299 resultados para Baremo odontológico
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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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.
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The sector of health insurance is the entrance of 42 millions Brazilian people for health services. Passed a lot of years until regulations appears. The objective of this article was made an analysis of dental institutions participation at the national agency of health insurance – ANS, response for regulation and investigation in Brazil. Through an documental analysis of texts described in meeting registration of ANS, from 1998 to 2006, was made an identification of dental citations, try to describe a standard of dental representation in the meetings. The dentistry was present in 135 citations, the dentistry representatives institutional made 77 citations (57%), 19 was about dentistry proceeds and 7 of those was to ask resolutions; others 35 citations was about manager and standard of services offer by insurance companies, 5 was ask resolutions; others 3 asks was about taxes and fees, and 10 others was about relationship between companies and employs. The results show that dentistry has a good presence by their institutional representatives in ANS meetings.
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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.
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Brazilian Curricular Directrix demand changes on teaching dental surgeon, proposing new scenes of learning and study other than the classroom. So, pedagogic projects should search for integral and adequate education by relating teaching, research and extension/assistance. This paper discusses the importance of university extension activities on teaching Odontology students and relates the experience of Araçatuba Dental School of São Paulo State University. This school develops some university extension activities since the 60s by Dental Service Beyond School (SEMO, in portuguese). Among the activities included by SEMO there are several projects, such as: “Program of Dental Attention for Pregnant Women”, “Program of Dental Attention to Juvenile Foundation at Araçatuba”, “Always Smiling – Health Promotion for Institutionalized Elderlies”, “Santa Clara de Assis Nursery School Program of Dental Attention”, and "Promotion of oral health in Araçatuba public kindergarten schools”. These programs give the student knowledge of structure dimensions of public health services; chance to participate on attendance for the population, comprehension of oral health politics, and the role of dental surgeon in social context, where these students will work in the future. The positive impact obtained with these services is perceived by students return. Most of them feel satisfied about the experience lived there.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Objective: The aim of this research was to determine the knowledge level of 400 dentists registered in the Regional Dental Council of Cuiabá, through a questionnaire about the importance of records in the process of human identification. Results: We observed that 48.36% of them dispense between 10 and 20 minutes. Only 13.1% of the surveyed dentists did not have the habit of writing down the oral conditions of their patients before starting treatment and 42.62% have only one odontogram filled. From the 122 participants, 11.11% reported that the documentation had no utility to establish the patients identity. To make the situation worse, 33.6% of them said they did not keep the records of patients updated. Conclusion: We conclude that the dentist of Cuiabá has enough knowledge on preparing, maintaining and importance of dental records before the death in the identification process for establishing the patient identity. But, always he did not properly fills the dental records, thus it has been reducing their clinical, administrative and legal value.
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The number of lawsuits against dental surgeons has increased considerably in the recent years. Probably this is due to a change in the behavior of the patients, from a passive role in the past to a more demanding stance now. A transversal study was carried out to evaluate the point of view of lawyers in Araçatuba, SP, Brazil, about the professional liability of dentist, the major reasons for treatment failure, the dental specialties more involved in legal actions, their attitudes if they were submitted to an unsuccessful dental treatment, their opinion on what the dentist should do when a patient does not accept the treatment provided, and, finally, what a dentist should do when facing a civil liability action. A questionnaire was sent to 318 lawyers, and 151 of them answered it. The results show that for most lawyers an occasional failure in the treatment occurs due to professional incompetence and, in their opinion, the specialty more involved in legal problems is orthodontics (64.7%). Of the lawyers interviewed, 27.0% affirmed they would seek another dentist and also a lawyer, if they were subjected to an unsuccessful dental treatment. For 36.5% of them, the dentist should give further information and explain the reasons why the treatment did not meet the patient's expectations. According to 36.1% of the interviewees the best policy to be adopted by the dentist in case of a civil liability action would be an extra judicial settlement.
