RESUMEN
This study aimed to systematically review the literature to evaluate the effectiveness of virtual reality in reducing anxiety and pain in patients undergoing third molar surgeries. Clinical trials evaluating patients who used virtual reality (VR) compared with no VR in the management of pain or anxiety after third molar extractions were included. A literature search was conducted in five electronic databases to identify relevant articles: Medline (PubMed interface), Web of Science, Virtual Health Library, Embase, and Scopus. There were no restrictions on the time or language of publication. The risk of bias was assessed using the Cochrane Risk of Bias Tool for Randomised Trials (RoB 2.0). A total of six studies were included in the qualitative analysis and three in the quantitative analysis. The results of the meta-analyses on anxiety revealed that patients in the intervention group before VR already showed less anxiety compared to those in the control group (-0.28 [-0.44 to -0.13, 95%CI] I²=24.51%. In the post-intervention evaluation, the group that received VR remained with a lower level of anxiety and a slight reduction compared to the pre-intervention. (-0.34 [-0.49 to -0.19, 95%CI] I²=36.61%. Virtual reality can be a clinical resource in dental care because it seems to cause a small reduction in anxiety, and with still uncertain results in the reduction of postoperative pain in extractions of third molars.
Asunto(s)
Tercer Molar , Dolor Postoperatorio , Extracción Dental , Realidad Virtual , Humanos , Tercer Molar/cirugía , Extracción Dental/psicología , Dolor Postoperatorio/prevención & control , Dolor Postoperatorio/etiología , Ansiedad al Tratamiento Odontológico/prevención & control , Ansiedad al Tratamiento Odontológico/psicologíaRESUMEN
El tratamiento odontológico sigue siendo percibido en la actualidad como una experiencia atemorizadora para muchas personas. Se han establecido diversos métodos para tratar de evaluar el temor y ansiedad que refieren las personas cuando deben recibir tra-tamientos bucales. Sin embargo, estos no han sido aplicados adecuadamente como parte de la atención clínica cotidiana. Considerando esto, podría suponer-se que el miedo es uno de los factores desencadenan-tes en la deserción de los tratamientos odontológicos, y las personas asistirían solo en el momento de una urgencia. El objetivo del presente estudio fue analizar el afrontamiento de emociones (miedo) en los pacien-tes que concurren a la consulta para la extracción de un tercer molar en la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA). La metodología que se utilizó fue cuantitativa y cualitativa. El diseño fue exploratorio-descriptivo (AU)
Dental treatment is still perceived today as a frightening experience for many people. Various methods have been established to try to assess the fear and anxiety that people report when they must receive oral treatments, however, these have not been adequately applied as part of daily clinical care. Considering this, it could be assumed that fear is one of the triggering factors in desertion of dental treatments and people would attend only at the time of an emergency. The objective of this study was to analyze the coping with emotions (fear) in patients who attend the consultation for the extraction of a third molar at the Faculty of Dentistry of the University of Buenos Aires (FOUBA). The methodology used was quantitative and qualitative. The design was exploratory-descriptive (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Pacientes/psicología , Extracción Dental/psicología , Ansiedad al Tratamiento Odontológico/psicología , Tercer Molar/cirugía , Argentina/epidemiología , Facultades de Odontología/estadística & datos numéricos , Epidemiología Descriptiva , Encuestas y Cuestionarios , Investigación CualitativaRESUMEN
Objective The aim of this study was to compare the effects of music at 432 Hz, 440 Hz, and no music on the clinical perception of anxiety and salivary cortisol levels in patients undergoing tooth extraction. Methodology A parallel-group randomized clinical trial was conducted. Forty-two patients (average age: 23.8±7.8 years, 27 women) with a moderate level of anxiety were distributed in three groups: use of music for 15 minutes at a frequency of 432 Hz (n=15), at 440 Hz (n=15) and a control group without music (n=12). The CORAH Dental Anxiety Scale and salivary cortisol levels, estimated by the solid phase enzyme-linked immunosorbent assay (ELISA), were measured and compared before and after the music intervention between groups (two-way ANOVA-Tukey p<0.05, RStudio). Results Significantly lower anxiety level values were observed at 432 Hz (8.7±2.67) and 440 Hz (8.4±2.84) compared to the control group (17.2±4.60; p<0.05). The salivary cortisol level at 432 Hz (0.49±0.37 µg/dL) was significantly lower than 440 Hz (1.35±0.69 µg/dL) and the control group (1.59±0.7 µg/dL; p<0.05). Conclusion The use of music significantly decreased clinical anxiety levels, and the frequency of 432 Hz was effective in decreasing salivary cortisol levels before tooth extraction.
