RESUMO Objetivo: Investigar a intenção materna de amamentar exclusivamente (IMA) e variáveis associadas entre as mulheres no terceiro trimestre de gravidez. Métodos: A coleta de dados foi realizada por meio de entrevista e questionário semiestruturado e autoadministrado, entre dezembro/2018 e novembro/2019. As gestantes (n=653) responderam à escala Infant Feeding Intentions (IFI) testada, traduzida e adaptada para o português do Brasil e ao questionário contendo perguntas sobre variáveis sociodemográficas, biológicas e familiares, bem como relacionadas à gestação, ao aleitamento materno, à assistência à saúde e a hábitos. Foram realizadas análises estatísticas descritivas e de regressão logística múltipla hierarquizada, com nível de significância de 5%, para estimar a associação entre as variáveis independentes e o desfecho. A IMA, medida pela escala IFI, foi dicotomizada pela mediana (<16 ou =16). Resultados: A pontuação média±desvio padrão para a escala IFI foi de 14,4±2,6. Os resultados da análise de regressão mostraram que as gestantes que não tinham intenção de oferecer mamadeira (OR=4,33; IC95% 2,79-6,72) ou não sabiam (OR=1,85; IC95% 1,21–2,82), que planejaram a gestação (OR=1,52; IC95% 1,09–2,12), aquelas que acreditavam que teriam ajuda nos cuidados com o bebê (OR=3,60; IC95% 1,51–8,56) ou que não sabiam (OR=3,97; IC95% 1,26–12,51), bem como aquelas que relataram conhecer as recomendações da Organização Mundial de Saúde sobre amamentação (OR=1,73; IC95% 1.13–2.64) tinham mais chances de mostrar uma IMA muito forte. Conclusões: As gestantes no terceiro trimestre de gestação apresentaram forte IMA. A maior IMA esteve significativamente associada aos determinantes estruturais, contextuais e individuais. Objetivo (IMA gravidez Métodos autoadministrado dezembro2018 dezembro 2018 dezembro/201 novembro2019 novembro 2019 novembro/2019 n=653 n653 n 653 (n=653 (IFI testada sociodemográficas familiares materno hábitos hierarquizada 5 5% desfecho <16 16 (<1 =16. =16 . =16) Resultados médiadesvio média desvio 14426 14 4 2 6 14,4±2,6 OR=4,33 OR433 OR 33 (OR=4,33 IC95 IC 2,796,72 279672 2,79 6,72 79 72 2,79-6,72 OR=1,85 OR185 1 85 (OR=1,85 1,21–2,82, 121282 1,21–2,82 , 21 82 1,21–2,82) OR=1,52 OR152 52 (OR=1,52 1,09–2,12, 109212 1,09–2,12 09 12 1,09–2,12) OR=3,60 OR360 3 60 (OR=3,60 1,51–8,56 151856 51 8 56 OR=3,97 OR397 97 (OR=3,97 1,26–12,51, 1261251 1,26–12,51 26 1,26–12,51) OR=1,73 OR173 73 (OR=1,73 1.13–2.64 113264 13 64 Conclusões estruturais individuais dezembro201 201 dezembro/20 novembro201 novembro/201 n=65 n65 65 (n=65 <1 (< =1 1442 14,4±2, OR=4,3 OR43 (OR=4,3 IC9 796 2,796,7 27967 279 2,7 672 6,7 7 2,79-6,7 OR=1,8 OR18 (OR=1,8 12128 1,21–2,8 OR=1,5 OR15 (OR=1,5 10921 1,09–2,1 0 OR=3,6 OR36 (OR=3,6 1,51–8,5 15185 OR=3,9 OR39 9 (OR=3,9 126125 1,26–12,5 OR=1,7 OR17 (OR=1,7 1.13–2.6 11326 dezembro20 20 dezembro/2 novembro20 novembro/20 n=6 n6 (n=6 < ( = 144 14,4±2 OR=4, OR4 (OR=4, 2,796, 2796 27 2, 67 6, 2,79-6, OR=1, OR1 (OR=1, 1212 1,21–2, 1092 1,09–2, OR=3, OR3 (OR=3, 1,51–8, 1518 12612 1,26–12, 1.13–2. 1132 dezembro2 dezembro/ novembro2 novembro/2 n= (n= 14,4± OR=4 (OR=4 2,796 2,79-6 OR=1 (OR=1 121 1,21–2 109 1,09–2 OR=3 (OR=3 1,51–8 151 1261 1,26–12 1.13–2 113 novembro/ (n 14,4 OR= (OR= 2,79- 1,21– 10 1,09– 1,51– 15 126 1,26–1 1.13– 11 14, (OR 1,21 1,09 1,51 1,26– 1.13 1,2 1,0 1,5 1,26 1.1 1, 1.