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In addition to understanding the distribution of the populations’ health-disease process, epidemiology has sought to study the causality associated with this process, which humanity developed over time, and to interpret the narrative of this field of knowledge. A solid review of the literature was done to emphasize the importance of using popular knowledge as a qualitative health-related investigation strategy and to demystify the use of social representations in the field of dentistry. By initiating the design of a new paradigm for understanding the oral health-disease process, which favors the idea that it is also the result of a sociocultural production, knowledge of the circumstances and context in which it is inserted becomes critical for health assessment actions. Although scientific dentistry has advanced the understanding of oral diseases, communication with popular knowledge leaves much to be desired, since most professionals find themselves trapped in a fragmented model of care. Reconstruction of the logic by which the representations of oral health were produced and socialized over time can be considered a relevant and productive purpose of the representations in the dental area.
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Conselho Nacional de Desenvolvimento Ciêntífico e Tecnológico (CNPq)
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Cerebral paralysis is a chronic illness that affects the central nervous system. In this article the author describes the techniques used at CAOE (Odontological Center for Assistance to patients with special needs) to restraint CP patients during dental treatment, because they present some pathological reflexes which interfere in their odontological assistance. Also it shows how to perform a special physical restraint and how to keep the mouth open by using simple tools including a homemade one. All the devices used during the dental treatment in cerebral palsy patients, such as the physical restraint with bands or sheet to wrap them up, cylindrical pad or cushion made of a soft material, or simple tools including a homemade one to keep the mouth open are usually and safely used in CAOE. All these simple devices are necessary, because there are no available funds for the acquisition of expensive material or equipment. Despite of a shortage of resources we can easily and efficiently assist these patients.
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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
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Osteomyelitis of the mandible and maxilla are common in developing countries and their treatment may be long-standing and difficult. Thus, the aim of this study was to discuss the main biological aspects of the chronic osteomyelitis of the jaws of especial interest for dental team. These infections are associated with a complex microbiota composed mainly by anaerobic bacteria, sometimes associated with microorganisms originated from the skin and digestive tract. These data suggest that chronic osteomyelitis of the mandible and maxilla should be treated as anaerobic infections in most cases. In addition, local surgical treatments are relevant in the therapy outcome, associated to the use of antimicrobial agents, and the failure to accomplish them is a major cause of treatment failure.
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This study evaluated the oral conditions of 50 cancer patients undergoing head and neck radiotherapy (RT). Clinical examinations were performed before treatment, immediately after 30 days after RT and 6 months after conclusion of RT. Periodontal conditions were evaluated using the criteria of the Periodontal Screening and Recording (SRP) and the need for dental treatment were determined. The presence of xerostomia, mucositis and other side effects of RT were also evaluated. Soon after the beginning of RT, the irradiated patients of radiotherapy developed severe mucositis, dermatitis, dysgeusia, xerostomia and, to a lesser extent, candidosis. After completion of radiotherapy, 68% of patients had level III or IV mucositis. It was found that the development of mucositis hinders oral hygiene and these factors contribute to exacerbate inflammation of periodontal tissues. The data from this study evidenced that the main cause of desertion of RT and of severity of sequelae of RT depends on the oral conditions of patients before starting treatment and the absence of previous dental treatment prior RT.
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The use of antimicrobial agents has facilitated the dissemination of multi-resistant microorganisms, compromising dental and medical treatment. The aim of this study was to evaluate the distribution of different opportunistic microbial species in patients who suffered head and neck trauma, under temporary maintenance in nosocomial environment, particularly intensive care units, on the occurrence of such microorganisms in the oral cavity of the patients. It was selected 38 patients subjected to head and neck traumas. After emergency surgical procedures, clinical samples of saliva, sub and supragingival biofilms and mucosal surfaces were collected at two different moments: just after stabilization of the patient and soon after patients’ release from medical units. The presence of opportunistic and superinfecting microorganisms was evaluated by culture on selective and non-selective media, and the presence of the family Enterobacteriaceae, as well as genera Enterococcus, Pseudomonas, and Staphylococcus was assessed by PCR. It was found that the use of antimicrobials, even for short periods of time was sufficient to facilitate colonization by microorganisms of the families Enterobacteriaceae and Pseudomonadaceae, as well as yeasts and enterococci. These results support the concept that medical and dental teams should make a periodically change of antimicrobials used in treatment protocols in hospital for head and neck trauma patients, in order to minimize dissemination of opportunistic or superinfecting microorganisms.