Asunto(s)
Ansiedad al Tratamiento Odontológico/terapia , Hidrocortisona/análisis , Musicoterapia/métodos , Música/psicología , Saliva/química , Extracción Dental/psicología , Adolescente , Adulto , Análisis de Varianza , Ansiedad al Tratamiento Odontológico/psicología , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Estadísticas no Paramétricas , Estrés Psicológico , Encuestas y Cuestionarios , Resultado del Tratamiento , Adulto JovenRESUMEN
Abstract Objective The aim of this study was to compare the effects of music at 432 Hz, 440 Hz, and no music on the clinical perception of anxiety and salivary cortisol levels in patients undergoing tooth extraction. Methodology A parallel-group randomized clinical trial was conducted. Forty-two patients (average age: 23.8±7.8 years, 27 women) with a moderate level of anxiety were distributed in three groups: use of music for 15 minutes at a frequency of 432 Hz (n=15), at 440 Hz (n=15) and a control group without music (n=12). The CORAH Dental Anxiety Scale and salivary cortisol levels, estimated by the solid phase enzyme-linked immunosorbent assay (ELISA), were measured and compared before and after the music intervention between groups (two-way ANOVA-Tukey p<0.05, RStudio). Results Significantly lower anxiety level values were observed at 432 Hz (8.7±2.67) and 440 Hz (8.4±2.84) compared to the control group (17.2±4.60; p<0.05). The salivary cortisol level at 432 Hz (0.49±0.37 μg/dL) was significantly lower than 440 Hz (1.35±0.69 μg/dL) and the control group (1.59±0.7 μg/dL; p<0.05). Conclusion The use of music significantly decreased clinical anxiety levels, and the frequency of 432 Hz was effective in decreasing salivary cortisol levels before tooth extraction.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Adulto Joven , Saliva/química , Extracción Dental/psicología , Hidrocortisona/análisis , Ansiedad al Tratamiento Odontológico/terapia , Música/psicología , Musicoterapia/métodos , Estrés Psicológico , Ensayo de Inmunoadsorción Enzimática , Encuestas y Cuestionarios , Reproducibilidad de los Resultados , Análisis de Varianza , Resultado del Tratamiento , Ansiedad al Tratamiento Odontológico/psicología , Estadísticas no ParamétricasRESUMEN
Abstract Objective Anxiety as a uni- or multidimensional construct has been under discussion. The unidimensional approach assumes that there is a general trait anxiety, which predisposes the individuals to increases in state anxiety in various threatening situations. In this case, there should be a correlation between state and trait anxiety in any situation of threat. Therefore, the aim of this study was to investigate the correlation between trait and state anxiety in participants exposed to two different anxiogenic situations: interpersonal threat (Video-Monitored Stroop Test - VMST) and physical threat (third molar extraction - TME). Methods Participants with various levels of trait anxiety (general trait: State-Trait Anxiety Inventory - STAI, Hospital Anxiety and Depression Scale; specific trait: Social Phobia Inventory, Dental Anxiety Scale) had their anxious state evaluated (STAI, self-evaluation of tension level, heart rate, electromyogram activity) before, during and after the VMST or the TME. Results In VMST, trait anxiety correlated to state anxiety (psychological parameters) in all test phases. However, in TME, the only trait measurement that correlated to state anxiety (psychological parameters) was the Dental Anxiety Scale. Conclusion Trait anxiety correlates positively to state anxiety in situations of interpersonal threat, but not of physical threat.
