Saúde bucal para pacientes com necessidades especiais: pesquisa avaliativa de Centros de Especialidades Odontológicas

ABSTRACT - The Dental Specialties Centers (CEOs) were created within the context of the National Oral Health Policy, and the main function of these establishments is to serve as units of reference in secondary oral health care in the Brazilian national health system (SUS), and they must offer at least the services of stomatology, specialized periodontology, minor oral surgery, endodontics, and attendance to patients with special needs. The aim of this study was to evaluate the quality of the CEOs in the mountain region of the Rio de Janeiro State, Brazil, in the perspective of the patients with special needs care or their companion’s satisfaction. Data were collected from 159 users by using a standardized self-applied individual semi-structured questionnaire. The results indicated a positive evaluation in most of the dimensions, except the accessibility dimension. Significant differences (p < 0.05) were observed between the services of the following dimensions of quality: accessibility, resoluteness, technical-scientific quality, efficiency, efficacy, and acceptability. The analysis of qualitative data, through the discourse of the collective subject technique (DCS) and social representations, showed five central ideas about users’ satisfaction and dissatisfaction with CEOs services (humanized health care, resoluteness of the service, professional competence, infrastructure and organization of the service, access to the services). In conclusion, most patients with special needs care and their companions were satisfied with specialized dental centers (SDC) services, although there were significant differences among SDCs services in relation to individuals’ satisfaction.RESUMO - Os Centros de Especialidades Odontológicas (CEOs) foram criados dentro do contexto da Política Nacional de Saúde Bucal e a principal função desses estabelecimentos é servir como unidades de referência em atenção secundária à saúde bucal no SUS, devendo oferecer pelo menos os serviços de estomatologia, periodontia especializada, cirurgia oral menor, endodontia e atendimento a pacientes com necessidades especiais. O objetivo deste estudo foi avaliar a qualidade dos Centros de Especialidades Odontológicas da região serrana do Estado do Rio de Janeiro, Brasil, por meio da satisfação dos pacientes com necessidades especiais ou de seus acompanhantes. Os dados foram coletados de 159 usuários utilizando um questionário semiestruturado individual auto-aplicado padronizado. Os resultados indicaram uma avaliação positiva na maioria das dimensões, exceto na acessibilidade. Diferenças significativas (p < 0.05) foram observadas entre os serviços nas seguintes dimensões de qualidade: acessibilidade, resolutividade, qualidade técnico-científica, eficiência, eficácia e aceitabilidade. A análise dos dados qualitativos, por meio da técnica do Discurso do Sujeito Coletivo (DSC) e das representações sociais, apresentou cinco ideias centrais sobre a satisfação e insatisfação dos usuários com os serviços dos CEOs (cuidado humanizado, resolutividade do serviço, competência profissional, infraestrutura e organização do serviço, acesso aos serviços). Em conclusão, a maioria dos pacientes com necessidades especiais e seus acompanhantes estavam satisfeitos com os serviços dos CEOs, embora houvesse diferenças significativas entre os serviços dos CEOs em relação à satisfação dos indivíduos.info:eu-repo/semantics/publishedVersio

Clinical and Social Variables Association on the Frequency of Intellectual Disability Persons to Dental Care

Objective: To evaluate the association of oral health indicators and social variables on the frequency of visit to the dentist by persons with intellectual disability (ID). Material and Methods: The study comprised a sample consisting of 149 participants with ID, aged from 11 to 29 years, from non-governmental institutions. Semi-structured interviews were held to collect sociodemographic and psychosocial information with their parents/guardians, followed by oral health evaluations in accordance with World Health Organization criteria. Crude analyses and multiple analysis were conducted to test whether oral health indicators and social data were predictors of the visit to dental care services. Results: In the multiple logistic regression model, individuals with lower DMF-t (OR=3.13; 95% CI=1.40-6.97) and those with less crowded housing (OR=2.33; 95% CI=1.06-5.12) presented less frequency of visits to oral health services. Conclusion: DMFT and crowded housing are associated to the frequency of persons with intellectual disability to dental care as well as this outcome measure affects the oral health of persons with ID. Therefore, identifying limiting factors to dental care of persons with intellectual disability is needed so that this group can receive adequate attention

Different methods of dental caries diagnosis in an epidemiological setting

Aim: To evaluate the performance of dental caries detection when adjunct methods are associated and their applicability in epidemiological survey of dental caries, at D3 (cavitated carious lesions at dentin layer) and D1+D3 (non cavitated and cavitated carious lesions at enamel/dentin layer) diagnostic thresholds. Methods: A total of 2189 posterior teeth from 165 12-year-old schoolchildren underwent visual examination without (CL1) and with artificial lighting (CL2), radiographic bitewing (BW), fiber-optic transillumination/FOTI (FT), DIAGNOdentTM (DD) and associations of these methods. Reproducibility was calculated by Kappa statistics and validity was calculated by sensitivity, specificity and accuracy tests. ANOVA (Scott-Knott test) was performed in order to compare the average values of DMF-S obtained by the diagnostic methods. Results: The CL2FTDDBW (D3) and CL2BW (D1+D3) exams presented the highest values for accuracy at epidemiological setting. The DMF-S index obtained for those exams was statistically different at D3 and D1+D3 thresholds. Conclusions: The association of adjunct methods increased the validity of dental caries examination in an epidemiological setting. However, the potential of CL2BW (traditional caries detection methods) or visual exam performed under a more refined diagnostic criteria must be considered in dental caries epidemiological surveys1417883FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP06/58881-

