Gerenciamento de resíduos odontológicos no serviço público

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Organização da demanda de um Centro de Especialidades Odontológicas

Introduction: Secondary care in oral health in Brazil is still a little researched topic. Objective: The aim of this study was to analyze the resolution of dental services in SUS based on the referral to secondary attention and backreferral to primary attention. Methodology: It’s a descriptive, quantitative study that used secondary data collected from dental records of patients seen at Centre of Dental Specialties (Ceo) in a city of São Paulo State. Result: It was analyzed 1030 dental records. Just 1236 proceedings received referral to Ceo and among then, 86.4% showed the first attendance on Basic Health Unity (UBS) through spontaneous demand and 50.4% (n=623) received referral to endodontic treatment. There was evasion of 2.27% of studied population (n=28) on the first specialized consultation. Among 1208 proceedings that started the treatment in Ceo, 62.6% (n=757) were finalized and received back-referral to primary attention, that finalized 61.1% (n=463) of proceedings. To conclude the treatment, considering the time spent in Ceo and primary attention, there was variation according to specialty: periodontics – 62 days (sd ±68) and endodontics – 71 days (sd ±51.8), requiring 3 consultations in average, regardless specialty. Conclusion: The Centre of Dental Specialties gave referral and attention to the majority of demand, regardless specialty. However, there are many cases of evasion during dental treatment, alerting managers to develop methods to entice these patients, reducing service expenses and raising solvability of dental procedures previously initiated.

Perceptions of educators and students about using fluoridated mouthwashes

Purpose: The objective of this study was to assess the perceptions and opinions of public school teachers and students in the city of Araçatuba, SP, Brazil, on the importance of using fluoridated mouthwashes, the difficulties of the method and the procedure in general. Methods: Students from grades 5 through 8 in schools with and without dental services were asked about their opinion on the use of fluoridated mouthwashes. The educators answered questions about the importance of preventive methods in oral health and the difficulties in performing those methods at school. Data were collected using a faces scale, a categorization method, and a Likert scale with five levels of responses to check the level of agreement with the questions. Results: The sample consisted of 264 (40.3%) teachers and 5,788 (73.6%) students. A total of 254 (96.2%) and 72 (27.3%) teachers responded favorably to the first and second questions, respectively. A total of 1,128 (19.5%) students had negative feelings about the fluoridated mouthwash. Conclusion: The majority of the teachers supported the use of fluoridated mouthwashes; however, a large number of teachers believed that the practice disrupts the class routine. Most of the students had a positive opinion about the use of fluoridated mouthwash, although they highlighted some negative aspects, which were overcome by the benefits that the method provides.

Prevalência de cárie dentária em pré-escolares de escolas de educação infantil de Araçatuba, São Paulo

Epidemiological data on the conditions of oral health are essential for professionals in the health care plan, execute and evaluate dental programs. In Brazil, most oral health programs directs its resources to middle schools, leaving the preschool children in a secondary plan. The objective of this study was to identify the prevalence of dental caries in preschool children from 4-6 years of age from schools of child education (EMEIs) of the city of Araçatuba-SP. The study was conducted on a sample of 275 children of both genders, representative of the population of preschool children in the city of Araçatuba-SP. In order to assess the prevalence and severity of dental caries indices we used the dmft and DMFT indexes, according to the codes and standards recommended by the World Health Organization (WHO).The average dmft of 1.88 was found, comprising 78% of decayed teeth, 21% of restaured teeth and 1% with indicated extraction teeth. Regarding the permanent dentition, the average DMFT was 0.08, consisting of 71% of decayed teeth, 29% restored and 0% of missing teeth. Based on results found, there was a high caries prevalence in deciduous and permanent teeth, demonstrating the need for more dental care to the group studied.

A relevância do periodontista na prevenção da doença periodontal em pacientes ortodônticos: relato de caso clínico

The increase of the retentive areas of bacterial plaque can be observed in patients who use dental braces in the mouth. The difficulty of making hygienic is one of the problems that this particular group of patients faces day by day, and consequently, the establishment of gingival inflammation becomes more frequent. The objective of this case report is to show the importance of the periodontist in preventing and promoting health to the users of dental braces, aimed at education and motivation as one of the priorities of this treatment. The ESA patient, 29 years old, male, attended the dental office of a periodontist, sent by the orthodontist, due to the extensive area of gingival hyperplasia and gingivitis, in both arches. The possibility of taking out the dental braces was considered by the orthodontist, but after the periodontist evaluation, this step was procrastinated. Thus, the periodontist started the adequacy of the oral environment together with the work of education and promotion of health, which lasted until the complete recovery of the healthy gingival condition of the patient. In this way, it is possible to observe the relevance of the work of the periodontist in the application of preventive methods in oral health for orthodontic patients. The motivation of these patients in relation to the orientations of buccal hygienic, maintenance of oral health and diet should not be considered as secondary and should be prioritized, because only in this way it would be possible to reach a good occlusion, without esthetic and functional prejudice.

