Odontologia baseada em evidências: otimizando a prática e a pesquisa

Clinical decisions in dentistry are often based on the knowledge obtained during graduation, clinical experience, information shared with colleagues and professor, textbooks, seminars, conferences and continuing education courses. However, it is necessary to know if this information is derived from scientifically validated researches since too much information may complicate this process. Initially in medicine and later in other health areas a method which enables a critical evaluation of scientific papers related to a specific issue and also, whenever it is possible, an evaluation of the results by meta-analysis,was developed by Cochrane in order to reduce the bias towards all information obtained. The aim of this work is to present some aspects of the Evidence Based Dentistry (EBD) and to show how this methodology can be used to better substantiate scientifically the clinical decision of the dentist and improve researches design with scientific validity. The paper discusses editorial trends focused on the EBD, shows the differences between a systematic and a conventional review, describes data about Cochrane and the advantages of scientific evidence synthesis and the implications of EBD for clinical practice and research as well as recommendation grades and evidence levels of general scientific studies.

La relacion entre la calidad de la ensenanza y mala prática odontológica: relato de un caso clínico

The activities developed in health area are of great importance, because they have the aim to preserve the life of the men, and therefore, must be performed by authorized persons. The increase of the number of dental schools, the decline at the education quality and a higher admission of students with low ability to exercise their profession, are facts that bring disastrous consequences for society. These facts are, also, reflected at the moral, ethical and technical-scientific performance of the professional. The purpose of this clinic case is to show that although there is a significant suplly of education institutions, there is a lack of scientific and adequate technical knowledgement from the graduated dentals surgeons. The patient MSL, 17 year old, female, went to a dental clinic presenting a tray type Vernis, attached to the lower arch. After clinical evaluation, it was showed that an incorrect material was used for the impression technique, being impossible to take out the tray by the conventional manner. The planning for the removal of the tray was through the divide of it. Thus, the consequence of the lack of knowledge in the use of impression materials had caused a great incovinience to the patient. It can be concluded that the rate of malpractice is directly related to the professional preparation, highlighting the importance of quality dental education for a responsible clinical practice.

Saúde bucal nas escolas: relato de experiência

The need for a closer contact between students and the community reality, as well as, the necessity of providing an education that can result in social changes early in life were crucial for the development of the Extension Project : Oral Health Education, which was developed in Public Child Care Schools in Araçatuba. The aim of this article is to describe the project, emphasizing its educational aspects and to share this experience in order to allow for reflection about this practice.

A influência da prática do aleitamento materno na aquisição de hábitos de sucção não nutritivos e prevenção de oclusopatias

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

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)

Saúde do trabalhador na odontologia: o cirurgião-dentista em foco

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Percepção de pacientes HIV-positivos de um centro de referência em relação a tratamento de saúde

Introduction: health professionals, in many cases, have defensive and exclusionary practices, patterns of prejudice and discrimination in response to HIVpositive patients. Objective: to verify the perception of patients seropositives from a reference center for STD/HIV/aids in relation to health care. Methods: there were interviews with questions related to discriminatory attitudes suffered, access and health care. Results: 130 individuals participated in the survey, from which 30 (23.1%) reported events of discrimination suffered outside the center of reference, predominantly from surgeon-dentists and 112 (86.2%) believed to have the same access and health care as other citizens. 62 (47.7%) treated with the dental center of reference, of which 56 (90.3%) felt good being treated in a dental unit only for HIV positive and six (9.7%) were indifferent, believed to be more exposed, or have a bias to attend dental seropositive individuals. Conclusion: it is concluded that many patients have already been discriminated against outside the reference center. However, most of them have a positive feeling towards the treatment received at a specifi c place for treating HIV-positive patients, due to the feeling of being welcome at that place due to the humanization and access to health care.

