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Dentistry in collective health


Dentistry in collective health

To celebrate the Dentist´s Day, on October 25, Josiane Aparecida Ferreira da Costa Montans and Marlívia Watanabe discuss in a relaxed chat, this professional role as a health agent.

Even with a great deal of awareness of the population, there are still questions about what is and is not appropriate when the subject is oral health. A few simple precautions, such as choosing the right toothbrush and the best way to sanitize the teeth, are constant concerns. For a long time, dentistry has been understood as a specialty devoted exclusively to the teeth, not occupying its rightful role in the health scenario. However, an expanded look has been establishing and promoting also studies and practices that give credibility, support and encourage the close relationship smile and overall health.

Thinking about the union between theory and practice, dental surgeons, Josiane Aparecida Ferreira da Costa Montans and Marlívia Gonçalves de Carvalho Watanabe, met to discuss the progress of the profession and changes in the academic career in recent years. Also inspired by a dentists´ family, both had no doubt when choosing dentistry as a profession. Josiane has specialization in Health Public Management and Public Health and currently serves as coordinator of the Collective Preventive and Procedures Program in Health of the Municipal Department of Dentistry in Singapore. Marlívia also specialized in Public Health and chose to follow in the footsteps of her uncle, acting as associate professor at the São Paulo University, adding experience in teaching, interaction teaching/service and health policies.

When pointing the experiences lived in their career, the experts stress the importance of forming a complete professional, responsible for health and dedicated to improving the quality of life. Check, in the following interview, an analysis of the development of dentistry.

Josiane: Initially, what sparked your interest in dentistry? How about the opportunity and the decision to stay at the São Paulo University?
Marlívia: I do not remember having made that choice at a specific time. Dentistry came naturally in my life. I had a dentist uncle who was also a professor and director of the Ribeirão Preto Dental School. I remember when I attended his dental office when I was a child. Then, as a teenager, when he has served as a professor in the College, my cousins and I visited a few times and I was delighted with that environment. I believe that their professional performance was important for my choice. I eventually improve myself, which culminated in the teaching career, by his invitation. I graduated in 1986 in Dentistry, did dental student residence and I was student from the first group of Public Health. Later, I specialize and I soon began to teach at the supervised training discipline.

Josiane: I also come from a family involved with dentistry. As you near to the graduation, many options present themselves before the new professional. How it was with you?
Marlívia: Actually, I did not see much closed within the four walls of a dental office even really enjoying the clinical part and the specific work of dentistry. Always had ability to deal with people and believed that it would develop better my job if I acted as a team. So when I was invited to work in the supervised discipline stage felt accomplished. At that time I was completing a specialization in Public Health at USP, in São Paulo. My work was focused on public health. The invitation allowed realizing my wish to act together the individual assistance to collective actions. I think that a situation of paths that were performing eventually led me to teaching. For me, at that time, being at college means to teach. The prospect that introduced me to be a teacher served as motivation to pursue a career at the University of Sao Paulo. I believe that the path we have chosen - both us in teaching, as you, with the service in public health - relate when we chose not to restrict professional life. Had always wanted to do something else, act beyond the specific exercise of the profession, something that could have a broader impact, it was beyond our patients. Therein it begins a partnership that, rightly understood, planned and executed, can greatly assist the population: the partnership teaching / service.

Josiane: In these almost 29 years in the profession, how do you see the Dentistry evolution at the academic academy?
Marlívia: Dentistry has changed a lot from the time we graduated to the present day. There was a very big technological development, offering us today, innovative devices, cutting-edge technologies, revolutionary materials, varied and that greatly facilitate the technical work of the profession. There is also an important scientific development. I believe that both the technological development and the scientific were of great value to the profession. Today, the academy begins to recognize the importance of social development of dentistry. Recover the social position that the profession has had is also one of this challenge, which seems very possible with the new curriculum guidelines in the formation of our future colleagues.

Josiane: It is notorious technological advances in the dental field; however, these features are not available for the entire population, by the high costs. What do you think about this reality?
Marlívia: This reality is placed. Technological development is important, but it takes the technology to be used well. Remember that it does not replace scientific knowledge, practical experience and humanized clinical tract professional. The technology does not have to be used way too much. We cannot rule out that, for the care of oral health, as well as in medicine, the clinical aspect needs to be respected and valued. It's not often that the technology will help in the diagnosis and treat the condition. I realize that sometimes we used a sophisticated examination and hence more expensive when we could have solved the problem more simply. I repeat: the technology is critical, but should be well used, justifiably.