Fluoretação das águas de abastecimento público no município de Araçatuba/SP

Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP)

Projeto Sempre Sorrindo: 10 anos de atenção ao idoso institucionalizado

Introduction: To correctly attend the health needs of the elderly population, it is necessary to invest in training of human resources. Thus, it becomes indispensable to insert the geriatric dentistry content into graduation courses. Objective: To describe the experiences and the results obtained during 10 years of an university extension project focused on oral health care of institutionalized elderly. Methodology: This is a documental and descriptive work, which was analyzed the institutional process of ten years of the University Extension Program, “Always Smiling - Dental Care for the Elderly Institutionalized of Araçatuba, “ developed at the Araçatuba Dental School, FOA/ UNESP. It were collected quantitative and qualitative data, and these were classified and interpreted according to the technique of categorizing the content. Results: In ten years of implementation, the project “Always Smiling” involved undergraduate students, professors and post-graduate students, who together have developed practical activities such as health education, hygiene supervision, recreational and educational activities, epidemiological surveys of oral health conditions and consequently, dental care according to the need of the treatment. Conclusion: The project “Always Smiling” serves as a working model for elderly health care, because it acts involves many aspects, from the prevention of diseases, even to the training of elderly caregivers, benefiting the institutionalized elderly and health professionals.

Estudo longitudinal sobre a prática de aleitamento materno e fatores associados ao desmame precoce

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeito de diferentes gomas de mascar sobre o pH salivar de crianças

Objective: To evaluate the effect of different chewing gum brands on the salivary pH of children with primary dentition. Method: Forty children were selected and assigned to four groups: control (no chewing gum); sugarless chewing gum; chewing gum with casein phosphopeptide-amorphous calcium phosphate; and chewing gum with xylitol. The first saliva collection was made after supervised tooth brushing for stabilization of the oral pH. Next, all children were instructed to drink slowly 100 mL of a cola-based soft drink (Coca-Cola®) and a new saliva collection was made 10 min later. Then, each group chewed on the chewing gum for 5 min and discarded it after this time. Saliva was collected again at 5, 10 and 15 min intervals after start using the chewing gum. Measurement of salivary pH was made with colorimetric test papers and a digital pH-meter. Data were analyzed statistically by analysis of variance and Tukey’s test at a 5% significance level. Results: The use of chewing gums accelerated the increase of salivary pH to considerably alkaline levels after consumption of an acidic beverage, especially within the first minutes. The highest levels were obtained in the groups of children that used chewing gums containing xylitol and casein phosphopeptide-amorphous calcium phosphate. Conclusion: Children that used the chewing gums after ingestion of an acidic soft drink presented an increase in salivary pH, with the best results in the groups that used chewing gums containing casein phosphopeptide-amorphous calcium phosphate and xylitol.

Qualitative methodogy: revealing a new path for research in dentistry

Currently, it is easy to find health professionals who not only attach importance to qualitative methods, but also recognize their help to better understand their patients' lives. However, its use in dentistry is still incipient, either due to ignorance or because of technical / operational difficulties in identifying possibilities for their use in research. Thus, the purpose of this study was to review the literature on the characteristics and peculiarities of the qualitative methodology, demonstrating their techniques of collecting, recording and analyzing data. For this, we performed a descriptive literature, from a survey in the "LILACS", "BBO" and "PUBMED" databases, by keywords related to the theme, selecting only the papers that mentioned the "importance" of qualitative research, the "characteristics and fundamentals," and the "techniques of collecting, recording and data analysis" involving this methodology. It was found that all studies have highlighted the importance of qualitative research to the construction of new knowledge that cannot be achieved by quantitative data. We found many different techniques to gather, record and analyze qualitative data applied to the dentistry field. It was concluded that qualitative research represents a new path to be followed by dentistry, so that we are able to plan actions in ethical and humane public health dentistry, bringing better results to the population, because of the depth of knowledge that your date can.