ABSTRACT Objective: To investigate exclusive breastfeeding (EBF) intention and associated variables among women in the third trimester of pregnancy. Methods: The data were collected with a questionnaire for the pregnant women (n=653), from December/2018 to November/2019. They answered the Infant Feeding Intentions (IFI) scale, translated and adapted to Brazilian Portuguese, and a questionnaire on sociodemographic, biological, family, pregnancy, breastfeeding, health care, and habits variables. Descriptive statistics and multiple logistic regression analyses were performed with a 5% significance level, following a multilevel hierarchical model that estimated the association between the dependent and independent variables. The outcome EBF intention measured by the IFI score was dichotomized by the median (<16 or =16). Results: Mean±standard deviation score for the IFI scale was 14.4±2.6 (score 0: very strong intention to not breastfeed at all; score 16: very strong EBF intention up to six months). The results from the regression analysis showed that pregnant women who had no intention to bottle feed (OR=4.33; 95%CI 2.79-6.72) or did not know (OR=1.85; 95%CI 1.21–2.82), those who planned the pregnancy (OR=1.52; 95%CI 1.09–2.12), those who believed they would have help to care for the baby (OR=3.60; 95%CI 1.51–8.56) or did not know (OR=3.97; 95%CI 1.26–12.51), and those who reported knowing the World Health Organization recommendations on breastfeeding (OR=1.73; 95%CI 1.13–2.64) were more likely to show a very strong EBF intention. Conclusions: Pregnant women in the third trimester of pregnancy presented a strong EBF intention. The higher EBF intention score was significantly associated with the structural, setting, and individual determinants. Objective (EBF Methods n=653, n653 n n=653 , 653 (n=653) December2018 December 2018 December/201 November2019 November 2019 November/2019 (IFI Portuguese sociodemographic biological family 5 level <16 16 (<1 =16. =16 . =16) Results Meanstandard Mean standard 14426 14 4 2 6 14.4±2. 0 all months. months months) OR=4.33 OR433 OR 33 (OR=4.33 95CI CI 95 2.796.72 279672 2.79 6.72 79 72 2.79-6.72 OR=1.85 OR185 1 85 (OR=1.85 1.21–2.82, 121282 1.21–2.82 21 82 1.21–2.82) OR=1.52 OR152 52 (OR=1.52 1.09–2.12, 109212 1.09–2.12 09 12 1.09–2.12) OR=3.60 OR360 3 60 (OR=3.60 1.51–8.56 151856 51 8 56 OR=3.97 OR397 97 (OR=3.97 1.26–12.51, 1261251 1.26–12.51 26 1.26–12.51) OR=1.73 OR173 73 (OR=1.73 1.13–2.64 113264 13 64 Conclusions structural setting determinants n65 n=65 65 (n=653 December201 201 December/20 November201 November/201 <1 (< =1 1442 14.4±2 OR=4.3 OR43 (OR=4.3 9 796 2.796.7 27967 279 2.7 672 6.7 7 2.79-6.7 OR=1.8 OR18 (OR=1.8 12128 1.21–2.8 OR=1.5 OR15 (OR=1.5 10921 1.09–2.1 OR=3.6 OR36 (OR=3.6 1.51–8.5 15185 OR=3.9 OR39 (OR=3.9 126125 1.26–12.5 OR=1.7 OR17 (OR=1.7 1.13–2.6 11326 n6 n=6 (n=65 December20 20 December/2 November20 November/20 < ( = 144 14.4± OR=4. OR4 (OR=4. 2.796. 2796 27 2. 67 6. 2.79-6. OR=1. OR1 (OR=1. 1212 1.21–2. 1092 1.09–2. OR=3. OR3 (OR=3. 1.51–8. 1518 12612 1.26–12. 1.13–2. 1132 n= (n=6 December2 December/ November2 November/2 14.4 OR=4 (OR=4 2.796 2.79-6 OR=1 (OR=1 121 1.21–2 109 1.09–2 OR=3 (OR=3 1.51–8 151 1261 1.26–12 1.13–2 113 (n= November/ 14. OR= (OR= 2.79- 1.21– 10 1.09– 1.51– 15 126 1.26–1 1.13– 11 (n (OR 1.21 1.09 1.51 1.26– 1.13 1.2 1.0 1.5 1.26 1.1 1.

Resumo Objetivo Analisar a percepção dos enfermeiros da Estratégia Saúde da Família em relação à Atenção Domiciliar oferecida às pessoas idosas. Método Trata-se de um estudo qualitativo descritivo, foram empregadas entrevistas semiestruturadas para aprofundar a compreensão da percepção desses profissionais sobre o tema. Combinando a abordagem do Discurso do Sujeito Coletivo com a Representação Social. Resultados Participaram do estudo 14 enfermeiros, sendo a maioria mulheres, especialistas em Saúde da Família e Comunidade, que normalmente realizavam atendimento domiciliar semanalmente. Os participantes relacionam a importância do cuidado, compreender a realidade do paciente e a prestação dos serviços de saúde. Além disso, relataram realizar diversos tipos de procedimentos durante o atendimento. Após os atendimentos domiciliares, os profissionais realizam as anotações nos prontuários, discutem com a equipe multidisciplinar ou agendam as próximas visitas. A maioria dos participantes enfatizou a importância do atendimento humanizado e do conhecimento técnico. A continuidade do tratamento e a formação de vínculo foram aspectos positivos. Quanto as desvantagens, a falta de recursos foi a mais prevalente entre os relatos. Conclusão Os participantes reconhecem a importância da Atenção Domiciliar na Estratégia Saúde da Família oferecida para pessoas idosas, essa prática promove a compreensão profunda do paciente e continuidade do tratamento, entretanto, ainda permanecem desafios para atuação. idosas Tratase Trata se descritivo tema Social 1 mulheres Comunidade semanalmente cuidado saúde disso domiciliares prontuários visitas técnico positivos desvantagens relatos entretanto atuação

Abstract Objective To analyze the perceptions of nurses under the Family Health Strategy regarding Home Care offered to older adults. Method A descriptive, qualitative study involving semi-structured interviews of nurses to elucidate the perceptions of these professionals about home care was conducted. The Discourse of the Collective Subject method, anchored in Social Representation theory, was employed. Results A sample of 14 nurses, predominantly women, Family and Community Health experts, who made weekly home-care visits, was studied. Participants reported the importance of care, of appreciating the patient´s situation and of delivering health services. The nurses also reported performing a range of procedures during visits. After the home visits, the professionals made notes in the patient medical records, discussed cases with the multidisciplinary team or scheduled the next visits. Most participants stressed the importance of humanized care and technical knowledge. Treatment continuity and building ties were positive aspects cited. Regarding drawbacks, lack of resources was the most commonly cited aspect. Conclusion The participants acknowledged the importance of Home Care in the Family Health Strategy offered to older adults, a practice which promotes deeper understanding of patients, provides treatment continuity, but that also faces challenges in practice. adults descriptive semistructured semi structured conducted method theory employed 1 women experts homecare visits studied patients s services records knowledge drawbacks aspect

