Desenvolvimento e validação de protocolo de acolhimento por classificação de risco em saúde bucal no Pronto-Socorro Odontológico da Universidade Federal de Uberlândia

Abstract

Triage with risk classification in oral health aims to organize the management of dental emergencies by prioritizing cases according to severity. In the Brazilian Unified Health System (SUS), despite significant progress, challenges in the management and provision of dental care still persist, justifying the need for specific protocols in oral health, integrating the principles of equity and humanization as recommended by the National Humanization Policy (PNH). The objective of this study was to develop and validate a protocol for risk classificationbased triage in oral health at the Dental Emergency Department of the Federal University of Uberlândia (UFU), focusing on optimizing care and improving service flows. This was a methodological study conducted in three stages: (1) a narrative literature review to identify models and guidelines for triage and risk classification protocols in dental emergency services; (2) development of the validation instrument, with evaluation of the results by expert judges; and (3) implementation of a pilot project. The protocol was based on the Manchester Triage System and the Oral Health Network Handbook of Paraná, and was structured into nine items: personal data, history of present illness, pain, pain classification, vital signs, need for medication, past medical history, priority of care, and risk classification. The pilot project was applied to 80 patients at the UFU Dental Emergency Department, revealing that 93.75% reported pain at the time of triage, with a predominance of spontaneous and highintensity pain. Most patients were classified as yellow risk (50%) and green (45%), while only 2.5% were classified as red and another 2.5% as blue. The average total waiting time between arrival and care was 1 hour and 33 minutes, with a dropout rate of only 2.5%. Validation was carried out with 10 oncall dentists who answered the “Content Validity Index (CVI)” questionnaire to measure agreement regarding the appearance, clarity, and relevance of the protocol. The Kappa coefficient was calculated to assess the level of agreement among the judges (97%). It was concluded that the risk classificationbased triage instrument for oral health developed in this study was considered valid in terms of appearance, clarity, and relevance. Therefore, it can be safely used by dentists or other health professionals as a screening tool in dental emergency settings.