Representações do cuidado em saúde bucal de crianças em vulnerabilidade numa cidade do Nordeste do Brasil

Abstract

Caries is one of the most prevalent clinical conditions in the world and a priority in public health. The effect of the polarization of the disease is observed in individuals in situations of social vulnerability, whose focus on comprehensive oral health care helps to develop individuals with greater self-awareness. Thus, the general objective was to analyze social representations of oral care of caregivers and their children in situations of vulnerability. With a qualitative, exploratory research, with children between five and twelve years old and their respective caregivers, in a territory covered by a primary health care unit in Fortaleza-Ceará, between April and July 2021. The sampling was non-probabilistic, composed of multiple cases, structured in the form of chains, being defined by contrast-saturation. Subjects with inability to draw, identifiable stress condition, recent dental pain and those who did not comply with the correspondence between child and caregiver were excluded. For chain 1, for children in care, data production was performed using the theme-based drawing-story technique, followed by oral examination using the Caries and Treatment Assessment Spectrum. In chain 2, for caregivers, the technique was through a semi-structured interview. Data processing was supported by NodeXL software in the descriptive reconstitution of the analyzed context. Under the abductive logic, the interpretative analysis of the information produced considered the basic constituent elements of the salutogenic theory and narrative review, evoked through social representations of the object of study in the multiple sources of data. The evocative process took place through thematic analysis of the content, with the themes of meanings and strategies for oral care and representations of the mouth being outlined: how it is. Children portray oral care as a body hygiene activity, in a routinized or coercive way. The mouth was reflected on the experiences, desires and idealizations of the condition of caries, occlusal dysfunction and empowerment, in the estrangement of the sensations caused by the loss of the deciduous tooth. For caregivers, the perception of oral care is a habit to reduce tooth dirt, associating prescriptive methods. For them, the sense of the mouth is in the presence of a painless dental state. The relationships in care were crossed by social structures that shape the institution of habits in the subjects: family, gender, income, dental care and alternative care practices. Limitations due to the absence of clinical caries indices and impositions by the COVID-19 pandemic, impacted the study.