Simone Dutra Lucas

Nem tudo é estágio: contribuições para o debate

This paper discusses supervised training as a fundamental opportunity for the consolidation of the teaching space and also as means of facing the challenges posed by the guidelines for dental courses. It is not a new proposal. It is in fact a fight for changes in dental practicing which began in the 70s with the movement for the integration between dental teaching and dental services. It approaches public health services spaces and the world of work as central for a new teaching strategy. That would generate the opportunity to graduate professionals with a more critical profile, also capable of understanding reality and intervening on it. The paper points the risks of understanding and misunderstanding - supervised training with practicing inside the dental school, under the label of curricular supervised training. In that perspective traditional practices, with emphasis on technical and biological aspects would not have the potential to achieve the changes proposed by the curricular guidelines. While highlighting the relevance of curricular supervised training in professional education, the paper sets a dialogue with ABENO, contesting some of its positions. In that sense, the paper shows the need for a deeper and more participative discussion, that joins as many dental schools as possible.

Variações no nível de cárie dentária entre crianças de 5 e 12 anos em Minas Gerais, Brasil

The aim of this ecological study was to analyze to what extent World Health Organization goals were met in relation to dental caries in 2000 in Minas Gerais State, Brazil, identifying factors associated with variation in DMFT and the occurrence of DMFT < or = 3 among 12-year-old children and in the percentage of caries-free 5-year-olds. Secondary data from different sources were used. Linear regression and multiple logistic regression techniques were applied to the analysis of the numerical and dichotomous dependent variables. Socioeconomic and dental services supply/utilization indicators were used as potential explanatory variables. The goals expressed by DMFT < or = 3 at 12 years and a minimum of 50% caries-free 5-year-olds were met by 37% and 9% of the States municipalities, respectively. In general the dependent variables were associated with socioeconomic level, and no associations were identified with dental care. The results should not be generalized, but they do suggest inequities in oral health and the role played by socioeconomic factors and water fluoridation.

Exploring professionalization among Brazilian oral health technicians

Professional dental auxiliaries emerged in the early 20th century in the United States of America and quickly spread to Europe and other regions of the world. In Brazil, however, oral health technicians (OHTs), who occupy a similar role as dental hygienists, had a long journey before the occupation achieved legal recognition: Brazilian Law 11.889, which regulates this occupation in the country, was only enacted in 2008. The aim of this paper is to review the literature on the professionalization of OHTs, highlighting the triggering, limiting and conflicting aspects that exerted an influence on the historical progress of these professionals in Brazil. We have tested Abbott’s and Larson’s theory on professionalization, against the history of OHTs. A number of different dental corporative interests exerted an influence over professionalization, especially in discussions regarding the permissible activities of these professionals in the oral cavity of patients. With primary health care advances in Brazil, the importance of these professionals has once again come to the forefront. This seems to be a key point in the consolidation of OHTs in the area of human resources for health in Brazil.

Conselheiros usuários do conselho municipal de saúde de Belo Horizonte: características sociais e representatividade

A preocupacao com os representantes dos usuarios do Sistema Unico de Saude (SUS) em Conselhos Municipais de Saude e uma realidade, pois mesmo com todo aparato juridico que garante a paridade com relacao aos demais membros, nao se pode garantir a representatividade de sua participacao. O objetivo desta pesquisa foi conhecer os Conselheiros Usuarios do Conselho Municipal de Saude de Belo Horizonte, suas caracteristicas sociais, bem como sua relacao com a base que representa. Foram aplicadas tecnicas de pesquisa quantitativa para conhecer as caracteristicas e qualitativa para avaliar o relacionamento com a base. Quanto as caracteristicas encontradas, observa-se que os conselheiros sao na maioria homens, aposentados e com baixa escolaridade. Os mandatos repetem-se sugerindo profissionalizacao dessa categoria. O relacionamento com a base apresenta limitacoes, principalmente quanto a comunicacao, e, ao que tudo indica, a educacao continuada dos conselheiros pode ser uma solucao para esse problema.

Atribuições dos Técnicos em Saúde Bucal na Estratégia Saúde da Família em Minas Gerais, Brasil

The scope of this article is to analyze the self-reporting of duties performed by the Oral Health Technicians in the State of Minas Gerais. A cross-sectional descriptive study was conducted through telephone interviews, with a representative sample of 231 workers. The descriptive analysis involved the calculation of proportions. It was found that 71.6% (95% CI, 64.4 to 77.5) performed coronal polishing, 63.2% (95% CI, 56.1 to 69.7) carried out scaling of dental calculus and 14.7% (95% CI, 10.3 to 15.4) inserted restorative materials. Regarding preventive/collective actions, 100% (95% CI, 97.6 to 100.0) participated in educational activities, 99% (95% CI, 96.1 to 99.8) demonstrated oral hygiene techniques, 96.6% (95% CI, 92.7 to 98.4) administrated topical fluoride, 77.9% (95% CI, 71.5 to 83.3) made home visits, and 96.6 % (95% CI, 92.7 to 98.4) performed collective actions, especially in schools. Oral Health Technicians have spent their more time on preventive/collective activities than on individual clinical care.