RESUMO A interação entre alunos de odontologia e pacientes é essencial para um aprendizado prático e próximo da realidade, oferecendo serviços à comunidade e configurando uma clínica-escola. Paralelamente, estudos sobre a satisfação do usuário do sistema público de saúde são fundamentais, contribuindo para o planejamento de medidas corretivas com base nas informações obtidas. O estudo teve os objetivos de conhecer o perfil demográfico e econômico dos pacientes atendidos na Clínica de Atenção Básica Odontológica de uma Faculdade pública; e avaliar a satisfação dos pacientes em relação ao serviço prestado e a infraestrutura da Clínica. Realizou-se um estudo transversal observacional, coletando dados socioeconômicos e de saúde geral de pacientes por meio de anamneses odontológicas. Utilizaram-se questionários validados: Questionário de Satisfação dos Usuários com os Serviços Públicos de Saúde Bucal, que abrange sete dimensões de qualidade, e o Questionário Pompeu, que contém aspectos do atendimento odontológico. As respostas foram tabuladas para análise estatística descritiva. Resultados: Os resultados do Questionário de Satisfação dos Usuários com os Serviços Públicos de Saúde Bucal indicam elevada satisfação dos pacientes em diversas dimensões, como relações humanas, eficácia do tratamento, acessibilidade e qualidade técnico-científica. O Questionário de Pompeu reforça esses achados, destacando a receptividade dos alunos e professores, orientações eficazes sobre cuidados bucais e uma alta taxa de recomendação da clínica pelos pacientes. Em resumo, ambos os questionários revelam uma satisfação geral positiva dos pacientes. Diante do cenário no momento do estudo, a grande maioria dos pacientes atendidos na referida clínica, sentem-se satisfeitos com a estrutura física, de atendimento e tratamento odontológico oferecidos. realidade clínicaescola. clínicaescola escola. escola clínica-escola Paralelamente fundamentais obtidas pública Realizouse Realizou se observacional odontológicas Utilizaramse Utilizaram validados descritiva Resultados humanas técnicocientífica. técnicocientífica técnico científica. científica técnico-científica achados professores resumo sentemse sentem física oferecidos

ABSTRACT The interaction between dental students and patients is essential for practical and realistic learning, providing community services, and establishing a dental school clinic. Simultaneously, studies on public healthcare user satisfaction are crucial, contributing to corrective measures planning based on obtained information. The study aimed to understand the demographic and economic profile of patients treated at the Basic Dental Care Clinic of a public university and to assess patient satisfaction with the services and infrastructure. A cross-sectional observational study was conducted, collecting socioeconomic and general health data from patients through dental anamnesis. Validated questionnaires were used: Questionnaire for User Satisfaction with Public Oral Health Services, covering seven quality dimensions, and the Pompeu Questionnaire, addressing dental care aspects. Responses were tabulated for descriptive statistical analysis. Results: Questionnaire for User Satisfaction with Public Oral Health Services results indicate high patient satisfaction in various dimensions, such as human relations, treatment effectiveness, accessibility, and technical-scientific quality. The Pompeu Questionnaire reinforces these findings, emphasizing the students’ and professors’ receptiveness, effective guidance on oral care, and a high clinic recommendation rate by patients. In summary, both questionnaires reveal an overall positive patient satisfaction. In the study’s context, the majority of patients treated in the mentioned clinic expressed satisfaction with the physical structure, service, and dental treatment offered. learning Simultaneously crucial information infrastructure crosssectional cross sectional conducted anamnesis used dimensions aspects analysis Results relations effectiveness accessibility technicalscientific technical scientific findings professors receptiveness summary studys s context structure service offered

Aim This cohort study aimed to investigate the exclusive breastfeeding (EBF) prevalence and its association with maternal EBF intention and other variables. Method Pregnant women (n=653) in the third trimester of pregnancy filled out a questionnaire on EBF intention using the Infant Feeding Intentions scale and other variables. After delivery, mothers were contacted by phone at the first (T1; n=467), third (T3; n=333), and sixth (T6; n=217) month of the baby’s life or until breastfeeding was terminated, to collect data on breastfeeding, delivery, the newborn, oral habits, and family variables. The associations between independent variables and the outcomes (EBF prevalence at T1, T3, and T6) were analyzed by simple and multiple logistic regression models (α =0.05). Results EBF prevalence was 81.2% at T1, 64.0% at T3, and 35.9% at T6. Nott use baby bottle (OR=612.59; OR=139.08; OR=15.05) and no pacifier use (OR=2.94; OR=2.78; OR=2.93) were associated with the outcome at T1, T3, and T6, respectively. Other associated variables were strong EBF intention (OR=1.71) at T1; higher birth weight (OR=1.62), childcare support (OR=2.59), maternal age (OR=0.54), being married or having a partner (OR=1.82) at T3; and not returning to work (OR=2.39) at T6. Conclusion The EBF prevalence was high at the first month of the baby’s life and decreased over six months. The EBF intention affected EBF initiation. Variables related to the mother´s demographic characteristics, the baby´s birth weight, the childcare support or the baby bottle/pacifier use were associated with EBF. n=653 n653 n 653 (n=653 delivery T1 T (T1 n=467, n467 n=467 , 467 n=467) T3 (T3 n=333, n333 n=333 333 n=333) T6 (T6 n=217 n217 217 babys s terminated newborn habits α =0.05. 005 =0.05 . 0 05 =0.05) 812 81 2 81.2 640 64 64.0 359 35 9 35.9 OR=612.59 OR61259 OR 612 59 (OR=612.59 OR=139.08 OR13908 139 08 OR=15.05 OR1505 15 OR=2.94 OR294 94 (OR=2.94 OR=2.78 OR278 78 OR=2.93 OR293 93 respectively OR=1.71 OR171 1 71 (OR=1.71 OR=1.62, OR162 OR=1.62 62 (OR=1.62) OR=2.59, OR259 OR=2.59 (OR=2.59) OR=0.54, OR054 OR=0.54 54 (OR=0.54) OR=1.82 OR182 82 (OR=1.82 OR=2.39 OR239 39 (OR=2.39 months initiation mother characteristics bottlepacifier n=65 n65 65 (n=65 (T n46 n=46 46 n33 n=33 33 n=21 n21 21 00 =0.0 8 81. 6 64. 3 35. OR=612.5 OR6125 61 5 (OR=612.5 OR=139.0 OR1390 13 OR=15.0 OR150 OR=2.9 OR29 (OR=2.9 OR=2.7 OR27 7 OR=1.7 OR17 (OR=1.7 OR16 OR=1.6 (OR=1.62 OR25 OR=2.5 (OR=2.59 OR05 OR=0.5 (OR=0.54 OR=1.8 OR18 (OR=1.8 OR=2.3 OR23 (OR=2.3 n=6 n6 (n=6 n4 n=4 4 n3 n=3 n=2 n2 =0. OR=612. OR612 (OR=612. OR=139. OR139 OR=15. OR15 OR=2. OR2 (OR=2. OR=1. OR1 (OR=1. (OR=1.6 (OR=2.5 OR0 OR=0. (OR=0.5 n= (n= =0 OR=612 OR61 (OR=612 OR=139 OR13 OR=15 OR=2 (OR=2 OR=1 (OR=1 OR=0 (OR=0. (n = OR=61 OR6 (OR=61 OR=13 OR= (OR= (OR=0 OR=6 (OR=6 (OR