Resumo Objetivo A ansiedade como um construto uni ou multidimensional tem estado em discussão. A abordagem unidimensional presume que há uma ansiedade-traço geral, a qual predispõe o indivíduo a aumentar a ansiedade-estado em situações de ameaça. Neste caso, deveria existir uma correlação entre estado e traço ansioso em diferentes situações ameaçadoras. Portanto, o objetivo deste estudo foi avaliar a correlação entre ansiedade-traço e ansiedade-estado em participantes que foram expostos a duas situações ansiogênicas diferentes: ameaça interpessoal (Teste de Stroop Monitorado por Vídeo - TSMV) e ameaça física (exodontia do terceiro molar - ETM). Métodos Participantes com vários níveis de ansiedade-traço (traço geral: Inventário de Ansiedade Traço-Estado - IDATE; Escala Hospitalar de Ansiedade e Depressão; traço específico: Inventário de Fobia Social, Escala de Ansiedade Dental de Corah) tiveram seus estados ansiosos avaliados (IDATE, escala analógica de tensão, frequência cardíaca, eletromiografia) antes, durante e depois do TSMV ou da ETM. Resultados No TSMV, a ansiedade-traço correlacionou-se com a ansiedade-estado (parâmetros psicológicos) em todas as fases do teste. Entretanto, na ETM, a única medida de traço que se correlacionou com a ansiedade-estado (parâmetros psicológicos) foi a Escala de Ansiedade Dental de Corah. Conclusão A ansiedade-traço correlaciona-se positivamente com a ansiedade-estado em situações de ameaça interpessoal, mas não de ameaça física.
Asunto(s)
Humanos , Masculino , Adolescente , Adulto , Adulto Joven , Personalidad , Ansiedad/diagnóstico , Ansiedad/fisiopatología , Pruebas de Personalidad , Escalas de Valoración Psiquiátrica , Extracción Dental/psicología , Análisis de Varianza , Músculo Esquelético/fisiopatología , Electromiografía , Test de Stroop , Relaciones Interpersonales , Tercer MolarRESUMEN
BACKGROUND: Tooth extractions are associated with anxiety-related situations that can cause behavioral problems in pediatric dental clinics. AIM: We aimed to describe the behavior of children during tooth extraction appointments, compare it to their behavior in preceding and subsequent dental appointments, and assess the behavioral differences according to gender, age, type of dentition, and reason for extraction. SETTINGS AND DESIGN: This was a retrospective study based on information obtained from records of children between 6 and 13 years of age who were cared for at the Dentistry School in Pelotas, Brazil. MATERIALS AND METHODS: Child behavior was assessed during the dental appointment that preceded the tooth extraction, during the tooth extraction appointment, and in the subsequent dental appointment using the Venham Behavior Rating Scale. STATISTICAL ANALYSIS: Results were analyzed using the Pearson Chi-square and McNemar tests. RESULTS: Eighty-nine children were included. Cooperative behavior prevailed in all the dental appointments. The prevalence of "mild/intense protest" was higher in the tooth extraction appointments than in the previous or subsequent dental appointments (P < 0.001). No significant differences in behavior were detected between the type of dentition (primary or permanent teeth), reason for extraction or gender. CONCLUSION: In this sample of children treated at a dental school, the occurrence of uncooperative behavior was higher during the tooth extraction appointments than in the preceding and subsequent dental appointments.
