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      Análise da cobertura de saúde bucal e práticas das equipes de saúde bucal na atenção primária em municípios sul-mato-grossenses Translated title: Analysis of oral health coverage and practices of oral health teams in primary care in Sul-Mato-Grossenses municipalities

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          Abstract

          Resumo Introdução Considerando a estimativa para o Brasil de 15.190 novos casos de câncer de boca e orofaringe para o triênio de 2020 a 2022, justifica-se a importância de o odontólogo na atenção primária estar capacitado para o diagnóstico precoce de câncer de boca e orofaringe, à biópsia e à regulação ao Centro de Especialidades Odontológicas. Objetivo Analisar a cobertura de saúde bucal e práticas das equipes de saúde bucal da atenção primária à saúde quanto ao cuidado ao câncer de boca e orofaringe em municípios de Mato Grosso do Sul. Material e método Estudo descritivo, transversal, quantitativo, em bases de dados secundários oficiais e públicos, referentes aos municípios do estado de Mato Grosso do Sul em que foram determinadas prevalência de câncer de boca e orofaringe, CID-10 C00 - C10, cobertura de saúde bucal e análise de dados de cuidado em saúde bucal do PMAQ-AB, 3º Ciclo. Resultado Houve divergência nas respostas entre as equipes de saúde bucal de alguns municípios no direcionamento do fluxo de referenciamento para biópsia e tratamento do câncer de boca e orofaringe, evidenciando desconhecimento das ofertas de serviços especializados. Conclusão Há fragilidades no processo de trabalho que podem influenciar no estadiamento do diagnóstico, tratamento, qualidade de vida e sobrevida do paciente com neoplasia maligna de boca e orofaringe. São importantes a capacitação e valorização das equipes de saúde bucal por meio de uma educação continuada e permanente, voltada ao diagnóstico precoce e à orientação dos fluxos assistenciais aos serviços especializados de referência, fortalecendo a coordenação do cuidado e ordenação na rede de atenção à saúde.

          Translated abstract

          Abstract Introduction Considering the estimate in Brazil of 15,190 new cases of oral and oropharyngeal cancer for the triennium 2020 to 2022, the importance of the dentist in Primary Care is justified in the early diagnosis of oral and oropharyngeal cancer, biopsy and regulation to the Dental Specialties Center. Objective To analyze the Oral Health coverage and practices of the Oral Health Teams of Primary Health Care, in the care of mouth and oropharynx cancer in municipalities of Mato Grosso do Sul. Material and method Descriptive, cross-sectional, quantitative study of official and public secondary databases referring to municipalities in the state of Mato Grosso do Sul in which the prevalence of oral and oropharyngeal cancer was determined, ICD-10 C00 - C10, coverage of oral health and analysis of oral health care data from the PMAQ-AB, 3rd Cycle. Result There was a divergence in the answers between the oral health teams of some municipalities in the direction of the referral flow for biopsy and treatment of oral and oropharyngeal cancer, evidencing a lack of knowledge of the offers of specialized services. Conclusion There are weaknesses in the work process that can influence the staging of diagnosis, treatment, quality of life and survival of patients with malignant neoplasm of the mouth and oropharynx. It is important to train and value the Oral Health Teams through continuous and permanent education, aimed at early diagnosis and guidance of care flows to specialized reference services, strengthening the coordination of care and ordering in Health Care Network.