ABSTRACT Objective: To determine the prevalence and analyze the variables associated with the use of pacifiers and/or bottles by infants up to 6 months of age. Material and Methods: Data on sociodemographic characteristics, intention to offer pacifier and bottle-feeding, pregnancy and breastfeeding (BF) variables were collected at baseline by interviews and a self-administered questionnaire among pregnant women in the 3rd trimester. After delivery, mother-baby binomials were followed by phone calls at the 1st, 3rd, and 6th months of the baby's life (n=467) to gather information on the type of delivery, baby’s gender, BF in the first hour of the newborn’s life, baby’s weight, mother’s return to work, and oral habits. Association analyses were performed using logistic regression models with a 5% significance level with the pacifier/bottle-feeding use as the outcome. Results: Most mothers (52.5%) reported their babies used bottle-feeding, 48.2% used pacifiers and 33.4% used both of them throughout the 6 months. Intention to offer pacifier and bottle-feeding was reported by 45.0% and 54.8% of the mothers at the 3rd trimester of the pregnancy, respectively. Not living in one’s own residence (OR=1.53; 95%CI: 1.05-2.24) and having the prenatal intention of offering a pacifier (OR=2.50; 95%CI: 1.63-3.83) to the baby were significantly associated with pacifier use. Variables significantly associated with bottle-feeding were mother’s return to work (OR=2.48; 95%CI: 1.54-3.97), baby’s lower birth weight (OR=1.58; IC95%: 1.07-2.33), and prenatal intention to offer bottle-feeding (OR=2.51; 95%CI 1.56-4.04). Conclusion: About half of the babies used pacifiers or were bottle-fed, which were associated with the mother’s prenatal intention to offer them to their babies and socioeconomic factors. Objective andor age Methods characteristics bottlefeeding, bottlefeeding bottle feeding, feeding (BF selfadministered self administered rd delivery motherbaby mother 1st st th babys s n=467 n467 n 467 (n=467 gender newborns newborn habits 5 pacifier/bottlefeeding pacifierbottlefeeding pacifier/bottle outcome Results 52.5% 525 52 (52.5% 482 48 2 48.2 334 33 4 33.4 450 45 0 45.0 548 54 8 54.8 respectively ones one OR=1.53 OR153 OR 1 53 (OR=1.53 95CI CI 95 1.052.24 105224 1.05 2.24 05 24 1.05-2.24 OR=2.50 OR250 50 (OR=2.50 1.633.83 163383 1.63 3.83 63 3 83 1.63-3.83 OR=2.48 OR248 (OR=2.48 1.543.97, 154397 1.54 3.97 , 97 1.54-3.97) OR=1.58 OR158 58 (OR=1.58 IC95% IC95 IC 1.072.33, 107233 1.07 2.33 07 1.07-2.33) OR=2.51 OR251 51 (OR=2.51 1.564.04. 156404 1.56 4.04 . 56 04 1.56-4.04) Conclusion bottlefed, bottlefed fed, fed bottle-fed factors n=46 n46 46 (n=46 pacifierbottle 52.5 (52.5 48. 33. 45. 54. OR=1.5 OR15 (OR=1.5 9 052 1.052.2 10522 105 1.0 224 2.2 1.05-2.2 OR=2.5 OR25 (OR=2.5 633 1.633.8 16338 163 1.6 383 3.8 1.63-3.8 OR=2.4 OR24 (OR=2.4 543 1.543.97 15439 154 1.5 397 3.9 1.54-3.97 IC9 072 1.072.33 10723 107 233 2.3 1.07-2.33 564 1.564.04 15640 156 404 4.0 1.56-4.04 n=4 n4 (n=4 52. (52. OR=1. OR1 (OR=1. 1.052. 1052 10 1. 22 2. 1.05-2. OR=2. OR2 (OR=2. 1.633. 1633 16 38 3. 1.63-3. 1.543.9 1543 15 39 1.54-3.9 1.072.3 1072 23 1.07-2.3 1.564.0 1564 40 4. 1.56-4.0 n= (n= (52 OR=1 (OR=1 1.052 1.05-2 OR=2 (OR=2 1.633 1.63-3 1.543. 1.54-3. 1.072. 1.07-2. 1.564. 1.56-4. (n (5 OR= (OR= 1.05- 1.63- 1.543 1.54-3 1.072 1.07-2 1.564 1.56-4 ( (OR 1.54- 1.07- 1.56-

RESUMO Pouco se sabe se as decisões de tratamento dos dentistas brasileiros para lesões cariosas proximais são comparadas às recomendações atuais baseadas em evidências, portanto, é necessário um melhor entendimento para fechar qualquer potencial lacuna entre a evidência e a prática. Purpose: Este estudo transversal teve como objetivo quantificar a lacuna entre a evidência e a prática na decisão de tratamento das lesões cariosas proximais e identificar os fatores associados a essa lacuna entre a evidência e a prática. Methods: Cirurgiões-dentistas brasileiros (n=214) de Araraquara, Estado de São Paulo, preencheram um questionário sobre suas características odontológicas e clínicas e uma versão traduzida do “Assessment of Caries Diagnosis and Caries Treatment” da U.S. National Dental Practice-Based Research Network. Cinco imagens radiográficas de lesões cariosas proximais em cenários de pacientes de baixo risco e alto risco foram usadas. Associações entre recomendações de tratamento e lesão, dentista e características da prática foram testadas (p<0,05). Results: As lesões confinadas ao esmalte seriam restauradas por 35% e 71% dos dentistas nos cenários de pacientes de baixo risco e alto risco, respectivamente, sugerindo uma lacuna entre a evidência e a prática substancial, dado que a intervenção cirúrgica das lesões do esmalte não é consistente com as evidências atuais. O limiar de profundidade da lesão para recomendar uma restauração permanente diferiu entre os cenários de pacientes de baixo risco e alto risco (p<0,001). Características específicas do dentista/prática (sexo do dentista, graduado em uma faculdade pública, pós-graduação, uso da avaliação de risco de cárie) foram significativamente associadas à lacuna entre a evidência e a prática, mas a magnitude dessas diferenças não foi importante. Conclusions: uma lacuna entre a evidência e a prática substancial na decisão de tratamento de lesões cariosas proximais foi encontrada para a amostra como um todo, mesmo quando os cenários clínicos apresentavam pacientes de baixo risco. Estratégias globais são necessárias para fechar essa lacuna entre a evidência e a prática. portanto Purpose Methods Cirurgiõesdentistas Cirurgiões n=214 n214 n 214 (n=214 Araraquara Paulo Assessment Treatment US U S U.S PracticeBased Practice Based Network usadas p<0,05. p005 p p<0,05 . 0 05 (p<0,05) Results 35 71 respectivamente p<0,001. p0001 p<0,001 001 (p<0,001) dentistaprática sexo pública pósgraduação, pósgraduação pós graduação, graduação pós-graduação cárie importante Conclusions todo n=21 n21 21 (n=21 p00 p<0,0 (p<0,05 3 7 p000 p<0,00 00 (p<0,001 n=2 n2 2 (n=2 p0 p<0, (p<0,0 (p<0,00 n= (n= p<0 (p<0, (n p< (p<0 (p< (p

