terceira idade

The present study seeks to understand tooth loss by investigating the social representations in the daily life of elderly individuals, thus characterizing itself as a comparative and analytic research. It is known that tooth loss is a common occurrence in elderly individuals, interfering at the psychosocial and biological levels, through its functional, esthetical and social implications. The area of oral health in Brazil is lacking studies on this topic, especially with respect to the psychosocial aspects of the elderly. The Theory of Social Representations and the Central Nucleus Theory were selected for theoretical-methodological support. The Free Association of Words Test was used, whose inducing stimulus were the words tooth loss , in which each subject was asked to associate 3 words, to respond to a questionnaire related to socio-economic conditions and containing an investigation of tooth loss, access to odontological services and the need for dental treatment, and to undergo a focus group interview. The study sample consisted of 120 individuals 60 years of age or over, resident in Natal, RN, Brazil and participants of the Live Together to Live Better group of the Basic Health Unit of Felipe Camarão Residential District and Unati (Open University of the Elderly); an interview was performed with 36 subjects. Data analysis was performed by Evoc 2000, SPSS/99, Graph Pad and Alceste softwares. The results demonstrate that the central nucleus of the social representations of tooth loss for the Live Together group emerged from the difficulty in eating categories, showing a relation between physiologic necessity, desire and pleasure from eating, not to mention the pain that resulted from justifying the tooth loss. Besides the central discourses, the following peripheral elements were gathered: difficulty in adapting to the prosthesis, treatment and difficulty in speaking. All of these categories, except the last, also comprised the class themes of the group interview. For the Unati group the central nucleus emerged from the socio-economic difficulties categories, demonstrating a narrow relation between poverty, access to health and education and esthetics, confirming in the discourse of common sense, the association between tooth loss and aging. At the margin of the central discourses was collected the peripheral element difficulty in adapting to the prosthesis, found both in the Live Together and Unati groups, which expresses the resistance of the subject to this new situation and the failure of the rehabilitation treatment in the sense of reviving the memory of their natural teeth. All of these categories also constitute the class themes of the of the group interview. Thus, through the study of the social representations, we can reveal a reality in the perspective of the social subjects, contemplating the multiple facets of the social-cultural reality experienced by these individuals

Dificuldades e/ou facilidades vivenciadas pelos profissionais que compõem a Estratégia de Saúde da Família

Descriptive and quantitative study, with the objective of review the positive and negative aspects experienced by professionals working in the Family Health Strategy (ESF) of Ceará-Mirim town, at Rio Grande do Norte state. The population included 190 healthcare professionals that integrate the family healthcare staff and the data-collection occurred in a meeting at their workplace, with the implementation of a questionnaire. Results were organized in Microsoft Excel spreadsheet software, with descriptive statistical analysis in tables, graphs and tables through frequencies, averages values and standard deviations. There is a predominance of females (n = 137) and higher rates in almost all professions, and higher average age (38.9%, SD = 7.8) and income wage (average = 10) in the medical category. Regarding the more developed activities, for physicians and nurses are the healthcare actions in the Unit, the oral hygiene for dentists, the immunization for auxiliary nurses (Aux-N), educational meeting for the dental office assistants (ACD), and home visitations to community-based health workers (ACS). About the easiness of work, 93.2% said to be presence of professionals with a personal profile in public healthcare; about the difficulties, 86.8% of professionals cited the unavailability of material, followed by salary range reported by nurses (80.9% ), dentists (80.0%), physicians (73.3%), ACS (83.1%), and Aux-N (90.5%). In relation to working conditions, the unavailability of materials was the most mentioned, with the exception of dentists who reported improvement in wages. We still identify among these difficulties: the drugs availability regarded as first grade obstacle by ACS and physicians, the type of contracts in second grade cited by the ACD and dentists and, in third grade, the salary range cited by dentists and auxiliary nurses. It is concluded that the difficulties and easiness faced by ESF professionals are divergent among themselves. For physicians and nurses, whose healthcare actions become directed to specific groups, the individual and the family, their difficulties relate to the unavailability of materials. For dentists, whose actions more quoted were topical application of fluoride and supervised toothbrush, their greatest difficulty is the salary range. As to the Aux-N, ACD and ACS, for all of them the unavailability of materials has hindered the implementation of their activities in ESF