Asunto(s)
Ansiedad al Tratamiento Odontológico/epidemiología , Ansiedad al Tratamiento Odontológico/psicología , Atención Dental para Niños , Extracción Dental/psicología , Adolescente , Brasil , Niño , Femenino , Humanos , Masculino , Prevalencia , Estudios RetrospectivosRESUMEN
OBJECTIVE: Anxiety as a uni- or multidimensional construct has been under discussion. The unidimensional approach assumes that there is a general trait anxiety, which predisposes the individuals to increases in state anxiety in various threatening situations. In this case, there should be a correlation between state and trait anxiety in any situation of threat. Therefore, the aim of this study was to investigate the correlation between trait and state anxiety in participants exposed to two different anxiogenic situations: interpersonal threat (Video-Monitored Stroop Test - VMST) and physical threat (third molar extraction - TME). METHODS: Participants with various levels of trait anxiety (general trait: State-Trait Anxiety Inventory - STAI, Hospital Anxiety and Depression Scale; specific trait: Social Phobia Inventory, Dental Anxiety Scale) had their anxious state evaluated (STAI, self-evaluation of tension level, heart rate, electromyogram activity) before, during and after the VMST or the TME. RESULTS: In VMST, trait anxiety correlated to state anxiety (psychological parameters) in all test phases. However, in TME, the only trait measurement that correlated to state anxiety (psychological parameters) was the Dental Anxiety Scale. CONCLUSION: Trait anxiety correlates positively to state anxiety in situations of interpersonal threat, but not of physical threat.
Asunto(s)
Ansiedad , Personalidad , Adolescente , Adulto , Análisis de Varianza , Ansiedad/diagnóstico , Ansiedad/fisiopatología , Electromiografía , Humanos , Relaciones Interpersonales , Masculino , Tercer Molar , Músculo Esquelético/fisiopatología , Pruebas de Personalidad , Escalas de Valoración Psiquiátrica , Test de Stroop , Extracción Dental/psicología , Adulto JovenRESUMEN
INTRODUCTION: Dental anxiety is an important factor in influencing patients' decisions to access treatment. It is crucial dental care professionals understand its causative factors in order to prevent and manage it, particularly as dentally anxious patients often have poor oral health. This report is of an elective study that tried to ascertain whether children with signs of dental neglect suffered greater dental anxiety, as existing research suggests that anxiety can stem from previous experiences. METHOD: 100 children in both the United Kingdom and Peru were examined for signs of dental neglect using the PUFA (Pulpal exposures, Ulcers, Fistulas & Abscesses) system, and their anxiety levels surveyed with the Modified Child Dental Anxiety Scale. A Spearman's rank analysis was performed. RESULTS: Both groups showed similar disease levels, but Peruvian children were significantly less anxious. The r values (United Kingdom r=-0.020 Peru r=-0.0099) were less than rc=0.165 at a significance level of P=0.05, showing that increased dental neglect does not make children more anxious. DISCUSSION: It appears that having a neglected dentition as a child does not make you more anxious, but the resultant invasive treatment procedures likely to have been experienced as a child may have a role. Ultimately, cultural background and attitude to dental care are suggested as being more important in determining the dental anxiety levels of children.
Asunto(s)
Comparación Transcultural , Ansiedad al Tratamiento Odontológico/clasificación , Enfermedades Dentales/clasificación , Niño , Atención Odontológica/psicología , Fístula Dental/clasificación , Exposición de la Pulpa Dental/clasificación , Restauración Dental Permanente/psicología , Inglaterra , Femenino , Humanos , Inyecciones/psicología , Masculino , Úlceras Bucales/clasificación , Absceso Periodontal/clasificación , Perú , Extracción Dental/psicologíaRESUMEN
The aim of the present study was to compare hemodynamic changes using midazolam 7.5 mg and diazepam 10.0 mg during the surgical removal of symmetrically positioned third molars. A prospective, randomized, double-blind, clinical trial was carried out involving 120 patients divided into three groups: Group 1 (diazepam and placebo), Group 2 (midazolam and placebo), and Group 3 (diazepam and midazolam). Each subject underwent two surgeries on separate occasions under local anesthesia. The following parameters were assessed at five different times (T0, T1, T2, T3, and T4): systolic, diastolic, and mean blood pressure (SBP, DBP, and MBP, respectively); heart rate (HR); oxygen saturation (SpO(2)); rate pressure product (RPP); and pressure rate quotient (PRQ). Statistically significant differences were found regarding heart rate at T2 and T3 (p < 0.005) in Group 2, with a higher rate occurring during midazolam administration. Moreover, significant differences in rate pressure product were found at T2, T3, and T4 in this group, with higher values also occurring during midazolam administration. In Group 3, significant differences in diastolic blood pressure were found at T3 and T4, with higher values occurring during diazepam administration, whereas a higher heart rate occurred at T3 with midazolam. Midazolam 7.5 mg and diazepam 10.0 mg exert an influence on some hemodynamic parameters without perceptible clinical changes in healthy patients undergoing lower third molar surgery.
