Evaluations by patients constitute an important part of the process of improving health services. This study examined patients’ perceptions of secondary dental care in three cities in Minas Gerais, Brazil based on the endodontic treatment received. Data were collected using semi-structured interviews (addressing access, treatment and results) and a field diary (direct observations and report of professionals). The interviews were audiotaped, fully transcribed, and analyzed using content analysis. Two principal themes were identified: access to service and quality of service. The difficulties in accessing service were associated with the insufficient number of professionals to meet the high demand for endodontic treatment, problems in referring from primary to secondary care and geographic barriers. Service quality was related to the presence/absence of pain and anxiety that patients experienced, the time and number of sessions required to complete treatment, how patients were treated by dentists, and whether those patients would recommend the service to other patients. Access to endodontic treatment was a problem emphasized by users, and satisfaction with the quality of the service was more related to how patients were treated than to the technical competence of the dentist.

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Jaw metastasis can be mistaken for inflammatory or infectious diseases. Then, they should be considered in the differential diagnosis of unknown jaw lesions. Study reported here involved metastasis of breast cancer in the mandible of a 45-year-old woman. The most important differential diagnostic was a reactive lesion in an unusual periapical location associated with a nonvital tooth. However, given patient’s medical history and because paresthesia and pain were observed a few days after pulpectomy, metastasis of breast cancer could not be ruled out. When bone scintigraphy suggested the metastasis of a malignant bone tumor, incisional biopsy was performed. Histopathologic examination and immunohistochemical reaction confirmed the diagnosis of metastasis of breastcancer, and chemotherapy was thus performed as well. Unfortunately, patient died 2 years after diagnosis. Dentists as well as general physicians should therefore consider presence of oral metastasis in cases involving atypical symptoms, especially in patients with known malignant disease.

Objetivo: Avaliar a taxa de infecção e eventos adversos no pós-operatório de cirurgias orais menores, em uma instituição pública de atenção odontológica, entre 2017 e 2018. Métodos: Após realização dos procedimentos cirúrgicos, um formulário foi preenchido com dados relacionados ao paciente e à cirurgia. Trinta dias após, os egressos cirúrgicos foram contactados, via telefone e questionados quanto à ocorrência de eventos adversos (dor, secreção, sangramento e deiscência de sutura) e sobre uso de antibióticos. Realizou-se a análise descritiva dos dados (distribuição de frequências e percentuais) e cálculo da taxa de infecção global. Resultados: Foram incluídos 3.745 procedimentos cirúrgicos. A média de idade dos pacientes da amostra foi de 42,7 anos, com ligeiro predomínio do sexo masculino (51,3%). A clínica de cirurgia teve a maior concentração de procedimentos cirúrgicos realizados (53,8%), a prevalência média anual de eventos adversos no pós-operatório foi de 1,7% e a dor foi o evento adverso mais informado (4,0%). A maioria dos pacientes (64,2%) não recebeu nenhum tipo de prescrição antibiótica (profilático, terapêutico ou ambos) e a taxa de infecção no pós-operatório apresentou prevalência média total de 1,1%. Conclusão: As taxas de eventos adversos e a de infecção das feridas cirúrgicas encontradas foram baixas, demonstrando que o serviço atua de forma comprometida com os padrões de biossegurança, zelando pelos cuidados com o paciente. Descritores: Infecção da ferida cirúrgica. Controle de infecções. Procedimentos cirúrgicos bucais. Gestão em saúde.

The aim of this study was to evaluate the perceptions of Municipal Oral Health Coordinators (MOHCs) of endodontic services in Dental Specialty Centers (DSCs) of Minas Gerais, Brazil. A questionnaire was sent to the MOHCs of municipalities that had DSCs. Endodontic productivity data were collected from the Health System database. Descriptive analysis and Spearman’s correlation were performed (p≤0.05). Most cities had one DSC operating (92.4%) with two endodontists (30.3%). Endodontic treatments (ETs) were performed exclusively in a DSC (87.9%). There were referral protocols for primary to secondary care in endodontics in 87.9%. Most of the DSCs had a target (84.8%); 60.6% followed the targets recommended by the Brazilian Ministry of Health (MofH), but 53.0% complied with the goal in less than 25% of the months. Technological auxiliary resources for endodontics were not present in 42.0% of the DSCs. Positive correlation was found between the number of dentists who performed ETs in DSCs with fulfillment of monthly targets (p=0.029), and a negative correlation between the availability of technological resources for the fulfillment of monthly targets (p=0.012). Some MOHCs were unaware of the principles of the MofH, suggesting that management measures and targets should be reevaluated.

The aim of this study was to evaluate the factors associated with the average monthly productivity in endodontic services at Dental Specialty Centers (DSCs) of Minas Gerais. Secondary data were collected: the dependent variable was the average monthly productivity in endodontic services at DSCs, and the independent variables: population size, Human Development Index (HDI), Gini Index, Family Health Program’s (FHP) population coverage rate, DSC type, and accreditation time. 76 DSCs were included. Median values for population size, HDI, Gini Index, FHP coverage, and accreditation service time were, respectively, 67,442.50, 0.732, 0.410, 77.945, and 8.00. The endodontic treatment of single-rooted teeth exhibited the highest median production. Most of the DSCs (61.7%) did not reach the targets set. Population size (p=0.001) and DSC type (p=0.025) were associated with the average monthly productivity. The average monthly productivity in endodontic services at these DSCs was low, which was positively associated with population size and accredited DSC type.

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