The classification of malocclusion

A study about the practice of buccal health in the Alagoinhas ­ BA Family Health Program (2001-2004) with intent to analyze the arrangements that direct whole attention to buccal health: vinculum, reception, autonomy, responsibility and resolubility. The methodology is of qualitative nature in a historical-social perspective. The empirical material consists of interviews with health workers, managers and patients, the observing of the practice and documentary sources. The results show that the practice is organized through individual and collective actions built by a restrained demand. Attention is fragmented; there exists an excessive importance given to technique and specialization, whose axis is directed by the doctor-centered model with limited resolubility. Reception appears as a tense and conflicting relationship, however with a potentiality to build alternatives for change. Vinculum and autonomy cross link in the rescue of the worker-patient relationship and the encounter with their potentialities, which makes possible to level knowledge, narrow bonds and consolidate liking. To conclude, the practice of buccal health is full of conflicts and contradictions and is a potential tool for change in the work process, coexisting with the old (fragmentation) and the new (integrality) in an unfinished process still under construction.

https://www.scielosp.org/pdf/csc/2006.v11n1/53-61/pt

Da fragmentação à integralidade: construindo e (des)construindo a prática de saúde bucal no Programa de Saúde da Família (PSF) de Alagoinhas, BA

O objetivo deste artigo e discutir a inclusao da saude bucal na Estrategia Saude da Familia, em cidades de uma microrregiao do sudeste do Brasil, sob a perspectiva dos recursos humanos. Foram aplicados questionarios aos integrantes do servico de saude bucal: dentistas, auxiliares e gestores. O instrumento considerou tres dimensoes: como e porque se adotou o novo modelo, como o servico esta se reorganizando e que avancos foram percebidos pelos profissionais. O motivo mais mencionado pelos gestores, para inclusao da Saude Bucal foi a possibilidade de mudanca do modelo tecno-assistencial. Dentistas e auxiliares quando questionados sobre sua motivacao, tambem consideraram prioritariamente a possibilidade de mudanca na pratica. Observou-se ainda que existem nos criticos na contratacao e capacitacao de recursos humanos para atuar na equipe de saude bucal e na integracao entre os profissionais de saude. Mas o acesso esta melhor, seja pela organizacao efetuada, seja pela expansao de equipes. Os municipios da microrregiao ainda enfrentam percalcos para que o funcionamento do servico de saude bucal, apos a Saude da Familia, apresente avancos reais nas praticas de atencao. Porem, os avancos existem e estes devem ser reforcados, para consolidacao do sistema de saude e melhoria na qualidade de vida da populacao.

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A inclusão da equipe de saúde bucal na Estratégia Saúde da Família: entraves, avanços e desafios

This article discusses the evaluation of secondary care in the area of health surveillance. This was a descriptive and normative/evaluative study. Performance analysis drew on secondary data, based on a historical series of dental procedures conducted at the specialized dental clinics implemented in Brazil and recorded by the Outpatient Information System of the Unified National Health System (SIA/SUS) in 2007, as well as primary data from site visits to the clinics, based on questionnaires completed by clinic staff. Performance of the clinics was poor in most regions of the country, and the North of Brazil had the lowest percentage of specialty services implemented. The indicator "Performance of Secondary Care in Oral Health" was 64.4%. The type 3 specialty clinics showed better results in terms of performance and achievement of targets. The study showed the need to review the legal framework for implementing specialized dental clinics by adjusting the criteria and norms, as well as definition of new standards for achievement of goals in the evaluation and monitoring of these services.