Atenção à saúde mental na Estratégia Saúde da Família no Município de Parnamirim/RN: opinião dos profissionais, dos portadores de transtornos mentais e seus acompanhantes

This study aims to analyze and compare the opinion of professionals, managers and users about the mental health care in the Family Health Strategy (FHS). It is characterized as an Operations Research or Health System Research with a cross-sectional design and a descriptive quantitative nature. The study was developed from the application of the Opinion Measurement Scale allied to techniques of observation and structured interview in the city of Parnamirim / RN. The sample consists of 409 subjects, 209 professionals of the Family Health Strategy, 30 of the Oral Health Strategy, 19 of the Family Health Support Center, 24 directors of Basic Health Units, plus 68 users with mental disorders and 59 caregivers, respecting the ethical parameters of Resolution 196/96 of the National Health Council, trial registration number: CAAE 0003.0.051.000-11. Quantitative data were submitted to the Epi-info 3.5.2 for analysis. The network of mental health in Parnamirim involves the flow between the FHS, Psychosocial Care Centers, clinics and hospitals, having as main barriers the fragility of the referral and counter-referral system, of the municipal health conferences, of the FHS teams by the limitations in material and human resources as well as the population´s lack of acknowledge about the organization of the mental health network, issues that affect the integral attention. Even though the FHS professionals recognize the importance of their actions, they question their role in mental health care, experiencing difficulties in accessing psychiatric services (76.5%). Although most agree that the mentally ill is best treated in the family than in hospital (65.2%), the community health workers were the predominant category in the partial or total disagreement of this statement (40.8%), who is the professional in greater contact with the family. Nevertheless the caregivers miss the support of the FHS as the main focus of attention is on revenue control. The views of professionals, mental patients and caregivers converged in several statements, showing the main weaknesses to be focused by the mental health network of the city, as the perceptions that: (a) physical strength is needed to take care of mental patients for its tendency to aggression, requiring it to stay in the sanatorium for representing danger to society, (b) only a psychiatrist can help the person with emotional problems, (c) the user of alcohol and drugs does not necessarily develop mental illness, (d) the access barriers and doubts about the quality of psychiatric services, (e) caring of a mental health patient does not bring suffering to professionals. Therefore, the commitment to consensus building, monitoring and evaluation of the network are important mechanisms for an effective management system, reflecting in the importance of strengthening the health conferences and approximating different institutions. The results reinforce the importance of strengthening primary care through programs of continuing education focusing on the actions and functions of professionals in accordance with its competences and duties what contribute to the organization and response of mental health care, favoring user´s care and the promotion of family health

O programa Saúde da Família pelo olhar do Cirurgião-Dentista

This study tried to know the social representation of dentists surgeons about the Family Health Program (FHP). Where used as methodological instruments a semi-structured interview and direct observation of work process in tive towns that are part of the metropolis region ofNatal city. During the interview some aspects where broached, such as the reasons of dentists surgeons join the FHP, what are the implications ofthe introduction of this program in the everyday practice, what kind of activities are they practicing and what are those professional missing the most in the FHP. In the direct observation where take in account some aspects related to the physic structure of health units, its service organization and demand, relationship amongst dentist and other member of the team, and about patient receptiveness, when they arrives at health unit. This study also identifY the researches subject showing their age, sex, for how they are graduates, what are them specialty and for how long they work for the FHP. The data had been analyzed through the analysis of content of Bardin5. The dentists depict the FHP for the change in assistance model through the preventive proposal of social work that makes possible to work with an ample concept of health. However what makes the FHP more attractive to dentists is the salary questiono The creation of bonds whit the community and the work whit groups and in team had been the main occurred changes in the daily one of the pratices ones of these professionals. The principal activities executed for these professionals inside of the new strategy of assistance in oral health are the carried trough preventive activities achieved in health units and social area. To them, the absence of institutional support and the employment of only one dentist for each team it is one the main point of strangling. There is no doubt that FHP is new strategy and that it is need a better integration amongst the professional, the institution

Perspectivados cirurgiões-dentistas sobre a inserção da fisioterapia na atenção básica de saúde