Josiane: Whenever I'm interested in your updated settings and renewed on the binomial academy/service. Whether you are a professional dedicated to public health, what is your opinion about this partnership?
Marlívia: Today, there is nothing that justifies having a formal education in health -digo this not only for dentistry, but for health in general and all its interfaces - that is far from social reality and health services in Brazil. It is necessary that the professions grow and develop aligned to the country's development and public policy. There is a movement that society itself imposed for health professions and, more specifically, for dentistry, which is acting in the public service. The Unified Health System (SUS) is the largest employer for dentistry in the country. Due to the difficulties imposed on the sector in the last two decades, with regard to the labor market, especially in the more developed regions, the dentists were seeking employment and seeking some stability in the face of competition from the private labor market. Some data show that about 1/3 of Brazilian dentists have any link with the NHS, even though part-turn. Thus, there is no possibility of the academy stay out of it at the time of formation. We can only the country's social reality get closer to the evolution happen both academia and in services, as both strive to promote health. When professionals formed for dentistry, we also have the ultimate goal of full health.

Josiane: The current Brazilian universities curriculum is aligned with public health policies?
Marlívia: We had recent movements in the Ministry of Education and the Ministry of Health that favor the approach gym / service. In 2002, the Ministry of Education published the new national curriculum guidelines, which advance when indicate that dental students must train professionals able to "exercise their profession in an articulated manner to the social, understanding it as a form of participation and contribution social". More recently, these ministries have implemented to encourage the development of joint teaching activities between academia and health care policies. Some universities have already made changes in this direction in the political-pedagogical projects. Other walk more slowly. This change will take time. However, the new guidelines carry more current bases and hope that oral health problems are more efficient and effectively tackled and solved.

JJosiane: Do you think the new dentists will be more prepared to develop studies related to the community?
Marlívia: The dentist of our time and until recently, it was formed to work in the dental office. That looks extended, covering and takes collective action as modifying tools of epidemiological profile, which coalesce education, prevention and health promotion, without denying the important curative role of dentistry, although not new, in practice, is more recent. When we talk about training and professional practice in dentistry, as well as in other areas of health, we cannot but stress the importance of developing the technical and scientific point of view. However, specifically on diseases that commonly, mostly affecting the oral cavity, it was found that all technological and scientific advances alone are not able to change the reality of a country where the decay is still very prevalent. Today, we seek knowledge more social approach to the issues facing the comprehensive care of the patient. I teach at the first graduation year, in a course titled Introduction in dentistry. I always speak to students who are starting the career: "Who does not like to care for, guide and interact with people should look for another profession; as health professionals, have to deal with people daily with dedication, care and attention ". The current education seeks to develop this human look at the professionals who helped to form. Exactly this more individualized and humanized care is the differential of professionals in a market as competitive and as restricted. I believe that when we can rescue this role in dentistry, we justify our importance on the population and society.

Josiane: We often talk about dentistry as "play" key in health and society. I would like that you give your view about the dentists´ participation as health agent.
Marlívia: There is a phrase, widely publicized by the Regional Council of Dentistry of São Paulo (CROSP), which says: "The health begins with the mouth." This placement is very true, because there is, for example, eating healthy without healthy and back teeth, as there is no general good health without a balanced diet. This demonstrates, in a very simplistic way that all aspects involving health are impossible to be separated. This sentence puts the dentist at the center of health wheel, as a special actor in relation to the other. I also believe that the move to leave the isolated space of dental offices will result in an important social replacement for the profession. I stress again restricted access to dental treatment in Brazil. We live in a country of inequality, and this is one of the areas still seriously affected. When analyzing the epidemiological survey data conducted in 2013, compared to Ribeirao Preto with the southeast region and the city of São Paulo, we realize that our county presented indices that suggest greater access to dental treatment. There were significant improvements, but much remains to be done across the country.

Josiane: After so many years dedicated to public health, socio-cultural components of our population and also to academy, how do you see the dentistry future?
Marlívia: Despite the great advances made in scientific and technological point of view, we still have to enlarge the social role of the profession. However, we will not alone. We need the gym to continue investing in the enhancement of the humanistic aspects of training, so that we have, in addition to great dentists, excellent healthcare professionals, able to perform care in all areas of the labor market in order to face and to seek solutions to the demands of society. That the services and the public health policies continue seeking to catch the social front due to the difficulties of access to oral health care and consequently the demands repressed the population. Finally, society to increasingly achieve better quality of life, with the professional partner that can contribute greatly to the maintenance and recovery of their oral health.

Cultivating smiles
"The opportunity to interview the Marlívia teacher gives us great joy and satisfaction. Though our lives have crossed in the corridors and in the amphitheaters of Ribeirão Preto Dental School (FORP-USP), we had the same friends and poorly socialized. The work I have been developing in recent years has enabled our approach, narrowed ties and revealed a hot professional and personal identification. Thank you for this privileged moment in which abasteço me the knowledge and opinions of a highly ethical and professional woman, dedicated, humble and available. I am Marlívia teacher, whom I admire and respect, in my heart as a dear friend and proudly honored as representative of the dental profession in this month we celebrate our profession."

Josiane Aparecida Ferreira da Costa Montans, coordinator of the Collective Preventive and Procedures Program in Health of the Municipal Department of Dentistry in Singapore.

Source: Revide, escrita por Pâmela Silva
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