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La idea propuesta a lo largo del presente trabajo consiste en el desarrollo de un proyecto de turismo médico, a través de la función de intermediarios que se efectuará entre estadounidenses que deseen realizarse procedimientos dentales o estéticos y clínicas locales de calidad a un precio accesible. La problemática inicial encontrada en este sector se basa en los elevados precios que se cobran por estos mismos procedimientos en los centros de salud del país norteamericano. Debido a ello, se halló una gran oportunidad de negocio a desarrollar a través de diferentes herramientas, como el Business Model Canvas, por el cual se pudo evaluar los distintos aspectos del giro del negocio, así como plasmar los principales factores que influyen directamente en el mismo. La determinación del tamaño de mercado también fue un factor relevante, dado que en base a ello se pudo identificar la cantidad de personas a quienes se les podría brindar el servicio. En cuanto a la validación del modelo de negocio se plantearon las hipótesis, en la cual se asumieron supuestos para que el modelo se valide y mediante el concierge se verificó la intención de compra del público objetivo. Asimismo, se realizó el plan estratégico para tomar las mejores decisiones a través del marketing de producto, precio, plaza y promoción. Por último, se efectuó el Plan Financiero del proyecto mediante el análisis de los estados financieros durante los 3 primeros años, así como de los ratios financieros que evidencian la rentabilidad y viabilidad del modelo de negocio. / The idea proposed throughout the present work consists in the development of a medical tourism project, through the function of intermediaries that will be carried out among Americans who wish to perform quality dental or aesthetic procedures and local clinics at an affordable price. The initial problem found in this sector is based on the high prices charged for these same procedures in the health centers of the North American country. Due to this, a great business opportunity was found to be developed through different tools, such as the Business Model Canvas, by which it was possible to evaluate the different aspects of the business, as well as to capture the main factors that directly influence the same. The determination of the market size was also a relevant factor, since based on this, the number of potential clients could be identified. Regarding the validation of the business model, the hypotheses were raised, in which assumptions were made for the model to be validated and through the concierge the purchase intention of the target audience was verified. Likewise, the strategic plan was made to make the best decisions through product marketing, price, place and promotion. Finally, the Financial Plan of the project was carried out by analyzing the financial statements during the first 3 years, as well as the financial ratios that show the profitability and viability of the business model. / Trabajo de investigación

<p>In this case study research project I have determined that multidrug sedation in children younger than eight years are possible.<br /> Conscious sedation [or sedation where verbal contact with the patient is possible] can be used successfully to decrease anxiety and fear for unpleasant experiences, like dental procedures.</p> <p><br /> Behaviour therapy in conjunction with one or more drugs can be used to depress the central nervous system in order to decrease the patient&rsquo / s awareness of unpleasant stimuli. This enables treatment to be carried out without patient interference. Extensive literature surveys were done to determine the ideal drugs as well as the ideal route for conscious sedation in dental treatment for children. In this study project drugs like midazolam, propofol, alfentanyl and ketamine were titrated intravenously to achieve conscious sedation.</p>

<p>In this case study research project I have determined that multidrug sedation in children younger than eight years are possible.<br /> Conscious sedation [or sedation where verbal contact with the patient is possible] can be used successfully to decrease anxiety and fear for unpleasant experiences, like dental procedures.</p> <p><br /> Behaviour therapy in conjunction with one or more drugs can be used to depress the central nervous system in order to decrease the patient&rsquo / s awareness of unpleasant stimuli. This enables treatment to be carried out without patient interference. Extensive literature surveys were done to determine the ideal drugs as well as the ideal route for conscious sedation in dental treatment for children. In this study project drugs like midazolam, propofol, alfentanyl and ketamine were titrated intravenously to achieve conscious sedation.</p>

Magister Scientiae Dentium - MSc(Dent) / This study was done to show that sedation is a safe and a viable option in young children. Dental procedures were done on children aged two to ten years. Two hundred children were included in the study. In all of these children the procedures were completed. Only two children were excluded, because an intravenous line could not be placed on the one child, and the other child was unmanageable under sedation. The safety of sedation was evaluated looking at the incidence of adverse events and complications. No serious adverse effects or complications occurred. The complications that occurred were all corrected with minimal or non-invasive interventions. Only six of the two hundred children required oxygen to correct a drop in oxygen saturation.