This work aims at investigating the surgeons-dentists acceptability in the field of public health in the city of Natal, State of Rio Grande do Norte, about the possibility of medicinal plants insertion in basic attencion of health. Moreover, it searchs to know if during their professinal formation it had some theoretician-pratical basement on this subject, as well as investigating their confidence on the medicinal plants. The basic motivation for developing this study is the possibility of contributing to the insertion of a tradicional health pratical at public assistance scope, endorsed by popular use, but now scientifically proven. For in a such way, the medicinal plants use is emphasized as a way to be followed to increase basic pharmaceutical assistance, improving the acess to the medicine and diminish expenses. Following this logic, family health program constitutes the way through which this pratical will be available to the users of health services. The research was done over thirty surgeonsdentists, all ofthem pertaining to public service ofNatal, state ofRio Grande do Norte. It was used, as research instrument, semi-estructured interview associated with methodological analysis user s speeches. On this form, this work is inserted in a trend observed nowadays not only in Brazil, where the use of the medicinal plants has been stimulated and defended to be inserted at programs ofprimary attenction of health

Hipossalivação e seus fatores de risco em idosos funcionalmente independentes e não institucionalizados

The aim of this study was to investigate the risk factors related to hyposalivation among non-institutionalized independently living elderly people, living in Natal-RN, Brazil. The study was a control-case type and the data collection was accomplished by carrying a questionnaire, oral examination and a non-stimulated and stimulated sialometry. The cases were identified by values of salivary flow rate <0,1mL/min and stimulated ≤ 0,5 mL/min, and the controls were by observing the values of sialometry that were bigger than the previously defined parameters. Age and gender were used as pairing variables. The data were analyzed using X2 (α = 0,05) and odds ratio. The sample was composed of 98,1% female and 1,9% male, with mean age 68. There was not association between hyposalivation and the following studied variables: income, schooling, profession, dwelling conditions, domiciliary density, illness, number of teeth and use of prothesis. However, a link was found between hyposalivation and smoking frequency in the passet (OR=5,14), indicating that, referring to elderly people, the tabagism frequency habit was a risk factor to the studied condition. Therefore, refering to non-institutionalized independently elderly people, economic-social-demographic conditions, general and bucal health, diet and habits such as alcoholism have been not risk factors to hyposalivation. However, people that have been smoking have more risk to have the studied conditions

A produção das perdas dentárias: narrativas de usuários do SUS

For a complete comprehension of the effect of tooth loss is necessary to listen to the patients that have it. This study, of qualitative approach, investigate, in the dental history of users of SUS, listening to his/her experiences with the services of dental care, the reason that lead his/her to dental lost and the repercussion of this in his/her life. The collect of data was made by narrative interview, obeying to a pre-defined schema. The subjects interviewed were six (three of urban zone and three of rural zone), all of them were users of Family Health Units. The criterions of inclusion were the followings: the presence of tooth lost (total lost in both dental arch or in one of them, or partial lost in at least six elements in one of the arches); age between 25 and 59; male or female; to live in municipal district of São Tomé/RN or Natal/RN. Based on previous interviews was elaborated the odontological history of each patient. Such narratives, systemized in odontological history, were analyzed taking as base the studies of Souza71 and the proposal of Schutze, suggested for Jovchelovitch, Bauer34. The results show that toothache was the main reason for the search of odontological care. The patients confront the ache with home-made medicaments, allopathic ones, and searching for dental care. The searching for exodontics was stimulated for geographic access difficulties or for repressed demand, which as a result produced the aggravation of the lesions and the discredit in restoration s treatment. The self-care practice of tooth-brush with juá or toothpaste and the controlled ingestion of sugar was not sufficient to avoid dental lost. Guilty sentiments were identified in relation with lack of care with teeth. The acceptance of dental lost as a natural factor is an important motivation in lack of pain and in the belief that it was a simple part of life in old age. Life with dental prosthesis makes clear the difference between which was natural and which was unnatural, and difficulties with the prosthesis appeared. The limitation of the prosthesis in its functional aspect can be compensated by esthetic restitution, making possible smiling expression. Starting with this study and considering the high number of dental lost, mainly in low-rent population, which live with toothless limitations or bad-quality prosthesis which do not rehabilitate adequately, we suggested the realization of qualitative researches which include, also, another actors in heath care services such as professionals and administrators