ABSTRACT Little is known about how Brazilian dentists’ treatment decisions for proximal carious lesions are compared to current evidence-based recommendations, so better understanding is needed to close any potential evidence-practice gap. Objectives: This cross-sectional study aimed to quantify the evidence-practice gap about proximal carious lesions treatment and identify dentist factors associated with this evidence-practice gap. Methods: Brazilian dentists (n=214) from Araraquara, São Paulo State, “completed a questionnaire about their dentist and practice characteristics and a translated version of the “Assessment of Caries Diagnosis and Caries Treatment” from the U.S. National Dental Practice-Based Research Network. Five radiographic images of proximal carious lesions in low-risk and high-risk patient scenarios were used. Associations between treatment recommendations and lesion, dentist, and practice characteristics were tested for statistical significance (p<0.05). Results: Lesions confined to the enamel would be restored by 35% and 71% of dentists in the low-risk and high-risk patient scenarios, respectively, suggesting a substantial evidence-practice gap given that surgical intervention of enamel lesions is not consistent with current evidence. The lesion depth threshold to recommend a permanent restoration differed between the low-risk and high-risk patient scenarios (p<0.001). Specific dentist/practice characteristics (dentist gender, graduate of a public dental school, postgraduate training, use of caries risk assessment) were significantly associated with the evidence-practice gap, but the magnitude of these differences was not major Conclusion: A substantial evidence-practice gap in treatment of proximal carious lesions was found for the sample overall, even when clinical scenarios presented low-risk patients. Global strategies are needed to close this substantial evidence-practice gap. evidencebased evidence based evidencepractice Objectives crosssectional cross sectional Methods n=214 n214 n 214 (n=214 Araraquara State completed Assessment Treatment US U S U.S PracticeBased Practice Based Network lowrisk low highrisk high used p<0.05. p005 p p<0.05 . 0 05 (p<0.05) Results 35 71 respectively p<0.001. p0001 p<0.001 001 (p<0.001) dentistpractice gender school training assessment Conclusion overall patients n=21 n21 21 (n=21 p00 p<0.0 (p<0.05 3 7 p000 p<0.00 00 (p<0.001 n=2 n2 2 (n=2 p0 p<0. (p<0.0 (p<0.00 n= (n= p<0 (p<0. (n p< (p<0 (p< (p

Aim Better understanding of dentists’ decision-making about defective restorations is needed to close the evidence-practice gap (EPG). This study aimed to quantify the EPG about defective restorations and identify dentist factors associated with this EPG. Methods 216 dentists from São Paulo State, Brazil, completed a questionnaire about three clinical case scenarios involving defective composite restorations with cementum-dentin margins (case 1) and enamel margins (case 2), and an amalgam (case 3) restoration. Dentists were asked what treatment, if any, they would recommend, including preventive treatment, polishing, re-surfacing, or repairing the restoration, or replacing the entire restoration. Replacing the entire restoration in any of these three scenarios was classified as inconsistent with the evidence, comprising an EPG. Bivariate analyses using Chi-square, ANOVA, or multiple comparison tests were performed (p<.05). Results for defective composite restorations, 49% and 55% of dentists chose to replace the entire restoration for cases 1 and 2, respectively. Twenty-nine percent of dentists chose to replace the entire amalgam restoration. Dentists were significantly more likely to choose to replace the defective amalgam restoration than the composite restoration with a defect at the cementum-dentin margins or the enamel margins (both at p < .001). Female dentists were more likely to choose a conservative treatment than male dentists for cases 1 (p=.034) and 2 (p=.009). Dentists with a higher percentage of patients interested in individualized caries prevention were also more conservative in case 1 (p=.045). Conclusion a substantial EPG regarding treatment decisions for defective restorations exists, especially for composite restorations. This study adds to the international evidence that an EPG exists in this clinical area and that global strategies need to be developed to close the gap. decisionmaking decision making evidencepractice practice . (EPG) 21 State Brazil cementumdentin cementum dentin , 2) 3 recommend polishing resurfacing, resurfacing re surfacing, surfacing re-surfacing Chisquare, Chisquare Chi square, square Chi-square ANOVA p<.05. p05 p<.05 05 (p<.05) 49 55 respectively Twentynine Twenty nine both .001. 001 .001 .001) p=.034 p034 034 (p=.034 p=.009. p009 p=.009 009 (p=.009) p=.045. p045 p=.045 045 (p=.045) (EPG p0 p<.0 0 (p<.05 4 5 00 .00 p=.03 p03 03 (p=.03 p00 p=.00 (p=.009 p04 p=.04 04 (p=.045 p<. (p<.0 .0 p=.0 (p=.0 (p=.00 (p=.04 p< (p<. p=. (p=. (p< p= (p= (p