Magister Scientiae Dentium - MSc(Dent) / In this case study research project I have determined that multidrug sedation in children younger than eight years are possible.Conscious sedation [or sedation where verbal contact with the patient is possible] can be used successfully to decrease anxiety and fear for unpleasant experiences, like dental procedures. Behaviour therapy in conjunction with one or more drugs can be used to depress the central nervous system in order to decrease the patient&rsquo;s awareness of unpleasant stimuli. This enables treatment to be carried out without patient interference. Extensive literature surveys were done to determine the ideal drugs as well as the ideal route for conscious sedation in dental treatment for children. In this study project drugs like midazolam, propofol, alfentanyl and ketamine were titrated intravenously to achieve conscious sedation. / South Africa

Esta tese é composta por três estudos ecológicos que incluíram as 27 capitais brasileiras. Esses três estudos foram os seguintes: 1- A associação entre a disponibilidade de cirurgiões-dentistas e a quantidade de procedimentos odontológicos nos serviços públicos de odontologia; 2- A associação entre a disponibilidade de cirurgiões-dentistas e a proporção de dentes restaurados (em relação ao total de dentes atacados pela cárie) em indivíduos de 15 a 19 anos ; 3- A associação da disponibilidade de cirurgiões-dentistas com a prevalência e severidade da cárie em indivíduos de 15 a 19 anos. As três investigações são apresentadas sob forma de artigos. Foram utilizados diversos bancos de dados secundários, disponíveis gratuitamente na internet. No primeiro estudo foi identificada associação do número de Equipes de Saúde Bucal do programa Saúde da Família (ESB) e de cirurgiões-dentistas no SUS de uma forma geral com o número de procedimentos odontológicos no serviço público; quanto mais ESB e cirurgiões-dentistas mais procedimentos odontológicos, tanto preventivos quanto restauradores. Mais dentistas no serviço público de odontologia significaram mais procedimentos preventivos e coletivos, porém um número relativamente pequeno a mais de restaurações. É preocupante a quantidade relativamente pequena de restaurações realizadas pelos dentistas do serviço público no Brasil diante do grande número de dentes com cárie não tratada, identificado pela pesquisa nacional de saúde bucal. O segundo estudo revelou que a quantidade de dentistas nas capitais brasileiras é muito grande e que, portanto, há capacidade instalada para atender todas as necessidades de tratamentos restauradores. Entretanto, o índice de cuidado odontológico em jovens de 15 a 19 anos revelou que menos da metade dos dentes atacados pela cárie tinham recebido o cuidado adequado, i.e., estavam restaurados. Este estudo concluiu que, o grande investimento da sociedade brasileira em odontologia, seja no setor público ou privado, não está tendo o retorno esperado, pelo menos para jovens de 15 a 19 anos. O terceiro estudo concluiu que fatores socioeconômicos amplos e flúor na água foram os principais determinantes da variação na prevalência e severidade da cárie em jovens de 15 a 19 anos e que a contribuição do dentista foi relativamente pequena. Diante do papel relativamente pequeno do dentista na prevenção da cárie, o esforço clínico do mesmo deveria, portanto, enfatizar tratamentos de maior complexidade, visando a restauração e reabilitação de danos relevantes para a função e bem estar (Serviço Pessoal de Saúde). Esforços efetivos para evitar a cárie dentária ocorrem principalmente no âmbito de estratégias preventivas populacionais (Serviço não Pessoal de Saúde), com uma contribuição relativamente pequena do trabalho clínico. / This thesis comprises three ecological studies including the 27 state capitals. These three studies were as follows: 1- The association between the availability of dentists and the amount of dental procedures in public dental services; 2- The association between the availability of dentists and the proportion of filled teeth (in relation to total teeth attacked by caries) in subjects 15-19 years; 3- The combination of the availability of dentists with the prevalence and severity of dental caries in individuals 15-19 years. The three investigations are presented in the form of articles. Many banks side, available freely on the internet data were used. In the first study association was found in the number of oral health teams of the Family Health Program (ESB) and dentists in the NHS in general with the number of dental procedures in the public service; ESB as more and more dentists dental procedures, both preventive as restorers. "Most dentists" in public dental services meant more collective and preventive procedures, but a relatively small number of the most restorations. Worryingly the relatively small amount of restorations performed by dentists of the public service in Brazil on the number of teeth with untreated caries, identified by a national survey of oral health. The second study revealed that the number of dentists in the Brazilian capital is very large and, therefore, there is capacity to meet all the needs of restorative treatments. However, the rate of dental care for young people aged 15 to 19 years revealed that less than half of the teeth attacked by caries had received proper care, for example, were restored. This study concluded that the large investment in Brazilian society in dentistry, whether in the public or private sector, is not having the expected return, at least for young people 15-19 years. The third study found that larger socioeconomic factors and fluoride in the water was the major determinant of variation in the prevalence and severity of dental caries in young people 15-19 years and that the contribution of the dentist was relatively small. Given the relatively small role of dental caries prevention, clinical effort it should therefore emphasize more complex treatments, aimed at the restoration and rehabilitation of significant damage to the function and well-being ("Personal Health Service"). Effective efforts to prevent tooth decay occur primarily in population-based prevention strategies ("no Personal Health Service"), with a relatively small contribution of clinical work.