Epidemiological assessment of predictors of caries increment in 7-10- year-olds: a 2-year cohort study

OBJECTIVE: The aim of this 2-year cohort study (2003 to 2005) was to investigate how caries experience, at initial lesions (early or non-cavited lesions) and cavited stages, predicts caries increment in permanent teeth in 7-10- year-olds. MATERIAL AND METHODS: The random sample of 765 children attending public schools in the city of Piracicaba, SP, Brazil, was divided into two groups: 423 children aged 7-8 years and 342 children aged 9-10 years. All subjects were examined by a calibrated examiner, using dental mirror and ball-ended probes, after tooth brushing and air-drying in an outdoor setting, based on the World Health Organization criteria. Active caries with intact surfaces were also recorded as initial lesion (IL). Univariate analysis was used for statistical analysis (Odds Ratios and Chi-square). RESULTS: The association between the DMFT (decayed, missing and filled teeth) increment and the presence of IL was significant only for 9-10-year-old children. The children with DMFT>;0 at baseline were more prone to have DMFT increment, with the highest risk for caries increment occurring in children aged 7-8 years. CONCLUSIONS: The predictors of caries increment were the presence (at baseline) of caries experience in permanent teeth for both age groups (7-8; 9-10-year-olds) and the presence of the IL (at baseline) for 9-10-year-olds

Effect Of Different Diagnostic Thresholds On Dental Caries Calibration - A 12 Month Evaluation.

To analyze the reproducibility of a calibration trial, at different diagnostic thresholds of dental caries, in a 12-month evaluation. A group of dental examiners (n = 11), who had previous experience in epidemiological surveys, participated in the study. An initial training phase (theoretical and clinical) and five calibration exercises (baseline, 3, 6, 9 and 12 months) were arranged. World Health Organization (WHO) criteria, including the active initial lesions (IL) were used. Six- to 7-year-old children took part in the study. They were selected according to past history and dental caries activity. The data were analyzed at WHO and WHO + IL diagnostic thresholds in accordance with tooth and dental surfaces. Excellent mean intra- and inter-examiner Kappa values were obtained for both diagnostic thresholds, in accordance with tooth and surface, during the calibration phases. However, the most relevant errors were related to the decayed component and to IL diagnosis. It was possible to use the methodology proposed in this study in epidemiological surveys when examining the mixed dentition, although new strategies to improve training in IL diagnosis and calibration are necessary.34213-

Comparação entre medidas de reprodutibilidade para a calibração em levantamentos epidemiológicos da cárie dentária

Comparar três medidas (kappa, porcentagem geral de concordância e índice dice) utilizadas para se determinar a reprodutibilidade do diagnóstico da cárie em levantamentos epidemiológicos, sob diferentes níveis de detecção da doença. Onze examinadores com experiência prévia em levantamentos epidemiológicos foram submetidos a um processo teórico-clínico de calibração. Dois níveis de detecção da cárie foram adotados: Organização Mundial da Saúde (OMS) e OMS com inclusão de lesões iniciais em esmalte (OMS + LI). Os exames foram realizados em 23 crianças de 6-7 anos de idade com e sem atividade da doença. A análise dos dados foi realizada mediante dois limiares: OMS e OMS + LI. Valores médios dos índices kappa, porcentagem geral de concordância e dice foram considerados altos (>0,90), à exceção do índice dice para o limiar OMS + LI (0,69). O kappa, por ser um índice de concordância ajustado, pode ser considerado como instrumento de escolha para a calibração dos examinadores. Entretanto, na impossibilidade de seu uso, recomenda-se a utilização da porcentagem geral de concordância associada ao índice dice, a fim de direcionar e aprimorar os examinadores no exame das lesões cariosas

Mechanical properties of alkasite restorative dental material - A Scoping Review

This scoping review focuses on analyzing the mechanical properties of alkasite restorative dental material, presenting a comprehensive description and analysis of published manuscripts on this subject

Depth Of Occlusal Caries Assessed Clinically By Fluorescence Laser Conventional And Digital Radiographic Methods

The purpose of this study was to evaluate the performance of conventional radiographic, direct digital radiographic and the fluorescent laser in determining the extent of caries. The results suggested that the accuracy of the radiographic method was low for detecting enamel lesions and high for dentinal lesions. The fluorescent laser showed a high percentage of false positive decisions, although, this can be considered a good method for diagnosing initial lesions and dentists should adopt a preventive approach in these situations.413735-74