Caracterização do processo de trabalho do cirurgiãodentista na estratégia de saúde da família do município de Parnamirim-RN

Family Health Strategy (FHS), founded in 1994 has appeared to play a strategic role in the SUS construction and consolidation. It has reaffirmed its Principles and Guidelines and has elected family as core of attention. The principle that has guided the work concerns the quality of the relationship between professional and family. Thus, the FHS has the family as a subject of health-disease process, and relations with its own characteristics and can be partners in building their health and improvement of quality of life of its members and the entire community. This study aims to characterize the surgeon-dentist (SD) working process in the family health strategy, from the knowledge of the SD integration with other team members; organization of services; development of shares, changes perceived by SDs, as well as knowing the surgeon-dentist profile who is part of this strategy. The collecting tool used was a semi-structured questionnaire, in which participated 30 professionals. As for profile, most professionals were women, completed the graduation in public university and did not have any training to work by joining the FHS. Almost all have other public or private working ties. They often carry out activities with students, and occasionally do home visits. In relation to team work, in activities such as home visits, school health, community activities, among others, they sometimes seek the cooperation of other members. The way of accessing for users in the most part has occurred through the schedule. The most frequently activities made to the Centro Especialidades Odontológicas (CEO), are in Endodontics and Prosthesis. The majority of them participate in team meetings, but they do not have frequency set to happen. As for the planning and programming of activities to be conducted, most said that individually develops them. Concerning the performance of their duties, most reported being satisfied, but that improvements could happen. Besides, they reported improvements in dental care following the inclusion of SD in the FHS in various aspects, such as access, organization, humanization, care and oral disease prevention. The professionals had poor integration with other team members, in addition to have a profile to more individualistic work, a fact seized by way of development and planning of actions. They work the actions in individual and curative way, in detriment promotion and collective ones. They work humanization, definition of territory and adscript population. Thus, it is concluded that the working process developed by SDs, includes the part which is advocated by FHS. This points out to a greater undertaking of this process aiming to detect the weakness met in order to reach the potential that the FHS represents in organization of basic attention

Centros de especialidades odontológicas: avaliação da atenção de média complexidade na rede pública da Grande Natal

The Specialized Dental Care Centers (CEO) were developed to provide specialized dental care to the population, given the accumulated needs of health since the past. They must operate as units of reference for the Oral Health Team of the Primary Care, complementing the dental procedures performed at this level of attention. This study aims to assess the performance of CEOs of the Grande Natal Health Region as a strategy of Secondary Care consolidation in oral health through users, dentists and managers. For this to try to identify factors about access, hosting and satisfaction with the service, the actions developed in these centers, integration between the CEOs and the Basic Health Units (UBS), considering the reference and counter reference. Data were collected through semi-structured interview, conducted in four CEOs, among 253 users, 31 dentists and 4 managers. It was submitted to descriptive statistical analysis and to content analysis by software ALCESTE 4.5. The results revealed that the specialties of prosthesis, endodontics and surgery were the most sought by 38.2%, 23.7% and 21.7% of respondents, respectively. It was noticed that among users aged 18 to 30 years-old the greatest demand is for the specialty of endodontics (44.4%) and over 50 years for prosthesis (76.4%). There is a weakness in the reference and counter reference between UBS and CEO, because part of users goes directly to the centers without going before to the Primary Care and the majority does not want to return to the dentist of Health Unit. Satisfaction with care was reported by 90.9% of users, because they resolved the problems needed and were welcomed by the team. But the delay in care was the main factor for not satisfaction. For most dentists, some users could solve their problems completely in Primary Care, which shows the existence of unnecessary referrals to the CEOs, however they consider the existence of limiting factors in UBS that compromise the service. Most dentists revealed that some users do not get to CEOs with the basic dental treatment done, and some of them do not counter reference users. It can be concluded that the studied CEOs are being resolutive for those who access them, offering necessary care for the population, and if they don t account with this service, will encounter obstacles to resolution of problems, ranging seek care service in particular, in another public sector, or even giving up treatment. However, it is perceived the need of professionals training to understand the importance of the reference and counter reference, to that they can better serve and guide users. It is also important that cities offer better conditions to UBS and CEOs, so they can work together, with complementary actions of oral health, seeking full care, aiming for better resolution to the users' health problems