Asunto(s)
Anestesia Dental , Ansiedad al Tratamiento Odontológico/tratamiento farmacológico , Diazepam , Hemodinámica/efectos de los fármacos , Midazolam , Tercer Molar/cirugía , Extracción Dental/psicología , Adolescente , Adulto , Ansiedad al Tratamiento Odontológico/psicología , Método Doble Ciego , Quimioterapia Combinada , Femenino , Humanos , Masculino , Proyectos Piloto , Adulto JovenRESUMEN
Extensive tooth loss and edentulism can have a negative impact on the general health and quality of life of older adults. The extent to which psychological and social factors affect an individual's decision to undergo tooth extraction and mouth clearance (extraction of all teeth), and the theoretical relationships between social structure, social life and oral health can be unraveled through qualitative research. This study aimed to explore the social and psychological factors involved in tooth extraction and mouth clearance within a historical perspective among rural Southern Brazilian older adults. It is based on qualitative data gathered via a series of eight focus groups among 41 older adults. Underlying the focus group discussions of different levels of health risks and resources for prevention of disease was the concept of vulnerability. Participants' responses illustrated that tooth loss and mouth clearance were related to a lack of public dental health policies and programs, were influenced by social norms (including values pertaining to gender), and were associated with a low level of oral health knowledge. The social and program-dependent contexts of vulnerability were shown to have played a major role in the development of norms and values towards tooth extraction and mouth clearance. Vulnerability must be reduced in order to prevent disease particularly among rural populations. The influence of fatalistic beliefs about the inevitable loss of teeth with age may negatively influence the acceptance of dental treatment and predilection for oral health self-care.
Asunto(s)
Envejecimiento , Conocimientos, Actitudes y Práctica en Salud , Boca Edéntula/psicología , Extracción Dental/psicología , Pérdida de Diente/psicología , Anciano , Anciano de 80 o más Años , Envejecimiento/psicología , Brasil , Cuidado Dental para Ancianos , Femenino , Grupos Focales , Accesibilidad a los Servicios de Salud , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Salud Bucal , Percepción , Investigación Cualitativa , Calidad de Vida/psicología , Población Rural , Apoyo Social , Factores Socioeconómicos , Poblaciones VulnerablesRESUMEN
The aim of the present investigation was to assess the impact of dental caries prevalence and the consequences of untreated cavitated dentine lesions on quality of life of 6- and 7-year-old Brazilian children. A total of 826 schoolchildren were assessed using ICDAS and pufa (to score consequences of dental caries on soft tissues) indices. History of extraction and toothache was recorded. Oral health-related quality of life was assessed using the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). A multiple logistic regression model was used to analyze the relationship between the prevalence of dentine carious lesions, pufa, history of extraction and toothache with the B-ECOHIS scores. A total of 587 questionnaires were analyzed. The prevalence of cavitated dentine lesions and pufa was 74.8 and 26.2%, respectively. Some 21.8% of children reported toothache and 9.2% had had at least one tooth extraction. The chance (OR) for children with cavitated dentine lesions, pufa ≥1, history of extraction and toothache of having higher B-ECOHIS scores than those not affected was 1.90 (95% CI: 1.18-3.06), 6.26 (95% CI: 3.63-10.83), 6.87 (95% CI: 2.75-17.16) and 3.68 (95% CI: 2.12-6.39), respectively. Children's quality of life was negatively influenced by untreated cavitated dentine lesions and their consequences.