Abstract Data on dental practices related to caries risk assessment (CRA) are scarce among Brazilian dentists. This study aimed to determine the prevalence of CRA use by dentists and factors associated with its use, as well as to quantify dentists’ ratings of the importance of specific factors when treatment planning. Dentists registered at the Regional Council of Dentistry of São Paulo State – Araraquara region were sent two paper questionnaires that comprised: a) characteristics of dentists themselves, their practices, and their patients; and b) the translated version of the “Assessment of Caries Diagnosis and Caries Treatment” Questionnaire from the U.S. National Dental Practice-Based Research Network. Participants were 206 dentists who currently practiced in Araraquara and treated dental caries. Descriptive statistics and multiple logistic regression analyses were used for data analysis. Thirty-six percent of the dentists reported they perform CRA and, among them, 36% indicated they record the assessment on a special form that is kept in the patient chart. More years since dental school graduation (OR = 1.1, p = 0.002) and holding an advanced academic degree (OR=2.6, p=0.005) were associated with a higher likelihood of performing CRA, whereas exclusively using a private practice model (OR = 0.5, p = 0.016) was associated with a lower likelihood of performing CRA. The current oral hygiene and commitment to return for follow-up were the most important risk factors for treatment planning. In conclusion, CRA was not a routine procedure in daily practice among the majority of participating dentists. Specific demographic, practice and academic education characteristics were associated with performing CRA.

ABSTRACT Objective: To describe the dental practice patterns related to caries prevention in children aged 6-18 years and associated factors. Material and Methods: Dentists (n=162) from Araraquara, Brazil, completed two paper questionnaires: (1) one about characteristics of their practice and their patient population; and (2) a translated version of the “Assessment of Caries Diagnosis and Caries Treatment” Questionnaire from the National Dental Practice-Based Research Network. Regression analyses were used for data analysis (p<0.05). Results: Dentists reported using in-office fluoride (IOF) and dental sealants (DS) in 74.2% and 45.1% of their pediatric patients, respectively. Regression analysis showed that female dentists (p=0.035 for DS; p=0.044 for IOF; p=0.011 for non-prescription fluoride rinse), those with advanced degrees (p=0.032 for prescription of fluoride), those who graduated from a private dental school (p=0.018 for chlorhexidine rinse), those who provided caries prevention regimens (p<0.001 for DS; p=0.004 for IOF; p=0.013 for non-prescription fluoride rinse), those with a greater percentage of patients interested in a caries prevention regimen (p=0.007 for non-prescription fluoride rinse), those working in a private practice model (p=0.047 for prescription of fluoride) were more likely to recommend some type of preventive methods to their pediatric patients. Conclusion: Dentists reported recommending IOF to most of their pediatric patients. Certain dentists’, practices’, and patients’ characteristics were associated to some caries prevention regimens recommended by dentists.

OBJETIVO: Avaliar a prevalência e a severidade da dor orofacial em gestantes. MÉTODOS: O estudo transversal foi realizado em uma amostra de gestantes em atendimento odontológico em uma faculdade de odontologia. Foi aplicado questionário estruturado com perguntas sobre a auto percepção das condições bucais e a presença e a severidade da dor orofacial sentida na boca ou dentes nos últimos 6 meses. RESULTADOS: Participaram do estudo 80 gestantes e, destas, 58,8% afirmaram ter algum problema nos dentes, 31,3% problema na gengiva, 61,3% gosto ruim na boca e 62,5% mau hálito. Apenas 22,5% não apresentaram nenhum tipo de dor orofacial. As dores mais relatadas foram: dor com líquidos quentes, frios ou doces (56,2%) e dor de dente espontânea (38,8%). Quanto à severidade, as dores de intensidade leve e moderada foram as mais frequentes, mas havia um grupo de 23,8% das gestantes com dores intensas ou muito intensas provocadas por líquidos frios ou quentes e 18,8% na mesma condição em relação à dor espontânea. CONCLUSÃO: Os resultados do estudo mostraram que, apesar da alta prevalência de dor orofacial encontrada, a severidade foi baixa e relacionada a algumas situações específicas.

OBJECTIVE: To evaluate the prevalence and severity of oral pain in pregnant women. METHODS: A cross-sectional study was conducted on a sample of pregnant women who were receiving dental care at a Dental School. A structured questionnaire about self-perception of oral conditions and the presence and severity of orofacial pain in the mouth or teeth in the last 6 months was applied. RESULTS: 80 pregnant women participated in the study and, of these, 58.8% reported having a problem with their teeth, 31.3% periodontal problems, 61.3% bad taste in mouth and 62.5% bad breath. Only 22.5% of pregnant women did not exhibit any form of oral pain. The most frequently reported pains were: pain with hot/cold liquids or sweets (56.2%) and spontaneous toothache (38.8%). With regard to severity, mild and moderate pain were the most frequently reported, but there was a group of 23.8% of pregnant women with severe or very severe pain caused by hot or cold liquids and 18.8% in the same condition in relation to spontaneous pain. CONCLUSION: The results of this study showed that, despite the high prevalence of pain detected in the pregnant women, severity was low and referred to specific situations.

O conhecimento do risco de cárie na gravidez é essencial para um correto plano de tratamento com ações educativas e preventivas às mães para que possam cuidar adequadamente de sua saúde bucal e de seus filhos. Este estudo retrospectivo teve como objetivo identificar o risco de cárie de gestantes (15-44 anos; média= 25 anos) que frequentaram a clínica de odontologia preventiva da Faculdade de Odontologia de Araraquara, Universidade Estadual Paulista de 1999 a 2007. Um total de 166 prontuários, preenchidos por alunos do 3º ano do Curso de Graduação, seguindo orientações pré-estabelecidas, foram utilizados. Coletou-se informação sobre: classificação do diagnóstico de risco de cárie, trimestre gestacional, consumo de carboidratos (entre ou durante as refeições), placa corada (registro de controle de placa de O'Leary), número e grupo de dentes com experiência de cárie. Para análise estatística foram utilizados o teste de qui-quadrado e ANOVA. A maioria das gestantes (92,1 %) apresentou 25 % ou mais das superfícies dentárias com placa dental. A média (desvio-padrão) de dentes obturados e cariados foi 7,9 (5,1) e 4,0 (3,4), respectiva emente. Os dentes posteriores foram os mais acometidos por cárie/restaurações. Quanto ao diagnóstico de risco à cárie, a classificação alta foi observada em 38,5 % das gestantes, moderada em 47,6 % e baixa em 13,9 %. Houve associação estatisticamente significativa (p= 0,001) entre o consumo de carboidratos e o diagnóstico de risco de cárie. O índice de placa foi semelhante nos diferentes trimestres gestacionais (f= 0,223; p= 0,803). Portanto pode-se concluir que o risco de cárie da grande maioria das gestantes foi alto ou moderado e esteve estatisticamente associado ao consumo de carboidratos.