Conhecimento sobre saúde bucal e práticas desenvolvidas por professores do ensino fundamental e médio

Introduction: The oral health education is a process that aims to transform attitudes and behaviors and to form habits for the benefit of individual health. For this to occur, it is necessary to strengthen and continuous repetition, as possible in the school environment. Objective: To analyze teachers’ knowledge about oral health, practices developed in the school environment, as well as the participation of dentists in guiding teachers of primary and secondary schools. Subjects and method: We used a semi-structured questionnaire with open and closed questions about teacher training, received guidance on oral health during their training, development of oral health issues in the classroom and knowledge on the subject . Results: Of the total respondents (n = 221), only 77 (34.8%) said they had guidance on oral health in their training to be a teacher. 70 (31.7%) said they did not develop oral health issues in the classroom and 91 (41.2%) stated no interaction between dentist and professor. We observed deficiency in teachers’ knowledge about certain issues related to dental health. There was statistically significant association between the dentist’s guidance to teachers and the development of oral health actions and the teacher’s knowledge about the location of the first permanent molar eruption (p <0.01). Conclusion: This study conclude that although most educators develop educational practices on oral health in the school environment, there is a deficiency in understanding by teachers of certain subjects, making it necessary a greater participation of the dentist in the transmission of technical and scientific knowledge to them.

Ética e atuação profissional: percepção de agentes comunitários de saúde

The perceptions of the Community Health Agent (CHA) referred to ethics in their work have been evaluated in this study. A questionnaire with social and ethical issues was applied in 61 ACS. 90% reported having received information about ethics, and “training courses” was the most cited source (68.9%). On a scale from 1 (least) to 5 (maximum), 67% claimed to have knowledge about ethics among 4 or 5 and 88.5% reported that this topic has an importance of 5 in their work. Ethical conflicts exposed had an average of 75% of respondents in agreement with the reference sources, and the two items involving “information privacy” showed the greatest disagreement. Ethics was considered important by the professional performance of subjects who had a good perception about the issue; however the topic about privacy of information generated controversy.

Educação em saúde bucal na visão de acadêmicos de odontologia

Aim: To analyze dental students' view concerning Oral Health Education. Materials and Methods: The present research, using both qualitative and quantitative approaches, addresses aspects related to dental students' understanding of Oral Health Education, the value that they attach to this practice in the school environment, as well as the importance of their participation in these and other activities during their studies in dentistry. Results: Although dental students recognize the importance of Oral Health Education in the school environment,as well as the importance of their own participation within these activities, their perception of "Oral Health Education" is reductionist and focused primarily on the disease. Conclusion: It is well-known that these findings are reflections and consequences of an established context within a university education. It is therefore necessary that these professional educators perform an in-depth rethinking of the dental practice, in an attempt to develop methodologies based on Health Education in their own teaching practices.

Saúde bucal no Brasil: uma nova política de enfrentamento para a realidade nacional

The implement of Specialized’s Dentistry Centers in Brazil is, on present-day, one of the prime faces of Oral Health Brazilian Political, of which is to amplify and to qualify the specialized’s dentistry services proffer. The aim of this study, done with indirect dates, was to analyze the implantation and geographical distribution of these Centers in Brazil and try to make a relationship between this information and social and oral health factors. The results obtained showed the presence of 339 Centers already implanted in Brazil, homogeneously allocated in 283 cities, by a total of 5.560 brazilian cities, presented in the five Greater Regions. The most of the Centers were presented in large load cities. The data showed Southeast, Central West and Northeast regions with the major percentage of cities carrying Specialized’s Dentistry Centers (7,6%; 6,5%; 6,1%, respectively), while North and South regions present the minor covering taxes (4,0% and 4,5%, respectively). Relation to population’s social and buccal needs, North and Northeast Regions have the most adverse conditions, on the contrary to South, Southeast and Central West Regions who show the best one. Although the finded results were not so expressive, reflecting the brazilian geographical and populational characteristics and the essential development of specialized dentistry services, this initiative presents a real progress over the reorganization of dentistry’s practice.

