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.

Prevalência de cárie dentária em gestantes atendidas no Sistema Único de Saúde em município paulista

The purpose of this study was to evaluate the dental caries prevalence and the use and needs of dental prosthetic in pregnant women attending in the National Health System in northwestern city of São Paulo state. The sample involved women, between 3 and 9 months of gestation, who were taking prenatal care in Health Units. Those who consented (n = 119) were examined and interviewed by calibrated dentists. We used the DMF-T index and indicators of the use and needs of dental prosthetic. The average age of the pregnant women was 24.7 years, the majority brown (48.7%) with complete high school (60.5%). The average DMFT was 11.7 and 25.2% and 46.2% of them require upper and lower prosthesis, respectively. The oral health indices showed a high DMT-F and great need for dental prostheses. The results show the need for actions directed, with the aim of to improve the specialized attention to the health of mothers and their babies.

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.

A importância da integração universidade e serviços de saúde

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.

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.

Pemphigus vulgaris in adolescence: a case report

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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.

Auditoria em Saúde: justificativas de glosas no setor odontológico

Objective – To collecting data about the main explanations for glosses and demonstrating the percentage of production loss in the odontologic procedures. Methods – It is about an epidemiological study of historical series, retrospective and quantitative, based on the data collection of DATASUS information system and reports realized by the city of Aquidauana/MS audit system from 2001 to 2010. Results – The results show that in this period, 921.300 odontologic procedures were presented as production; being 223.226 (24,2%) individual procedures and 698.074 (75,8%) collective. There were 23.881 (2,6%) glosses, being 10.158 (42,5%) in the collective procedures and 13.723 (57,5%) in the individual ones. The main cause for glosses related to individual procedures was the repetition of procedures for the same patient and the same tooth (42,4%). In the collective activities, it was the non-accomplishment of the oral health collective program (68,9%). There was an increase of loss in the individual procedures going from less than 5% in the period of 2001 to 2007; to 5,8 % in 2008; 8,9% in 2009 and 14,1 % in 2010 and in the collective procedures the loss reached 4% in 2010. Conclusion – It was concluded that the most frequent cause of glosses explanation was the repetition of procedures for the same patient and the same tooth in the individual cases and the non-accomplishment of the oral health collective program in the collective activities. The importance of the audit system as a trust-worthy instrument for the managers in the planning and evaluation of health actions with the intention of guarantee the solution of the serv-ices provided.

Odontologia baseada em evidência: etapas e métodos de uma revisão sistemática

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O conceito de saúde geral e bucal na visão dos cuidadores de idosos

The aim of this study was to analyze the perception of elderly caregivers in relation to the meaning of general and oral health and about oral health status of the institutionalized aged. It was performed a qualitative study, using Discourse of Collective Subject method. It were interviewed 42 caregivers who worked in longterm care facilities of Araçatuba City, SP and Passo Fundo City, RS – Brazil, applying a structured questionnaire. The interviews were recorded and transcript to be performed the qualitative analysis. The answers were analyzed and them it was elaborated the discourses of collective subject (DCS). Oral health, according to caregivers, was hygiene habits and good diet, while the absence of oral health was sequelae of oral diseases. It's possible to note that older means of health were being substituted by new perceptions of quality of life and is very divergent between older professionals and those who graduated during last two decades. However, according to caregivers, this health perception as quality of life was not included in Dentistry, where the old mean "absence of symptoms" was prevalent. For part of them, the institutionalized elderly have no oral health and the only way to improve their condition was through clinical attendance.

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.