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Avaliação da atenção secundária em saúde bucal: uma investigação nos centros de especialidades do Brasil

OBJECTIVE To analyze oral health work changes in primary health care after Brazil’s National Oral Health Policy Guidelines were released. METHODS A literature review was conducted on Medline, LILACS, Embase, SciELO, Biblioteca Virtual em Saude, and The Cochrane Library databases, from 2000 to 2013, on elements to analyze work changes. The descriptors used included: primary health care, family health care, work, health care policy, oral health care services, dentistry, oral health, and Brazil. Thirty-two studies were selected and analyzed, with a predominance of qualitative studies from the Northeast region with workers, especially dentists, focusing on completeness and quality of care. RESULTS Observed advances focused on educational and permanent education actions; on welcoming, bonding, and accountability. The main challenges were related to completeness; extension and improvement of care; integrated teamwork; working conditions; planning, monitoring, and evaluation of actions; stimulating people’s participation and social control; and intersectorial actions. CONCLUSIONS Despite the new regulatory environment, there are very few changes in oral health work. Professionals tend to reproduce the dominant biomedical model. Continuing efforts will be required in work management, training, and permanent education fields. Among the possibilities are the increased engagement of managers and professionals in a process to understand work dynamics and training in the perspective of building significant changes for local realities.

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Advances and challenges in oral health after a decade of the “Smiling Brazil” Program

O presente estudo teve como objetivo central a descricao e analise da pratica odontologica nas Unidades Basicas de Saude (UBS) em Feira de Santana, no processo de municipalizacao da saude. Trata-se de uma pesquisa qualitativa, do tipo descritiva-exploratoria. Os dados empiricos foram analisados a partir de entrevista semi-estruturada com cirurgioes-dentistas (10 profissionais) e de observacao nao participante em 3 UBS. O tratamento do material empirico foi baseado na analise de conteudo de Bardin (1979) e Minayo (1999), em que se buscou desvendar os conteudos manifestos e latentes dos discursos dos entrevistados, e uma maior compreensao da pratica odontologica na rede basica. Os resultados obtidos demonstram que o profissional CD nao se inseriu no processo de municipalizacao, e encontra-se ainda exercendo uma pratica pautada no modelo tradicional de atencao a saude bucal, privilegiando acoes individuais, autonomas, curativas e tecnicistas. Concluimos que a pratica odontologica nas UBS-FS precisa ser (re)construida, para atingir os objetivos preconizados pelo SUS. E, principalmente, o profissional CD se inserir como sujeito do processo, apontando para praticas alternativas voltadas para a promocao, prevencao, tratamento e reabilitacao da saude bucal.

/pdf/a-pratica-odontologica-em-unidades-basicas-de-saude-em-feira-52lorejuxs.pdf

A pratica odontologica em Unidades Basicas de Saude em Feira de Santana (BA) no processo de municipalizacao da saude: individual, curativa, autonoma e tecnicista

objective: To evaluate dentofacial patterns of patients with normal occlusion and Angle malocclusions, examining potential differences between specific cephalometric measures as they relate to gender, both intra- and intergroup. methods: The sample consisted of 200 lateral cephalometric radiographs obtained from young Brazilians of both genders, aged between 11 years and 2 months and 19 years and 10 months, with permanent dentition. The material was divided according to the type of occlusion into five groups: One group consisted of patients with normal occlusion and four groups of patients with Angle malocclusions, and each group was also divided by gender. Angular and linear cephalometric measures were evaluated. Results: Genders did not differ in most measures. Position of the maxilla showed no significant differences between groups. Mandibular retrognathia was remarkable in groups with Class II, Divisions 1 and 2. Vertical imbalances were observed with some significant differences. The pattern was found to be hypodivergent for groups with normal occlusion and Class II, Division 2, and neutral for groups with Class I; Class II, Division 1 and Class III. Dentoalveolar compensation was evident in groups with Class III and Class II, Division 2. Finally, the normal occlusion group profile was more convex than the patterns found in the US population. conclusions: In general, some features of facial morphology were associated with certain types of malocclusion. However, individual assessment of each face is still necessary as some of the features are shared across different types of occlusion.

/pdf/comparative-cephalometric-study-of-dentofacial-patterns-of-naexe31k97.pdf

Dayliz Quinto Pereira

Papers

A pratica odontologica em Unidades Basicas de Saude em Feira de Santana (BA) no processo de municipalizacao da saude: individual, curativa, autonoma e tecnicista

Comparative cephalometric study of dentofacial patterns of individuals with normal occlusion and Angle malocclusions