Saúde coletiva: promoção de saúde bucal na gravidez

Objective: The aim of this study was to analyze the perception and attitudes about oral health of pregnant women recorded on SIS-Prenatal from Bilac city, São Paulo State. Method: the data collection was through interviews with pregnant women using a semi-structured questionnaire. Pregnant women that were not present on attendance with gynecologist and those whose children were born were excluded of sample. Result: Among the  20 interviewed pregnant women, 80% didn’t received any type of information about oral health during pregnancy, 45% of total didn’t know how to maintain baby’s oral health,  85% didn’t know the mean of carie disease. The majority of pregnant women (95%) interested to make part of projects about promotion of oral health. Conclusion: the future mothers showed little knowledge in relation to preventive proceedings in dentistry and about diseases that could involve their and baby’s oral health. It’s necessary to perform programs about oral health, pointing the cares for mother-baby

Exercício físico aeróbio para promoção da saúde de pacientes com doença de Alzheimer

Introdução: Sabe-se que a prática regular e sistematizada de atividade física é uma eficiente estratégia para evitar a deterioração cognitiva e funcional associada à Doença de Alzheimer (DA), uma doença progressiva, degenerativa e irreversível. Na população idosa os benefícios observados com a prática de exercícios físicos aeróbios já se encontram bem estabelecidos, contudo pouco ainda se sabe quanto à prática deste tipo de atividade em pacientes com DA. Em estudos realizados com modelo animal pode-se observar que o exercício físico aeróbio foi capaz de reduzir os níveis da proteína β-amilóide, sendo esta uma proteína característica da DA, que provoca degeneração no cérebro dos pacientes. A redução dos marcadores característicos da doença pode promover benefícios para os pacientes. Objetivos: Promover a prática de exercícios físicos para promoção/manutenção da saúde de pacientes com DA. Métodos: O estudo está sendo desenvolvido no PRO-CDA (Programa de Cinesioterapia Funcional e Cognitiva em Idosos com Doença de Alzheimer), projeto de Extensão do Departamento de Educação Física da UNESP – Campus Rio Claro, vinculado ao Núcleo Local UNESP-UNATI. O projeto atende atualmente 34 pacientes, divididos em dois grupos: Grupo Convívio Social e Grupo Exercício. O primeiro tem por objetivo desenvolver a adaptação do paciente à rotina do projeto. Já o segundo grupo busca promover os benefícios observados com a prática de atividade física nos pacientes participantes. Ambos os grupos realizam atividades três vezes na semana, com 60 minutos de duração cada sessão. O projeto conta com a participação de alunos de graduação, dos cursos de educação física, pedagogia e biologia, bem como discentes de pós-graduação da UNESP, além de aprimorandos graduandos e graduados dos cursos de educação física, fisioterapia, gerontologia e psicologia de outras universidades, que atuam sob a coordenação de docentes vinculados ao Departamento de Educação Física e de Educação. Resultados: Por se tratar de um protocolo de intervenção motora iniciado recentemente, o presente estudo ainda não apresenta resultados. Contudo protocolos de atividade física desenvolvidos anteriormente no PRO-CDA evidenciam melhora na realização de atividades de vida diária, manutenção das funções cognitivas, qualidade de vida e redução dos distúrbios de comportamento nos pacientes participantes. Espera-se que o protocolo de exercício físico aeróbio possa influenciar positivamente os participantes do projeto, com melhora na qualidade de vida, tanto de pacientes como de cuidadores, redução de sintomas depressivos, melhora dos distúrbios do sono e da condição motora.

Projeto Saúde na Praça: uma experiência de promoção da saúde em Araraquara-SP

Introduction: Considering the benefi ts of a regular physical activity already indicated on literature and, on the other hand, the high prevalence of physical inactivity, the negative impact of this behavior to the population’s health and also to the public safe, Araraquara city hall (SP) creates the project Health in the Square off ering Lian Gong practice to elderly people since 2001. Objective and Methodology: This experience report describes such project and how it is monitored by city hall through some indicators of physical assessment that was obtained whit the participants in 2007 (General Gymnastics mode). Results: During nine years, this project evolved exponentially because included three physical activity types (General Gymnastics, Hidrogymnastics and Tai-chi-chuan) in 55 city’s spots, mostly public squares, and it benefi ciates about 1.300 adults. The Project has achieved good results in provides health of participants, what justify continuation and expansion of the project in this city.

Atividade física para promoção da saúde de idosos com doença de Alzheimer e seus cuidadores

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