Objective: to access and identify barriers to oral health care of people with intellectual disabilities (ID), from the caregivers' perspective. Material and Methods: the random sample was composed of 55 caregivers of people with ID and an interview script with a qualitative approach was applied to deepen the understanding of this group about oral health services accessibility. The qualitative analysis was performed through the Discourse of the Collective Subject Method. Results: we observed some barriers to access and care to oral health to patients with disabilities, such as: lack of structure and organization of the service, deficient training of professionals for attendance, among others. In addition, the health care within a practice little paid in and weakly based on health promotion were other factors that compromised the access of people with ID. Conclusion: the access evaluation is extremely important, because it allows the reordering of actions and services according to the users' needs. However, despite the advances, the patient with ID still has been facing barriers, basically to the accessibility to treatment performed by professionals, to reception and low management.
Objective: To evaluate the association of oral health indicators and social variables on the frequency of visit to the dentist by persons with intellectual disability (ID). Material and Methods: The study comprised a sample consisting of 149 participants with ID, aged from 11 to 29 years, from non-governmental institutions. Semi-structured interviews were held to collect sociodemographic and psychosocial information with their parents/guardians, followed by oral health evaluations in accordance with World Health Organization criteria. Crude analyses and multiple analysis were conducted to test whether oral health indicators and social data were predictors of the visit to dental care services. Results: In the multiple logistic regression model, individuals with lower DMF-t (OR=3.13; 95% CI=1.40-6.97) and those with less crowded housing (OR=2.33; 95% CI=1.06-5.12) presented less frequency of visits to oral health services. Conclusion: DMFT and crowded housing are associated to the frequency of persons with intellectual disability to dental care as well as this outcome measure affects the oral health of persons with ID. Therefore, identifying limiting factors to dental care of persons with intellectual disability is needed so that this group can receive adequate attention.
The Dental Specialties Centers (CEOs) were created within the context of the National Oral Health Policy, and the main function of these establishments is to serve as units of reference in secondary oral health care in the Brazilian national health system (SUS), and they must offer at least the services of stomatology, specialized periodontology, minor oral surgery, endodontics, and attendance to patients with special needs. The aim of this study was to evaluate the quality of the CEOs in the mountain region of the Rio de Janeiro State, Brazil, in the perspective of the patients with special needs care or their companion’s satisfaction. Data were collected from 159 users by using a standardized self-applied individual semi-structured questionnaire. The results indicated a positive evaluation in most of the dimensions, except the accessibility dimension. Significant differences (p < 0.05) were observed between the services of the following dimensions of quality: accessibility, resoluteness, technical-scientific quality, efficiency, efficacy, and acceptability. The analysis of qualitative data, through the discourse of the collective subject technique (DCS) and social representations, showed five central ideas about users’ satisfaction and dissatisfaction with CEOs services (humanized health care, resoluteness of the service, professional competence, infrastructure and organization of the service, access to the services). In conclusion, most patients with special needs care and their companions were satisfied with specialized dental centers (SDC) services, although there were significant differences among SDCs services in relation to individuals’ satisfaction.
Objetivo: o objetivo desta série de relatos de caso foi avaliar a ansiedade em pacientes pediátricos submetidos a duas técnicas mecânicas de preparo cavitário: instrumentos rotatórios convencionais (alta e baixa velocidade) com ponta de diamante e abrasão ultra-sônica com sistema CVD ™. dicas. Material e Métodos: quatro pacientes, com idades entre 06 e 09 anos, que tinham pelo menos dois molares decíduos com superfície oclusal de cárie foram selecionados para este estudo. Os dentes foram divididos aleatoriamente em dois grupos experimentais: CVD (sistema CVD com preparo cavitário) e grupo CRI (preparo cavitário com instrumentos rotatórios). Os procedimentos de preparo foram realizados sob anestesia local e o dique de borracha e as cavidades foram restauradas com resina composta. No início e no final de cada visita, aplicou-se um questionário fechado que objetivou avaliar a ansiedade da criança durante a visita, na qual cada técnica de preparo foi utilizada. Os resultados foram submetidos à análise estatística descritiva. Resultados: comportamento e ansiedade foram avaliados em 04 dentes de cada grupo (dois de cada criança). A ansiedade moderada / grave foi observada em todos os pacientes, independentemente da técnica utilizada para a remoção da cárie. Independentemente da intervenção testada na maioria dos casos, as crianças tratadas ficaram ansiosas antes das consultas. Conclusão: considerando as limitações deste estudo preliminar, pode-se observar que o tratamento odontológico e seus eventos relacionados, independentemente das técnicas mecânicas de preparo cavitário utilizadas, podem estar relacionados à ansiedade do paciente pediátrico.
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