The knowledge of risk of carried during pregnant is essential for an appropriate treatment using educational and preventives actions to mother for a good care of their oral health and that of children. The main objective of present retrospective study was to identify the risk of caries of pregnants (aged 15-44, mean= 25 years) came to clinic of Preventive Odontology of Araraquara-UNSEP from 1999 to 2007, using 166 medical records obtained by the third pregraduate year students, following the pre-established guidelines. The information collected includes: classification of caries risk diagnosis, pregnancy trimester, carbohydrates ingestion (between or during foods), dental plaques (O'Leary's plaque control registry) and the number of teeth with caries. The statistical analysis used the Chi² and ANOVA tests. Most of patients showed a 25 % or more of teeth surfaces with dental plaques (92.1 %) and carbohydrates consumption among foods (89.2 %). The mean (SD) of carried and restores teeth was of 7.9 (5.1) and 4.0 (3.4), respectively and the posterior teeth were the more involved by caries/restorations. As regards the diagnosis of caries risk, classification of high risk was observed in the 38.5 % of pregnants, moderate in the 47.6 %) and low in the 13.9 %. There was a statistically significant association (p= 0.001) between the carbohydrates consumption and the diagnosis of caries risk. The plaque's rate was similar in the different trimesters of pregnancy (f= 0.223; p= 0.803). The caries risk of most pregnant women was high or moderate and it was associated with the consumption of carbohydrates.

El conocimiento del riesgo de padecer de caries dental durante el periodo de embarazo es esencial para un correcto plan de tratamiento con las acciones educativas y preventivas necesarias para que las madres puedan cuidar adecuadamente de su salud bucal y la de sus hijos. Este estudio retrospectivo tuvo como objetivo identificar el riesgo de caries dental en las mujeres en periodo de gestación con edades comprendidas entre 15 y 44 años, con una media de 25 años, que acudieron a la clínica de odontología preventiva de la Facultad de Odontología de Araraquara, Universidad Estadual Paulista, del año 1999 al 2007. Se utilizaron 166 historias clínicas hechas por los estudiantes de tercer año de pregrado, según las directrices preestablecidas. La información recogida fue: clasificación del diagnóstico de riesgo de caries, trimestre de embarazo, la ingesta de hidratos de carbono entre o durante las comidas, placa dental (registro de control de placa de O'Leary) y el número de grupo de dientes con caries. El análisis estadístico utilizó el Chi cuadrado y ANOVA. La mayoría de los pacientes mostraron el 25 % o más de las superficies de los dientes con la placa dental con un valor de 92,1 % e hidratos de carbono consumidos entre comidas con un valor de 89,2 %. La media (desviación estándar) de los dientes cariados y restaurados fue de 7,9 (5,1) y 4,0 (3,4) respectivamente; los dientes posteriores se vieron más afectados por la caries o restauraciones. En cuanto al diagnóstico de riesgo de caries, la clasificación de alto riesgo se observó en 38,5 % de las mujeres embarazadas, moderado en 47,6 % y bajo en 13,9 %. Existió una asociación estadísticamente significativa (p= 0,001) entre el consumo de hidratos de carbono y el riesgo de caries. El índice de placa fue similar en los diferentes trimestres del embarazo (f= 0,223 y p= 0,803). El riesgo de padecer caries dental en la gran mayoría de las mujeres embarazadas fue alto o moderado y se asoció significativamente con el consumo de hidratos de carbono.

O objetivo desta pesquisa foi determinar o efeito da adequação do meio bucal sobre a contagem de Streptococcus mutans em gestantes de alto risco à cárie, participantes de um programa de prevenção em uma instituição de ensino público, antes e após adequação do meio bucal. Amostras de saliva de 30 gestantes (18 a 43 anos) que procuraram atendimento na Clínica de Odontologia Preventiva da FOAr-UNESP foram coletadas antes e após procedimentos de adequação do meio bucal, e examinadas para observação e contagem das UFCs de S. mutans. Foi demonstrado que houve diminuição na quantidade das UFCs (p<0,0001) entre as amostras. Em relação à faixa etária, 70,0% das gestantes tinham entre 18 e 30 anos de idade e 30,0% pertenciam à faixa etária de 31 a 43 anos. Dados relativos ao período da gestação revelaram que 73,4% estavam no 2º trimestre e 13,3% estavam igualitariamente no 1º e 3º trimestres. A adequação do meio bucal se mostrou eficaz na diminuição das UFCs de S. mutans presentes na saliva de gestantes de alto risco de cárie. Este procedimento é simples e extremamente efetivo, atendendo às necessidades de tratamento básico de gestantes que procuram atendimento odontológico no serviço público de saúde.

The aim of this study was to determine the effect of oral environment stabilization (OES) on the counting of Streptococcus mutans in high-caries-risk pregnant women participants of a prevention program in a public teaching institution. The sample was composed of 30 pregnant women aged 18 to 43 years, who looked for treatment at the Preventive Dentistry Clinic of the Araraquara Dental School, UNESP. Saliva samples were collected before and after the OES procedures and were forwarded to the pathology for observation and quantification of S. mutans CFU. There was a decrease in the number of S. mutans CFU, which was significantly different (p<0.0001) between samples. Considering the age group, 70.0% were between 18 to 30 years old and 30.0% belonged to the 31-43-year-old age group. Data related to the pregnancy period showed that 73.4% were in the second trimester, 13.3% in the first and 13.3% in third trimester. OES showed to be an effective clinical procedure in diminishing the number of S. mutans CFU in the saliva of high-caries-risk pregnant women. This management is simple and effective, corresponding to the basic treatment needs of pregnant women that search dental care in this public service.

