Saliva has become an important resource for evaluating physiological and pathological conditions in humans. The use of saliva has many advantages, including the simple and non-invasive method of collection and its easy, low-cost storage. With the addition of modern techniques and chemical instrumentation equipment, there has been an increase in its use for laboratory investigations, applicable for basic and clinical analyses in the fields of medicine and dentistry. The value of these methods for the diagnosis of oral and systemic diseases has been the subject of study by several researchers with the aim of increasing its use alongside complementary exams.

A avaliação do grau de satisfação dos usuários do sistema de saúde é um importante indicador a ser considerado no planejamento das ações. O objetivo deste estudo foi avaliar o grau de satisfação de usuários dos serviços de saúde pública municipal quanto aos serviços utilizados. Este estudo tipo inquérito foi conduzido em cinco municípios do Estado de São Paulo. A amostra foi selecionada de forma estratificada e aleatória, sendo entrevistados 471 chefes de família ou respectivos cônjuges. Os dados qualitativos foram analisados pelo método de Análise de Conteúdo, e os dados quantitativos foram processados utilizando-se o software estatístico Epi Info. Dentre os usuários dos cinco municípios, 93,0% utilizam o serviço municipal de saúde. Para 72,0%, os serviços de saúde prestados estão resolvendo os problemas e necessidades da população. Com base no acesso ao atendimento, 57,6% da população queixaram-se da presença de filas para o atendimento. Mais da metade (69,5%) afirmou ter confiança na equipe de saúde; no entanto, muitos relatos demonstraram a carência de um atendimento humanizado. Em relação aos serviços de saúde, 61,7% classificaram-os como ótimo ou bom. Conclui-se que a maior parte dos usuários mostrou-se satisfeita com os serviços de saúde municipais, apesar da grande quantidade de queixas quanto ao atendimento, falta de humanização e acolhimento, deficiência de recursos físicos e materiais. A percepção do usuário é de extrema importância ao se dimensionar o reflexo das ações que vem sendo desenvolvidas no setor saúde, e serve como vetor de direcionamento e planejamento do serviço.

BackgroundThe increased prevalence of malocclusions represents a secular trend attributed to the interaction of genetic and environmental factors. The analysis of factors related to the causes of these changes is essential for planning public health policies aimed at preventing and clinically intercepting malocclusion. This study investigated the sucking habits, nocturnal mouth breathing, as well as the relation of these factors with malocclusion.MethodsThis is a longitudinal study in which 80 mother-child pairs were monitored from the beginning of pregnancy to the 30th month after childbirth. Home visits for interviews with the mothers were made on the 12th, 18th and 30th months of age. Finger sucking, pacifier sucking, bottle feeding, breastfeeding and nocturnal mouth breathing, were the variables studies. On the 30th month, clinical examinations were performed for overjet, overbite and posterior crossbite. A previously calibrated single examiner (Kappa coefficient = 0.92) was responsible for all examinations. Data were analyzed using the chi-squared or Fisher’s exact tests, at a significance level of 5%.ResultsBottle feeding was the most prevalent habit at 12, 18 and 30 months (87.5%; 90% and 96.25%, respectively). Breastfeeding was 40%, 25% and 12.50% at 12, 18 and 30 months, respectively. Nearly 70% of the children in this study had some sort of malocclusion. Pacifier sucking habit at 12, 18 and 30 months of age was associated with overjet and open bite; and at 30 months, an association with overbite was also observed. Finger sucking habit and breastfeeding at 12, 18 and 30 months were also associated with overjet and open bite. The posterior crossbite was associated with bottle feeding at 12 and 30 months, and nocturnal mouth breathers at 12 and 18 months.ConclusionsSucking habits, low rates of breastfeeding, and nocturnal mouth breathing were risk factors for malocclusion.

Resumo

The aim of this study was to analyze the influence of sociobehavioral variables on the prevalence and severity of dental caries in 4-to 6-year-old children. A cross-sectional study was performed on a sample of 1993 children enrolled in 58 public preschools from Araçatuba City, São Paulo State, Brazil, during 2010. The exams were made using the decayed, missing, and filled teeth index (World Health Organization methodology) and detection criteria for non-cavitated lesions. A tested, self-administered questionnaire was sent to parents to obtain information about their socio-behavioral characteristics. Standardization was performed to verify concordance among examiners (kappa = 0.84). The prevalence of cavitated caries lesions was 41.2% (821), and the prevalence of both, cavitated and non-cavitated caries lesions, was 43.9% (875). The means ± standard deviations of the decayed, missing, and filled teeth index for children aged 4, 5, and 6 years were 1.18 ± 2.45, 1.65 ± 2.67, and 1.73 ± 2.77, respectively. Caries were significantly more prevalent in children from families with low incomes and low educational levels. The presence of dental caries was associated with access to dental services (p < 0.05). The associations between both, cavitated and non-cavitated dental caries lesions, and the frequency of oral hygiene were statistically significant. The prevalence of dental caries in preschoolers was strongly associated with factors related to the children's parents. Therefore, information about parents' socio-economic status, behaviors, and attitudes in relation to oral health should be considered when planning prevention and educational programs for the oral health of preschool children.