Asunto(s)
Caries Dental/psicología , Dentina/patología , Calidad de Vida , Brasil/epidemiología , Niño , Caries Dental/complicaciones , Caries Dental/epidemiología , Caries Dental/patología , Fístula Dental/etiología , Fístula Dental/psicología , Exposición de la Pulpa Dental/etiología , Exposición de la Pulpa Dental/psicología , Femenino , Humanos , Modelos Logísticos , Masculino , Absceso Periapical/etiología , Absceso Periapical/psicología , Pobreza , Prevalencia , Perfil de Impacto de Enfermedad , Encuestas y Cuestionarios , Extracción Dental/psicología , Diente Primario/patología , Odontalgia/psicologíaRESUMEN
OBJECTIVE: To evaluate the degree of perception of laypersons, dental professionals, and students with regard to the esthetics of the smile in cases of mandibular incisor extractions with the presence of black spaces between them. MATERIALS AND METHODS: Changes were made to a front-view intraoral photograph of occlusion treated by means of a mandibular incisor extraction, simulating various configurations of black spaces between mandibular incisors. For this purpose, a specific image manipulation program was used (Photoshop CS3). After digital manipulation the photographs were printed on photographic paper and attached to a questionnaire and distributed to laypersons, dental professionals, and students (n â=â 90). To evaluate the degree of esthetics, an attractiveness scale was used, in which a score of 0 would represent "hardly attractive," 5 "attractive," and 10 "very attractive." The differences between examiners were checked using the Mann-Whitney test. All of the statistics were performed with a confidence level of 95%. RESULTS: The results demonstrated that dentistry professionals, students, and laypersons were capable of identifying cases with and without black spaces. In all groups evaluated, with the increase in black spaces the scores assigned were statistically lower (P < .05). CONCLUSIONS: It could be concluded that black spaces occurring after mandibular incisor extraction had a negative repercussion on dental esthetics for the dentist, the dental student, and the layperson.
Asunto(s)
Estética Dental/psicología , Incisivo/cirugía , Mandíbula/cirugía , Adolescente , Adulto , Actitud del Personal de Salud , Actitud Frente a la Salud , Odontólogos , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Mandíbula/anatomía & histología , Persona de Mediana Edad , Fotografía Dental , Sonrisa/psicología , Estudiantes de Odontología , Extracción Dental/psicologíaRESUMEN
PURPOSE: The aim of this study was to verify possible associations between oral health-related quality of life (QoL) and the position of the lower third molar among patients undergoing lower third molar surgery during the first postoperative week. MATERIALS AND METHODS: We performed an interventional prospective study of 86 patients for whom the preoperative treatment plan included the removal of 2 third molar teeth from the same side in a 1-time procedure. The patients were divided into 2 groups depending on the position of the lower third molar. QoL was evaluated before and after the surgical procedure (during the first 7 days) with the Oral Health Impact Profile (OHIP) 14 questionnaire. Data were treated according to Stata 10.0 (StataCorp, College Station, TX). Variables were evaluated by use of split-plot analysis of variance for the repeated-measures analysis to identify the association between QoL and the position of the lower third molar. RESULTS: Patients can have deterioration in their QoL immediately after surgery, especially during the first and second postoperative days, and subsequently show rapid improvement. The variation in the total OHIP score during the days after surgery was significant, whereas a decrease in QoL was observed immediately after the procedure (P = .001), which returned to initial value (preoperative) levels after the sixth postoperative day. The OHIP domains with higher scores (ie, those that had an impact) were physical pain, psychological discomfort, and physical disability (domains 2, 3, and 4, respectively). CONCLUSIONS: Teeth considered to be associated with technical difficulties for extraction based on their position had a higher score on the OHIP-14 questionnaire and worse health-related QoL score. QoL outcomes may be as important as clinical signs in decisions regarding third molar extractions.