OBJETIVOS: avaliar a percepção das condições de saúde bucal de um grupo de gestantes, através da aplicação do índice General Oral Health Assessment Index (GOHAI). MÉTODOS: participaram do estudo 53 gestantes que freqüentavam uma Unidade Básica de Saúde em Araraquara, São Paulo. Foi aplicado um questionário contendo questões do índice GOHAI, questões sobre a autopercepção das condições bucais e sobre as características sócio-demográficas. Por meio dos testes não-paramétricos Mann-Whitney e Kruskall-Wallis, foram determinados a associação das variáveis sociais e de autopercepção com o índice GOHAI. RESULTADOS: a percepção das condições bucais, medida pelo índice GOHAI, foi positiva e apresentou um valor médio de 31,6. Os dados subjetivos mostram que apenas 12,0% das gestantes classificaram sua condição bucal como "ruim", a maioria declarou nenhum problema dentário, embora 58,7% tenha relatado distúrbios gengivais. As questões como dor e/ou desconforto foram as mais percebidas pelas gestantes. CONCLUSÕES: as gestantes fizeram uma avaliação positiva de sua condição bucal, estando o índice GOHAI associado a variáveis relacionadas à autopercepção. Tal índice pode ser aplicado em grupos populacionais como as gestantes, possibilitando medidas educativas e/ou preventivas direcionadas às suas reais necessidades.

OBJECTIVES: to assess oral healthcare conditions of a group of pregnant women through the application of the General Oral Health Assessment Index (GOHAI). METHODS: fifty three pregnant women clients of the Basic Oral Health Clinic in Araraquara São Paulo were enrolled in the program. A questionnaire with the GOHAI rating questions, questions related to self-perception of oral conditions and to social and demographic characteristics was applied. Through these Mann-Whitney and Kruskall-Wallis non-paramedic tests, the association of social variables and self-perception of the GOHAI rates were determined. RESULTS: oral conditions perception as measured by the GOHAI index was positive and presented a median value of 31,6. Subjective data indicated that only 12,0% of the pregnant women rated their oral condition as "bad", the majority did not disclose any dental problem, although 58,7% reported gum problems. Issues such as pain and/or discomfort were the ones more closely perceived by the pregnant women. CONCLUSIONS: pregnant women had a positive assessment of their oral conditions with the GOHAI rating associated to self-perception variables. This index could be applied to population groups such as pregnant women, enabling educational and/or preventive measures focused on their real needs.

O objetivo do estudo foi avaliar o efeito de soluções de fluoreto de sódio a 0,05% contendo 2,5% ou 12,5% de xilitol no número de estreptococos do grupo mutans presentes na saliva. Participaram do estudo duplo cego, do tipo cruzado, 50 meninos entre 8 e 16 anos, distribuídos aleatoriamente em quatro grupos. Destes, 33 finalizaram o estudo. As soluções utilizadas foram: solução placebo; solução de fluoreto de sódio a 0,05%; solução de fluoreto de sódio a 0,05% + 2,5% xilitol + 2% sorbitol; solução de fluoreto de sódio a 0,05% + 12,5% xilitol + 2% sorbitol. Os indivíduos utilizaram 20 mL de uma das soluções, duas vezes ao dia. Cada solução foi utilizada por um período experimental de 28 dias. Os períodos experimentais foram intercalados por períodos de descanso de 10 dias. As soluções contendo xilitol a 2,5% e 12,5% não apresentaram diferença significativa (P = 0,32) em termos do logaritmo do número de estreptococos do grupo mutans. No entanto, a diferença foi significativa quando essas soluções foram comparadas às soluções de fluoreto de sódio e placebo (P < 0,001). Os resultados sugerem que a solução de fluoreto de sódio a 0,05% com adição de xilitol a 2,5% ou 12,5% reduziu significativamente o número de estreptococos do grupo mutans.

The objective of this study was to assess the effect of 0.05% sodium fluoride solutions containing 2.5% or 12.5% xylitol on the number of Streptococcus mutans in the human mouth. Fifty boys between 8 and 16 years of age participated in this double-blind crossover study. Of the original 50 boys, 33 finished the study. Participants were randomly divided into four groups. The following solutions were employed: placebo solution; 0.05% sodium fluoride solution; 0.05% sodium fluoride + 2.5% xylitol + 2% sor-bitol; 0.05% sodium fluoride + 12.5% xylitol + 2% sorbitol. Each solution was used for a 28-day period (20 mL/day, twice a day), with a 10-day washout period between solutions. There were no significant differences (P = 0.32) between the two xylitol-containing solutions (2.5% vs. 12.5%) concerning the number of Streptococcus mutans. However, there was a significant difference between these two xylitol-containing solutions and the sodium fluoride and placebo solutions (P <0.001). Our results suggest that the 0.05% sodium fluoride solutions containing either 2.5% or 12.5% xylitol caused a significant reduction in the number of Streptococcus mutans.

O objetivo deste estudo foi avaliar as condições de saúde bucal em pessoas com 60 anos ou mais no Município de Araraquara, Estado de São Paulo, Brasil, no ano de 1998. Participaram do estudo 194 pessoas (91 institucionalizadas, com idade média de 73,6 anos, e 103 não-institucionalizadas, com idade média de 69,3 anos), que foram examinadas por um cirurgião-dentista, previamente treinado, para determinar a prevalência das principais doenças bucais. Os resultados mostraram um grande número de pessoas edentadas (72% dos institucionalizados e 60% dos não-institucionalizados) e de dentes extraídos (93 e 90%, respectivamente), grande freqüência de bolsas periodontais (57 e 75%) e de próteses inadequadas (80% das próteses em pessoas institucionalizadas e 61% em pessoas não-institucionalizadas). Os resultados mostram o comprometimento da qualidade de vida de grande parte dessas pessoas e indicam a necessidade de maior atenção dos serviços públicos a esse grupo populacional.

This study assessed the oral health of individuals 60 years or older in the city of Araraquara, São Paulo, Brazil, in 1998. Of the 194 people who participated in the study, 91 of them were institutionalized and had an average age of 73.6 years, and 103 were not institutionalized and had an average age of 69.3 years. The study participants were examined by a previously trained oral surgeon who determined the prevalence of the most common oral health problems. The results revealed a large number of edentulous individuals (72% of those institutionalized and 60% of the noninstitution-alized participants) and many persons with extracted teeth (93% and 90%, respectively), as well as a high frequency of periodontal pockets (57% and 75%, respectively) and of inadequate dentures (80% and 61%, respectively). Our results show reduced quality of life for a large proportion of these older individuals, and also indicate that public health services should pay greater attention to this population group.