Sandra Garrido de Barros

Contribuição ao estudo da cárie dentária em crianças de 0-30 meses

Este estudo avaliou as condicoes de saude bucal de 340 criancas de 0-30 meses de idade (21,3 ± 5,6), sendo 54,4% meninos, 45,6% meninas, de 20 creches de Salvador, considerando lesoes incipientes e relacionando-as a alguns fatores determinantes da carie. Os exames foram realizados por um unico examinador utilizando-se espelho, sonda e lanterna. Os dentes foram limpos, secos com gaze e as lesoes classificadas de acordo com o grau de severidade em cinco niveis (C0-C4; ativa/inativa). Um questionario avaliou o conhecimento sobre a carie, fatores de risco, instrucao, renda familiar e uso de fluor. Foram incluidos 229 questionarios (67,35%). A analise dos dados foi realizada no Epi-info 6.02. Observou-se uma prevalencia de carie de 55,3% quando todos os estagios da lesao foram considerados: 25% entre 0-12 meses; 51,18% entre 13-24 meses; 71,03% entre 25-30 meses (chi² = 25,31; p < 0,01). Avaliando-se apenas manchas brancas ativas, 49,7% das criancas mostraram-se afetadas e 17,6%, apenas com lesoes cavitadas. Das criancas afetadas, 90,96% apresentavam apenas dentes anteriores afetados: 80% das lesoes eram incipientes e 20%, cavitadas. Nao foi observada diferenca significante entre sexos. O aumento da quantidade de biofilme dental mostrou associacao positiva com a carie nesta faixa etaria (chi² = 67,61; p < 0,01) e a porcentagem de criancas afetadas mostrou-se maior na presenca de aleitamento noturno (chi² = 0,24; p = 0,62). Foi observado um aumento da prevalencia de carie com a idade (chi² = 25,31; p < 0,01) e com o numero de dentes irrompidos (chi² = 122,95; p < 0,01). Sugere-se atencao precoce a saude bucal para o diagnostico de lesoes incipientes e adocao de medidas educativas e preventivas, incentivando mudancas na higiene bucal e dieta.

A utilização do Sistema de Informações Ambulatoriais (SIA-SUS) como instrumento para caracterização das ações de saúde bucal

Palavras-chave: descentralizacao; servicos odontologicos; sistema de informacao; politicas de saude bucal. Summary This study assessed the process of decentralization of oral health activities in Brazilian municipalities using data from the Outpatient Information System (SIA-SUS). A strategy for the evaluation of oral health care is proposed. A historical series (1995 to 2001) of oral health attendances was constructed for two Brazilian municipalities (A and B ) of Bahia State. Oral procedures were classified as: dental appointments, oral health community actions (OHCA), preventive individual procedures, dental fillings, surgery and periodontal procedures. An increase of outpatient attendances was observed for both municipalities (from 0.18 to 0.43 procedures/ person/year and from 0.21 to 0.33 procedures/person/year, respectively), as well as an increase of OHCA targeted to groups aged 5 to 14 years (from 0.00 to 0.58 OHCA/person/year for A and from 0.00 to 2.33 OHCA/person/year for B). Oral health community actions predominated in Municipality B. Regular registration of individual clinical procedures was observed but OHCA were not, showing the need of register standardization. The proposed methodology permitted an assessment of oral health activities in the study areas and could be useful for the evaluation of oral health care programs.

Maus-tratos: estudo através da perspectiva da delegacia de proteção à criança e ao adolescente em Salvador, Bahia

This cross-sectional study describes the occurrences of maltreatment recorded over three years (1997-1999) in a Brazilian Police Department for the Protection of the Child and the Adolescent. Socio-demographic and physical data of victims, aggressors and denouncers were investigated in a sample consisting of 2073 cases. The victims were aged between 0-18 years, of which 56.1% were girls. Data were entered into EPI INFO 2000 software and analyzed using descriptive statistics and chi-square test to determine significant differences (p<0.05). All manifestations of abuse, except physical abuse, tend to occur more frequently in females, and tend to be more prevalent in the 11-to-15 year-old subgroup. Physical abuse was the most common offense (64.7%). Injuries of face and jaw were found in 65.3% of the cases. Most of the aggressors were males (71.8%). There was a positive correlation between gender (female) and sexual abuse. Physical violence against boys was more intensive, as indicated by the presence of more severe body lesions. Health professionals should increase their diagnostic skills and raise the awareness of their communities to take action for reducing the incidence and the impact of violence upon children and adolescents.

Política de Saúde Bucal no Brasil 2003-2014: cenário, propostas, ações e resultados

This study examined the implementation of Brazils National Oral Health Policy by the three governments during the period 2003 to 2014. It provides a general overview of oral health care scenarios and examines institutional proposals and actions developed by the executive branch based on the components of the health care system. A documental analysis was conducted using documents produced by key government agencies. The findings show that there was an increase in the provision and coverage of public dental services between 2003 and 2006 and that rates were maintained to a certain degree in subsequent periods (2007 to 2010 and 2011 to 2014). There was an expansion in government funding, human resources and infrastructure. The amount of funds transferred to state and local governments increased from 83.4 million in 2003 to 916 million in 2014, equivalent to a 10.9 fold increase. However, the use of public dental services remained stable, with only a slight increase from 29.7% in 2003 to 30.7% in 2008, while private service utilization increased from 64.4% in 2003 to 74.3% in 2013. The care model component was given lowest priority by the three governments. This shortcoming influences policy effectiveness and requires the adoption of future measures by healthcare managers and officials to correct the situation.

O movimento da Saúde Bucal Coletiva no Brasil

Resumo A Saude Bucal Coletiva (SBC) pode designar um fenomeno historico especifico, distinto das outras “Odontologias Alternativas” e um referencial teorico para as praticas odontologicas em servicos de saude. Este estudo buscou compreender a permanencia das “Odontologias Alternativas” no espaco social de luta pela saude bucal no Brasil, a partir de posicoes dos agentes fundadores e precursores, levando em consideracao as concepcoes de SBC, Saude Coletiva (SC) e SUS. Partiu-se da teoria das praticas de Pierre Bourdieu, complementada pelos conceitos de hegemonia e contra-hegemonia em Gramsci. Realizaram-se 12 entrevistas em profundidade, revisao documental e analise da producao cientifica, alem das trajetorias dos agentes e seus capitais em 1980 e 2013. Os resultados indicam que a concepcao de SBC e SC como ruptura com as praticas de saude oriundas as “Odontologias Alternativas” prevaleceu entre aqueles com disposicoes politicas em defesa da democracia e da Reforma Sanitaria. Embora a SBC tenha proposta critica, permanecem antigas “Odontologias” na producao cientifica e nas praticas de saude bucal.