Asunto(s)
Tercer Molar/cirugía , Salud Bucal , Calidad de Vida , Extracción Dental , Diente Impactado/cirugía , Personas con Discapacidad/psicología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Tercer Molar/diagnóstico por imagen , Dolor Postoperatorio/psicología , Estudios Prospectivos , Radiografía Panorámica , Factores de Riesgo , Estrés Psicológico/psicología , Encuestas y Cuestionarios , Extracción Dental/psicología , Diente Impactado/diagnóstico por imagen , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: To evaluate the degree of perception of laypersons, dental professionals, and dental students regarding dental esthetics in cases with mandibular central incisor extraction. MATERIALS AND METHODS: Using a smile photograph of a person with normal occlusion and all teeth, modifications were made to reflect the extraction of a mandibular incisor of various compositions and sizes. For this purpose a program specifically for image manipulation (Adobe Photoshop CS3, Adobe Systems Inc) was used. After manipulation the images were printed on photographic paper, attached to a questionnaire and distributed to laypersons, dental professionals, and dental students (n â=â 90) to evaluate the degree of perception and esthetic using a scale of attractiveness, where 0 â=â hardly attractive, 5 â=â attractive, and 10 â=â very attractive. The differences between examiners were checked by the Mann-Whitney test. All the statistics were performed with a confidence level of 95%. RESULTS: The results demonstrated the skill of the dental professionals and dental students in perceiving the difference between cases of normal occlusion and cases where an incisor was lacking (P < .05). The photograph in which the lateral incisors were shown to be larger than the central incisor was the one that obtained the highest value among the cases of extraction in all groups of evaluators. CONCLUSIONS: It can be concluded that dental professionals and dental students are more skillful at identifying deviation from normality. In addition, central incisor extraction should always be discarded when there are other treatment options available.
Asunto(s)
Actitud del Personal de Salud , Actitud Frente a la Salud , Oclusión Dental , Estética Dental/psicología , Incisivo , Mandíbula , Extracción Dental/efectos adversos , Adolescente , Adulto , Odontólogos , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Masculino , Fotografía Dental , Estadísticas no Paramétricas , Estudiantes de Odontología , Extracción Dental/psicologíaRESUMEN
AIM: The aim of this study was to investigate the level of dental anxiety and its possible causes among people in Trinidad and Tobago. METHOD: This is a cross-sectional survey of parents and guardians accompanying children who were attending a paediatric dental clinic. Participants completed a questionnaire while in the waiting room, which included the Modified Dental Anxiety Scale (MDAS), age, gender and occupation. An additional item was included which asked participants to rate the anxiety felt on having a tooth extracted. RESULTS: There were 100participants (81% female). Overall, 40% of participants reported moderate to severe anxiety. Twenty-three per cent of participants had moderate anxiety (MDAS 15-18) and 17% had severe anxiety/phobia (MDAS 19-20). Level of anxiety was related to gender (multiple linear regression, p < 0.05). Proportions of participants were very/extremely anxious of having a tooth drilled (48%), local anaesthetic injection (53%) and extraction (52%). Thirty-six per cent of participants had avoided dental treatment in the past because they were too anxious. CONCLUSION: High levels of dental anxiety were found in this sample of Trinidadian adults. The MDAS was able to detect significant elements of that anxiety. The addition of a question on extraction revealed that this procedure may contribute substantially in anxiety toward dental treatment in the Caribbean.