Análise da atenção secundária em saúde bucal no estado de Minas Gerais, Brasil

The scope of this study was to describe and analyze specialized outpatient procedures in periodontics, endodontics and oral surgery performed in the State of Minas Gerais in 2010. Secondary data for the procedures performed in healthcare facilities and registered in the Information System of the Unified Health System were used. Descriptive and bivariate analysis was performed, considering p <0.05. 707,559 procedures were performed in 2,547 health units distributed in 693 (81%) counties in the State. Of these procedures, 55% are in the area of surgery, 28% in periodontics and 17% in endodontics. The units are predominantly public under municipal administration, 52.5% of which have an oral health team (OHT) and 96.9% have no qualification as Dental Specialty Centers (DSCs). DSCs are more efficient than the other units (p <0.001), but there is a significant percentage that fails to comply with the goals of the Ministry of Health. Municipalities that have DSCs have higher population, more OHTs, lower potential coverage and better HDI. A significant number of specialized procedures are performed in the State of Minas Gerais, especially in primary care settings. DSC establishments are more efficient than non-DSC, considering the average number of procedures. The minimum production goals are met by a minority of DSCs.

A 15-Year Time-series Study of Tooth Extraction in Brazil

AbstractTooth loss is considered to be a public health problem. Time-series studies that assess the influence of social conditions and access to health services on tooth loss are scarce.This study aimed to examine the time-series of permanent tooth extraction in Brazil between 1998 and 2012 and to compare these series in municipalities with different Human Development Index (HDI) scores and with different access to distinct primary and secondary care.The time-series study was performed between 1998 and 2012, using data from the Brazilian National Health Information System. Time-series study was performed between 1998 and 2012. Two annual rates of tooth extraction were calculated and evaluated separately according to 3 parameters: the HDI, the presence of a Dental Specialty Center, and coverage by Oral Health Teams. The time-series was analyzed using a linear regression model.An overall decrease in the tooth-loss tendencies during this period was observed, particularly in the tooth-extraction rate during primary care procedures. In the municipalities with an HDI that was lower than the median, the average tooth-loss rates were higher than in the municipalities with a higher HDI. The municipalities with lower rates of Oral Health Team coverage also showed lower extraction rates than the municipalities with higher coverage rates.In general, Brazil has shown a decrease in the trend to extract permanent teeth during these 15 years. Increased human development and access to dental services have influenced tooth-extraction rates.

Measuring social capital through multivariate analyses for the IQ-SC

BackgroundSocial capital can be viewed as a societal process that works toward the common good as well as toward the good of the collective based on trust, reciprocity, and solidarity.Our study aimed to present two multivariate statistical analyses to examine the formation of latent classes of social capital using the IQ-SC and to identify the most important factors in building an indicator of individual social capital.FindingsA cross-sectional study was conducted in 2009 among working adolescents supported by a Brazilian NGO. The sample consisted of 363 individuals, and data were collected using the World Bank Questionnaire for measuring social capital. First, the participants were grouped by a segmentation analysis using the Two Step Cluster method based on the Euclidian distance and the centroid criteria as the criteria for aggregate answers. Using specific weights for each item, discriminant analysis was used to validate the cluster analysis in an attempt to maximize the variance among the groups with respect to the variance within the clusters. “Community participation” and “trust in one’s neighbors” contributed significantly to the development of the model with two distinct discriminant functions (p < 0.001). The majority of cases (95.0%) and non-cases (93.1%) were correctly classified by discriminant analysis.ConclusionsThe two multivariate analyses (segmentation analysis and canonical discriminant analysis), used together, can be considered good choices for measuring social capital. Our results indicate that it is possible to form three social capital groups (low, medium and high) using the IQ-SC.

Análise das resoluções do Conselho Municipal de Saúde de Belo Horizonte no período de 1991 a 2010

The scope of this study is to observe how the relationship between participative and representative democracy in Belo Horizontes Municipal Health Council (Conselho Municipal de Saude de Belo Horizonte - CMS/BH) has been developing since its foundation in 1991 through to 2010. The methodology applied involved the analysis of approvals and vetoes from the Executive power regarding the councils resolutions, with special emphasis on the period between 1997 and 2008. The data were collected from the Resolutions Archive and from the CMS/BH webpage. The results were related to each mayors term and to the segment of the councils presidents. The results show that only one resolution was vetoed by the Executive power, however 26% of the resolutions do not show any record of ratification, whereby 41% of these faced opposition from the authorities in the voting process. It is hoped that the reality presented may lead to reflections regarding the exercise of power, encouraging the council members to effectively build participative democracy in this space.

Sentinel event in oral health: experience with children with up to six years of age, users of the Unified Health System

Objective The aim of this study was to find out the children’s profile identified as Sentinel Event in oral health by the Municipal Health Department of the city of Belo Horizonte, State of Minas Gerais, Brazil. Methods A quantitative, analytical, exploratory and documentary analysis study was developed in the city of Belo Horizonte, State of Minas Gerais, Brazil, involving 545 children, age ranging from zero to six years old. Sentinel event data were collected through an electronic form created in the Unified Health System and filled out by the municipal oral health teams. Information systems of the city council were consulted. The variables studied were as follows: Health Vulnerability Index, race/color, age, sex, to be beneficiary of the Bolsa Família Program (a social program sponsored by the government), to be monitored by the Strategy of the Family Health Program, to reside in the Belo Horizonte Citizenship Program area, nature of the school and region of residence. Statistical analysis was performed in the SPSS software, 20th version. Results The results showed that the majority of children live in areas of medium and high social risk, they are five to six years old, male, dark-skinned, do not benefit from the Bolsa Família program, are not under the Strategy of the Family Health Program, do not reside in the territory of the Belo Horizonte Citizenship Program, and study in institutions of the municipal education network. The sentinel event is present in the nine regions of Belo Horizonte, with a higher prevalence in the regions of Venda Nova, Northeast, West, East and Barreiro. Conclusion The study demonstrates the crucial importance of comprehensive social policies in order to influence oral health. Indexing terms: Child. Dental caries. Oral health. Primary health care. Public health. Sentinel event surveillance.