Esta tese é composta por três estudos ecológicos que incluíram as 27 capitais brasileiras. Esses três estudos foram os seguintes: 1- A associação entre a disponibilidade de cirurgiões-dentistas e a quantidade de procedimentos odontológicos nos serviços públicos de odontologia; 2- A associação entre a disponibilidade de cirurgiões-dentistas e a proporção de dentes restaurados (em relação ao total de dentes atacados pela cárie) em indivíduos de 15 a 19 anos ; 3- A associação da disponibilidade de cirurgiões-dentistas com a prevalência e severidade da cárie em indivíduos de 15 a 19 anos. As três investigações são apresentadas sob forma de artigos. Foram utilizados diversos bancos de dados secundários, disponíveis gratuitamente na internet. No primeiro estudo foi identificada associação do número de Equipes de Saúde Bucal do programa Saúde da Família (ESB) e de cirurgiões-dentistas no SUS de uma forma geral com o número de procedimentos odontológicos no serviço público; quanto mais ESB e cirurgiões-dentistas mais procedimentos odontológicos, tanto preventivos quanto restauradores. Mais dentistas no serviço público de odontologia significaram mais procedimentos preventivos e coletivos, porém um número relativamente pequeno a mais de restaurações. É preocupante a quantidade relativamente pequena de restaurações realizadas pelos dentistas do serviço público no Brasil diante do grande número de dentes com cárie não tratada, identificado pela pesquisa nacional de saúde bucal. O segundo estudo revelou que a quantidade de dentistas nas capitais brasileiras é muito grande e que, portanto, há capacidade instalada para atender todas as necessidades de tratamentos restauradores. Entretanto, o índice de cuidado odontológico em jovens de 15 a 19 anos revelou que menos da metade dos dentes atacados pela cárie tinham recebido o cuidado adequado, i.e., estavam restaurados. Este estudo concluiu que, o grande investimento da sociedade brasileira em odontologia, seja no setor público ou privado, não está tendo o retorno esperado, pelo menos para jovens de 15 a 19 anos. O terceiro estudo concluiu que fatores socioeconômicos amplos e flúor na água foram os principais determinantes da variação na prevalência e severidade da cárie em jovens de 15 a 19 anos e que a contribuição do dentista foi relativamente pequena. Diante do papel relativamente pequeno do dentista na prevenção da cárie, o esforço clínico do mesmo deveria, portanto, enfatizar tratamentos de maior complexidade, visando a restauração e reabilitação de danos relevantes para a função e bem estar (Serviço Pessoal de Saúde). Esforços efetivos para evitar a cárie dentária ocorrem principalmente no âmbito de estratégias preventivas populacionais (Serviço não Pessoal de Saúde), com uma contribuição relativamente pequena do trabalho clínico. / This thesis comprises three ecological studies including the 27 state capitals. These three studies were as follows: 1- The association between the availability of dentists and the amount of dental procedures in public dental services; 2- The association between the availability of dentists and the proportion of filled teeth (in relation to total teeth attacked by caries) in subjects 15-19 years; 3- The combination of the availability of dentists with the prevalence and severity of dental caries in individuals 15-19 years. The three investigations are presented in the form of articles. Many banks side, available freely on the internet data were used. In the first study association was found in the number of oral health teams of the Family Health Program (ESB) and dentists in the NHS in general with the number of dental procedures in the public service; ESB as more and more dentists dental procedures, both preventive as restorers. "Most dentists" in public dental services meant more collective and preventive procedures, but a relatively small number of the most restorations. Worryingly the relatively small amount of restorations performed by dentists of the public service in Brazil on the number of teeth with untreated caries, identified by a national survey of oral health. The second study revealed that the number of dentists in the Brazilian capital is very large and, therefore, there is capacity to meet all the needs of restorative treatments. However, the rate of dental care for young people aged 15 to 19 years revealed that less than half of the teeth attacked by caries had received proper care, for example, were restored. This study concluded that the large investment in Brazilian society in dentistry, whether in the public or private sector, is not having the expected return, at least for young people 15-19 years. The third study found that larger socioeconomic factors and fluoride in the water was the major determinant of variation in the prevalence and severity of dental caries in young people 15-19 years and that the contribution of the dentist was relatively small. Given the relatively small role of dental caries prevention, clinical effort it should therefore emphasize more complex treatments, aimed at the restoration and rehabilitation of significant damage to the function and well-being ("Personal Health Service"). Effective efforts to prevent tooth decay occur primarily in population-based prevention strategies ("no Personal Health Service"), with a relatively small contribution of clinical work.