Aleitamento materno e prevenção da má oclusão dentária: visão dos odontólogos da rede pública de saúde
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Data
2017-02-16
Autores
Cardoso, Bruna Portela Andrade [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: Sabe-se que a amamentação diminui o riscodedesenvolver más oclusões, consideradas problemas de saúde pública. Cabe ao odontólogo orientar as gestantes e puérperas sobre a importância da prevenção precoce de más oclusões e alterações crânio-mandibulares por meio do aleitamento materno (AM). Objetivo: Conhecer a visão dos odontólogos da rede municipal de saúde de um município do interior paulista acerca do AMna prevenção da má oclusão dentária. Material e Método: estudo descritivo de abordagem quantitativa e qualitativadesenvolvido nas unidades básicas de saúde tradicionais, nas unidades de Estratégia de Saúde da Família e no Centro de Especialidade Odontológica. A população do estudo foi de40 odontólogos e a coleta de dados foi realizada de novembro de 2015 a maio de 2016, por meio de questionário semiestruturado, contendo 38 questões fechadas e uma questão aberta. Para tratamento dos dados da questão aberta, utilizou-se a análise de conteúdo representacional do tipo temática, sendo a discussão alicerçada no Caderno de Saúde Bucal (SB) da Atenção Básica (AB) nº 17 do Ministério da Saúde.Resultados:A maioria dos odontólogos (82, 5%) relatouter especialização e 84,8% referiram que a pós-graduação não forneceu um bom conhecimento sobre AM. Observou-se que 30% desses profissionais desenvolveram trabalho preventivo e/ou educativo junto a gestantes e puérperase77,5% não possuíam conhecimento da Política Nacional de Saúde Bucal relativa a gestantes e puérperas. Destaca-se que 67,5% delesnão orientam na fase do desmame, 90% não orientam as mães sobre a importância do AM para reduzir o hábito de interposição labial e62, 5% não orientaram as mães sobre a relação existente entre AM e má oclusão. Na dimensão qualitativa desvelaram-se cinco categorias temáticas: 1) “Sobrecarga aliada ao excesso da demanda curativa em detrimento do trabalho preventivo”. 2) “Deparando-se com a má oclusão na prática clínica e a insuficiência da prevenção”. 3) “Culpabilização das mães por não amamentarem seus filhos”. 4) “Falta de apoio da gestão e de capacitação para desenvolver ações preventivas”. 5) “Ausência de protocolos norteadores e políticas públicas voltadas a gestantes e puérperas, incluindo os cuidados preventivos com a má oclusão”. Conclusão: infere-se que os participantes conhecem a importância do AM para a prevenção de más oclusões e entendem a relevância das orientações às mães, para que haja o correto desenvolvimento do sistema estomatognático e facial das crianças. No entanto, em virtude da baixa autonomia profissional aliada ao excesso da prática curativa, em detrimento da preventiva, e de uma supervalorização do saber técnico-científico, em detrimento da parte educativa, os odontólogos se sentem distantes do tema e não se veem como agentes de promoção da SB para o desenvolvimento facial. Ressalta-se uma culpabilização das gestantes e puérperas, devido as suas condições socioeconômicas e culturais. Embora as questões das más oclusões sejam abordadas pelo caderno de SB da AB, os odontólogos apresentam pouco conhecimento tanto sobre as normas e diretrizes gerais como sobre aquelas voltadas às gestantes e puérperas, todas presentes no caderno de SB. Espera-se, portanto, que os resultados possam estimular os gestores e odontólogos a valorizarem a prevenção da má oclusão por meio do AM, a orientarem as gestantes e puérperas e a estabelecerem protocolos orientadores sobre a temática. Essas atitudes podem ser consideradas uma possível resolução, a médio e longo prazo, da questão, configurando-se como uma estratégia real de enfrentamento das oclusopatias e de todos os agravos decorrentes destas ao desenvolvimento bio-psico-social adequado dos indivíduos.