Reflexões sobre o conceito de atendimento humanizado em Odontologia

Humanization at dental care is highly important due to uneven relation between scientific / technical advances in dentistry and thequality of human contact. The dental treatment goes beyond the field of scientific knowledge. Therefore, the dental treatment requiresbalance among technical skill, scientific training, and humanist vision of health promotion. Contemporarily, humanization is understoodas tripod based on user's rights, dental practice and organization of a humanized model. Curriculum integration of ethical, humanistic,scientific and technical contents is an important and current challenge on teaching / learning process for professionals at Dentistry. Thispaper aims to, guided by the literature review, to present some considerations on human care in dentistry, with emphasis on theimportance of professional /patient relationship for promoting oral health. It is suggested that dentists reflect on the urgent need ontheoretical basis of humanization and patient-professional relationship for health care.Descriptors: Humanization of Assistance; Dental Staff

Influência da menopausa no tratamento endodôntico

A menopausa é uma das mudanças fisiológicas caracterizadas pelo encerramento dos ciclos menstrual e ovulatório, ocorrendo nas mulheres entre a quarta e a quinta década de vida. Com ela, ocorre uma diminuição na produção de estrógeno, um importante hormônio que atua em muitos processos fisiológicos do indivíduo, como a regulação do sistema esquelético. O declínio nos níveis de estrógeno resulta em perda de densidade mineral óssea, aumento do risco de fratura, bem como no aparecimento de doenças ósseas, como a osteoporose, um processo patológico onde há o aumento na reabsorção de cavidades que não são completamente preenchidas por osso neoformado. Além disso, a deficiência de estrógeno pode causar muitas mudanças na saúde bucal do indivíduo. Na presença de uma infecção bacteriana no tecido pulpar, essa deficiência pode agravar a periodontite apical. Vários medicamentos têm sido estudados como potenciais agentes terapêuticos para suprir a deficiência de estrógeno. Essas drogas têm como objetivo reduzir o risco de fraturas e prevenir a perda óssea e distúrbios cardiovasculares e mentais resultantes de deficiência hormonal pós-menopausa. O raloxifeno (RLX), é uma das drogas terapêuticas mais estudadas, demonstrando prevenir a perda óssea. Mesmo com a indicação e benefícios do raloxifeno no metabolismo ósseo e na manutenção da densidade óssea, estudos sobre o seu papel na infecção endodôntica em organismos osteopênicos precisam ser realizados.

Condições bucais de crianças e adolescentes portadores de síndrome de down

Os pacientes com síndrome de Down têm mostrado diferentes condições de saúde bucal, destacando-se uma baixa ocorrência de cárie e maior suscetibilidade às doenças periodontais. Assim, o presente estudo objetivou avaliar a prevalência de cárie, patologias periodontais e níveis de cocos cariogênicos em portadores de Síndrome de Down. A população foi constituída de 40 pacientes portadores da síndrome, com idade de 6 a 18 anos, de ambos os gêneros, e igual número de pacientes do grupo controle, os quais foram submetidos ao exame clínico periodontal segundo os critérios do PSR e para determinação do índice de cárie empregando-se os índices ceo-d e CPOD, e avaliação dos níveis de cocos cariogênicos através do real-time PCR. Verificou-se que nas crianças com síndrome de Down o índice médio ceo-d foi 1,17 e o CPO-D 3,53 enquanto que no grupo controle foi observado ceo-d 1,97 e o CPO-D 2,77. Verificou-se que 32,5% das crianças com síndrome de Down eram saudáveis, 65% com gengivite e 2,5% com periodontite e, no grupo controle, 50% foram saudáveis e 50% mostraram gengivite. Os resultados evidenciaram que a população de cocos cariogênicos foi similar entre pacientes portadores ou não de síndrome de Down. Concluiu-se que a ocorrência de cárie em crianças com síndrome de Down foi maior nos dentes permanentes comparadas com o grupo controle, enquanto que na dentição decídua a ocorrência de cárie foi maior no grupo controle, enquanto que as condições periodontais foram semelhantes entre os dois grupos.

Necessidades de tratamento odontológico entre nativos brasileiros da reserva indígena Umutina, Estado do Mato Grosso

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Percepção e atitudes de pedagogos sobre aspectos relevantes do uso de escovas dentárias

Objective: To evaluate the perception and attitude of kindergarten teachers in relation to the storage of toothbrushes. Methodology: The analysis instrument used was a structured and previously validated questionnaire. The sample universe of this study was composed of all states and municipals kindergarten school teachers who taught in school year of 2010 at the town of Araçatuba / SP (n = 232). The criteria used to integrate the study were: to have a college degree and agree to participate. Results: 164 teachers participated of the study. The results were analyzed using Epi Info 6.04 and showed that 55% of the teachers had received some information about the proper storage of toothbrushes, and only 35% believed that the toothbrushes were storaged improperly. Most teachers, 97% reported being possible the transmission of microorganisms through the brush, however, there was observed difficulty in identifying which diseases could be transmitted. About the question related to the execute of supervised toothbrushing, 93% of the educators said that they realize supervised toothbrushing and the same percentage was observed for the identification of preschoolers at the toothbrushes. Conclusions: The perception and attitude of the teachers ahead the storage of toothbrushes are weak and limited, so there is a need for educational programs targeted to this group, so that they would have more information and knowledge related to the correct storage of toothbrushes and would continue to perform oral health preventive methods.