Remoção seletiva de tecido cariado : uma nova perspectiva clínica de atenção à saúde.

Abstract

Dental caries is considered a public health problem in the world population. As a consequence, there are a few questions from dentists regarding the technique used to remove the decayed tissue, since the amount and need for removal must be considered. Therefore, these professionals have two alternatives: total removal and selective removal of decayed tissue. Traditionally, total removal is the eligible and preferable method to be used in clinical practice, nevertheless, in the management of deep lesions, this technique becomes an increased risk for pulp exposure.Thus, the selective removal of decayed tissue is contextualized as a method of Minimal Intervention Dentistry, which significantly reduces the risk of pulp exposure, increasing the longevity of the tooth, functionally in the mouth. The purpose of this research is to analyze the perception of dentists, who work in the public network of municipalities that are part of the 13th Regional Health Coordination/RS (CRS), regarding to the technique of selective removal of decayed tissue.This quantitative descriptive approach study was conducted with 30 professionals, out of a total of 94, who work in the public network of the municipalities that are part of the 13th CRS. Data collection was gathered between August and September 2021, through an online survey made available to participants (Google Forms platform) and the collected data was analyzed and described in a spreadsheet. The results showed that 66.7% of the participants comprehend and use the technique of selective removal of decayed tissue, 100% with the justification of avoiding pulp exposure, 75% due to the cost-effectiveness to the patient and 65% due to the increase of tooth longevity. The reasons reported by professionals who know the technique but do not perform it (26.6%) include not believing in the success of the procedure, due to the distrust that the remaining decayed tissue that enables the lesion to advance, and considering that the technique requires a new intervention to complete the treatment, which can lead to technique failure due to lack of adherence of the patients. Participants also report difficulty in performing the technique, especially regarding the assessment of how much decayed tissue can remain in the cavity. And finally, 6.7% of survey participants reported not knowing the technique. It is concluded that most professionals reported using the technique of selective removal of decayed tissue. This way, due to the current scientific evidence that proves the successful application of the technique, the importance of discussions in order to clarify the procedure is highlighted, as well as professional training for its performance, so dentists who work in public health could apply the selective removal of decayed tissue routinely, and with this, allowing greater longevity of dental elements, and consequently, better quality of life related to oral health for the population.