The relationship between mother and child in the context of oral health has traditionally been exposed by the scientific literature in microbiology, which lacks a broad and necessary discussion of health and illness seen as processes, both biological and social. ObjectiveInvestigate the family social determinants associated with the caries history of children and the need for dental treatment (NDT) among their mothers was the objective of this study. Material and methodsThis research employed a cross-sectional study of mother-child pairs living in southern Brazil. Data collection occurred in public institutions of early childhood education. The instruments included a structured questionnaire administered to mothers and clinical oral examinations of the mothers and children. The social variables considered were marital status, maternal education, number of children, income, employment status, and frequency of visits to a dental professional. The measured outcomes were the maternal NDT and child caries history. Data were analyzed by the chi-square test (χ2) and by discriminant analysis. ResultsThe final sample consisted of 272 mother-child pairs and it was found that the greatest need for treatment was among mothers with low educational level and low family income who rarely or never visited a dentist. Tooth decay was less frequent in only child, and most frequent in children of mothers with low educational attainment, and in children in lower income households who rarely or never visited the dentist. The social determinants of caries in children and of the maternal NDT were similar. It follows that the maternal NDT and caries history among children were strongly associated with maternal education (p<0.0001), household income (p<0.0001), and frequency of visits to a dental professional (0.0018). Caries history among children was also associated with number of children in the household (p<0.0001).ConclusionsThe results suggest that the caries experience in children depended less on the family social variables than on the maternal NDT.

ResumoO artigo discute as práticas de assistência, políticas, estratégias e ações governamentais formalizadas para a saúde do idoso, visto que, embora o tema "humanização" se faça presente em várias discussões e que, inclusive, tornou-se diretriz da tão aclamada Política Nacional de Humanização, esses pacientes enfrentam, ainda, vários obstáculos para assegurar alguma assistência à saúde. À desinformação e ao desrespeito aos cidadãos da terceira idade somam-se a precariedade de investimentos públicos para atendimento às necessidades específicas dessa população, a falta de instalações adequadas, a carência de programas específicos e de recursos humanos. Dessa forma, faremos uma reflexão sobre a humanização na assistência à saúde focada nessa população, primeiramente fazendo um resgate da humanização nos diversos cenários do setor saúde, considerando a valorização dos diferentes sujeitos implicados nesse processo, para que o cuidado dessa especial e crescente fatia da população seja realizado de forma humanizada, visto ser este um paciente especial que requer um atendimento diferenciado. Palavras-chave: Humanização da assistência; Qualidade da assistência em saúde; Políticas públicas; Assistência a idosos.

INTRODUÇÃO: A Atenção Secundária em saúde bucal no Brasil ainda é um assunto pouco pesquisado. OBJETIVO: Analisar a resolubilidade dos serviços odontológicos do Sistema Único de Saúde, com base na referência para a atenção secundária e a contrarreferência à atenção primária. METODOLOGIA: Trata-se de um estudo descritivo, quantitativo, que utilizou dados secundários coletados dos prontuários dos pacientes atendidos no Centro de Especialidades Odontológicas de um município do Estado de São Paulo. RESULTADO: Do total de 1030 prontuários analisados, verificaram-se 1236 procedimentos referenciados para atenção especializada. Destes, 86,4% deram entrada na Unidade Básica de Saúde por livre demanda e 50,4% (n=623), para especialidade de Endodontia. Houve evasão de 2,2% (n=28) já na primeira consulta especializada. Nos pacientes que deram início ao tratamento especializado, foram realizados 1.208 procedimentos no Centro de Especialidades Odontológicas, tendo sido 62,6% (n=757) concluídos e contrarreferenciados para a Atenção Primária, que finalizou 61,1% (n=463) dos procedimentos. Para a conclusão do tratamento, considerando o tempo no Centro de Especialidades Odontológicas e na Atenção Básica, houve variação de acordo com a especialidade: Periodontia, 62 dias (dp= ±68), e Endodontia, 71 dias (dp= ±51,8), sendo necessárias três consultas em média, independentemente da especialidade. CONCLUSÃO: O Centro de Especialidades Odontológicas referencia, contrarreferencia e atende à maioria da demanda, independentemente da especialidade. Porém, ainda há muita evasão durante o tratamento odontológico, servindo de alerta para os gestores desenvolverem métodos de controle dos pacientes atendidos, com vistas à diminuição de gastos e ao aumento da resolutividade dos serviços, com a conclusão dos tratamentos iniciados.