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          Most cited references21

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          Oral Cancer and Precancer: A Narrative Review on the Relevance of Early Diagnosis

          Oral cancer (OC) is an uncommon malignancy in Western countries, being one of the most common cancers in some high-risk areas of the world. It is a largely preventable cancer, since most of the different risk factors identified, such as tobacco use, alcohol consumption, and betel nut chewing, are behaviors that increase the likelihood of the disease. Given its high mortality, early diagnosis is of utmost importance. Prevention and the anticipation of diagnosis begin with identification of potentially malignant lesions of the oral mucosa and with local conditions promoting chronic inflammation. Therefore, every lesion must be recognized promptly and treated adequately. The clinical recognition and evaluation of oral mucosal lesions can detect up to 99% of oral cancers/premalignancies. As stated by the World Health Organization, any suspicious lesion that does not subside within two weeks from detection and removal of local causes of irritation must be biopsied. Surgical biopsy remains the gold standard for diagnosis of oral cancer. Adjunctive tools have been developed and studied to help clinicians in the diagnostic pathway, such as toluidine blue vital staining and autofluorescence imaging. In the near future other methods, i.e., identification of salivary markers of progression may help in reducing mortality due to oral cancer.
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            Saúde bucal na rede de atenção e processo de regionalização

            O artigo tem por objetivo caracterizar a construção da rede regionalizada de saúde, focalizando a atenção à saúde bucal e identificando dificuldades e avanços na sua implementação. Teve por contexto o modelo de rede sugerido nacionalmente pelas políticas que orientam o Sistema Único de Saúde. Estudo exploratório-descritivo, com abordagem qualitativa e sustentação metodológica na Teoria Fundamentada nos Dados. Realizaram-se entrevistas com gestores, profissionais de saúde e professores graduados em Odontologia, constituindo três grupos intencionais. A categoria central denominou-se "Potencializando a interação no cuidado à saúde bucal na rede de atenção à saúde no processo de regionalização". No modelo teórico proposto, a potencialização das interações decorre de condições como: Caracterização do cuidado à saúde bucal na rede regionalizada de atenção à saúde; Identificação das dificuldades na implementação e Análise do funcionamento da rede de atenção à saúde bucal. A inserção da saúde bucal na rede está no início, por vezes descolada do conjunto de relações que constitui a rede de atenção que, também, está em consolidação. Os elementos recolhidos neste estudo indicam a implantação da rede regionalizada de atenção como condição para levar o cuidado à saúde bucal a um novo patamar de atenção e assistência.
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              The challenge of the approach to oral cancer in primary health care

              Abstract The aim of this study was to understand the performance of dentists in public health about mouth cancer. A cross-sectional study was performed whit 121 dentists from Fortaleza Health Department, interviewed through a semi-structured questionnaire. The study did not identify statistically significant difference regarding the ability to perform biopsy by gender, year of graduation, expertise or time of public service. Only 22 professionals (18.2%) reported being able to perform biopsies and 13 (10.7%) would do so at the Family Health Unit. The reference and counter-reference system, by including another stage in patient care, increase the possibility of absenteeism from patient to health service. Although clearly identify the relevance of oral cancer mortality in the population, the vast majority of dentists is not equipped to perform the biopsy as a routine activity. Whereas the vast majority of biopsies of the oral tissues is performed as an outpatient, low technological complexity to perform the procedure and the effectiveness of biopsy in the early diagnosis of oral cancer, it is essential to hold this procedure in primary care, what can effectively contribute to decreasing mortality from oral cancer.
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                Author and article information

                Journal
                rounesp
                Revista de Odontologia da UNESP
                Rev. odontol. UNESP
                Universidade Estadual Paulista Júlio de Mesquita Filho (Araraquara, SP, Brazil )
                0101-1774
                1807-2577
                2022
                : 51
                : e20220042
                Affiliations
                [01] Campo Grande Mato Grosso do Sul orgnameUniversidade Federal de Mato Grosso do Sul orgdiv1Programa de Pós-Graduação em Saúde da Família Brazil
                Article
                S1807-25772022000100431 S1807-2577(22)05100000431
                10.1590/1807-2577.04222
                fcb83f72-1a80-478f-90ff-ab2defbb2aef

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 11 November 2022
                : 17 November 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 22, Pages: 0
                Product

                SciELO Brazil

                Categories
                Artigos Originais

                Saúde da família,oral neoplasms,oral health services,primary health care,Family health,neoplasias bucais,serviços de saúde bucal,atenção primária à saúde

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