Introduction: It is acknowledged that breastfeeding reduces the risk of developing malocclusions, considered to be public health problems. It is up to the dentist to guide the pregnant and postpartum women about the importance of the early prevention of malocclusions and cranial mandibular alterations through breastfeeding. Objective: To know the vision of the dentists of the municipal health system of a municipality in São Paulo countryside towards the AMna prevention of dental malocclusion. Material and Method: descriptive study of quantitative and qualitative approach developed in the basic units of traditional health, in the Family Health Strategy units and in the Dental Specialty Center. The study population consisted of 40 dentists and the data collection was performed from November 2015 to May 2016, through a semi-structured questionnaire, containing 38 closed questions and one open question. For the treatment of the data of the open question, the analysis was used of representational content of the thematic type, and the discussion was based on the Oral Health Brochure of Basic Care No. 17 of the Ministry of Health. Results: Most dentists (82.5%) reported having specialization and 84.8% -reported that the post-graduation did not provide a good understanding of AM. It was observed that 30% of these professionals developed preventive and / or educational work with pregnant women and postpartum women, and 77.5% did not have knowledge of the National Oral Health Policy regarding pregnant women and postpartum women. It is striking that 67.5% of them do not guide the weaning phase, 90% do not advise mothers on the importance of AM to reduce the habit of lip insertion, and 62.5% did not advise mothers about the relationship between AM and Malocclusion. In the qualitative dimension, five thematic categories were revealed: 1) "Overload combined with excess curative demand to the detriment of preventive work". 2) "Facing malocclusion in clinical practice and insufficient prevention". 3) "Mothers are blamed for not breastfeeding their children." 4) "Lack of management support and capacity to develop preventive actions". 5) "Absence of guiding protocols and public policies aimed at pregnant women and postpartum women, including preventive care with malocclusion". Conclusion: It is inferred that the participants consider a value of AM for occlusion prevention and understand a relevance of the guidelines for mothers, so that there is or correct development of the stomatognathic and facial system of children. However, due to the low professional autonomy coupled with the excess of the curative practice, to the detriment of prevention, and a supervision of the technical-scientific knowledge, to the detriment of the educational part, dentists feel distant from the subject and does not see itself as a SB promotion agent for facial development. It is important to blame pregnant women and puerperal women for their socioeconomic and cultural conditions. Although the issues are more comprehensive and are addressed by AB's SB notebook, the topics related to this topic are about general guidelines and guidelines on those focused on pregnant women and puerperal women. It is expected, therefore, that the results are estimated in managers and dentists to value the prevention of malocclusion through the MA, a guide as pregnant women and puerperas and a set of guiding protocols on a thematic. These attitudes can be considered in a possible resolution, a medium and long term, a question of configuration, a real strategy of coping with the occlusions and all the problems of development.
Introduction: It is acknowledged that breastfeeding reduces the risk of developing malocclusions, considered to be public health problems. It is up to the dentist to guide the pregnant and postpartum women about the importance of the early prevention of malocclusions and cranial mandibular alterations through breastfeeding. Objective: To know the vision of the dentists of the municipal health system of a municipality in São Paulo countryside towards the AMna prevention of dental malocclusion. Material and Method: descriptive study of quantitative and qualitative approach developed in the basic units of traditional health, in the Family Health Strategy units and in the Dental Specialty Center. The study population consisted of 40 dentists and the data collection was performed from November 2015 to May 2016, through a semi-structured questionnaire, containing 38 closed questions and one open question. For the treatment of the data of the open question, the analysis was used of representational content of the thematic type, and the discussion was based on the Oral Health Brochure of Basic Care No. 17 of the Ministry of Health. Results: Most dentists (82.5%) reported having specialization and 84.8% -reported that the post-graduation did not provide a good understanding of AM. It was observed that 30% of these professionals developed preventive and / or educational work with pregnant women and postpartum women, and 77.5% did not have knowledge of the National Oral Health Policy regarding pregnant women and postpartum women. It is striking that 67.5% of them do not guide the weaning phase, 90% do not advise mothers on the importance of AM to reduce the habit of lip insertion, and 62.5% did not advise mothers about the relationship between AM and Malocclusion. In the qualitative dimension, five thematic categories were revealed: 1) "Overload combined with excess curative demand to the detriment of preventive work". 2) "Facing malocclusion in clinical practice and insufficient prevention". 3) "Mothers are blamed for not breastfeeding their children." 4) "Lack of management support and capacity to develop preventive actions". 5) "Absence of guiding protocols and public policies aimed at pregnant women and postpartum women, including preventive care with malocclusion". Conclusion: It is inferred that the participants consider a value of AM for occlusion prevention and understand a relevance of the guidelines for mothers, so that there is or correct development of the stomatognathic and facial system of children. However, due to the low professional autonomy coupled with the excess of the curative practice, to the detriment of prevention, and a supervision of the technical-scientific knowledge, to the detriment of the educational part, dentists feel distant from the subject and does not see itself as a SB promotion agent for facial development. It is important to blame pregnant women and puerperal women for their socioeconomic and cultural conditions. Although the issues are more comprehensive and are addressed by AB's SB notebook, the topics related to this topic are about general guidelines and guidelines on those focused on pregnant women and puerperal women. It is expected, therefore, that the results are estimated in managers and dentists to value the prevention of malocclusion through the MA, a guide as pregnant women and puerperas and a set of guiding protocols on a thematic. These attitudes can be considered in a possible resolution, a medium and long term, a question of configuration, a real strategy of coping with the occlusions and all the problems of development.
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Palavras-chave
Prevenção, Má oclusão, Aleitamento materno, Odontólogos, Prevention, Malocclusion, Breastfeeding, Dentists