OBJETIVO: El objetivo de este estudio fue investigar el nivel de ansiedad dental y sus posibles causas entre las personas en Trinidad y Tobago. MÉTODO: Éste es un estudio transversal de padres y guardianes que acompañan a los niños que asistían a una clínica dental pediátrica. Los participantes llenaron un cuestionario mientras se hallaban en la sala de espera. El cuestionario incluía la Escala de Ansiedad Dental Modificada (EADM), edad, género y ocupación. Se incluyó un punto adicional que pedía a los participantes que clasificaran la ansiedad que sentían por la extracción de un diente. RESULTADOS: Había 100 participantes (81% hembra). En general, el 40% de los participantes reportó sentir una ansiedad de moderada a severa. El veintitrés por ciento de los participantes tenía una ansiedad moderada (EADM 15-18) y el 17% tenían ansiedad severa/fobia (EADM 19-20). El nivel de ansiedad guardaba relación con el género (regresión logística múltiple p < 0.05). Muchos participantes estaban muy/extremadamente ansiosos por tener un diente bajo la fresa dental (48%), una inyección con anestésico local (53%) y una extracción (52%). Treinta y seis por ciento de los participantes habían evitado el tratamiento dental en el pasado porque se sentían demasiado ansiosos. CONCLUSIÓN: Se encontraron niveles altos de ansiedad dental en esta muestra de adultos trinitenses. La EADM pudo detectar elementos significativos de esa ansiedad. Al añadirse una pregunta sobre extracción, se puso de manifiesto que este procedimiento puede contribuir substancialmente al problema de la ansiedad hacia el tratamiento dental en el Caribe.
Asunto(s)
Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Ansiedad al Tratamiento Odontológico/epidemiología , Preparación de la Cavidad Dental/psicología , Inyecciones/psicología , Extracción Dental/psicología , Estudios Transversales , Trastornos Fóbicos , Encuestas y Cuestionarios , Trinidad y Tobago/epidemiologíaRESUMEN
OBJECTIVE: To identify factors associated with patient satisfaction at least 5 years after orthodontic treatment. MATERIALS AND METHODS: A total of 209 orthodontic patients were included in the study. All subjects were treated with upper and lower fixed orthodontic appliances. Dental casts (n = 627) were examined using the Peer Assessment Rating (PAR) Index pretreatment (T1), at the end of treatment (T2) and at a long-term follow-up (mean, 8.5 years; T3). At T3, a Dental Impact on Daily Living questionnaire was used to assess the long-term effects of orthodontic treatment on daily living and satisfaction with the dentition. Multiple regression analyses were used to quantify associations between patient satisfaction and changes produced by the orthodontic treatment (PAR T2-T1), posttreatment stability (PAR T3), age at the start of treatment (T1), treatment duration (T2-T1), gender, and extraction. RESULTS: Orthodontic treatment produced a significant improvement of 94.2% in the PAR Index (T2-T1), but this change was not associated with the level of satisfaction when the patient was questioned at least 5 years after treatment. Regression analysis showed that satisfaction was significantly associated only with the long-term posttreatment PAR index (r(2) = 0.125, P < .0001). No significant association was observed with the severity of malocclusion at the beginning (PAR-T1) or end of the orthodontic treatment (PAR-T2), age at T1, the amount of time taken during orthodontic treatment, gender, or extraction. CONCLUSIONS: Over the long term, patient satisfaction is slightly associated with the stability of the orthodontic treatment regardless of the initial occlusal condition or the final result of the orthodontic treatment.
Asunto(s)
Ortodoncia Correctiva/psicología , Satisfacción del Paciente , Adolescente , Adulto , Factores de Edad , Niño , Femenino , Humanos , Estudios Longitudinales , Masculino , Maloclusión Clase I de Angle/psicología , Maloclusión Clase I de Angle/terapia , Maloclusión Clase II de Angle/psicología , Maloclusión Clase II de Angle/terapia , Revisión por Expertos de la Atención de Salud , Recurrencia , Análisis de Regresión , Índice de Severidad de la Enfermedad , Factores Sexuales , Perfil de Impacto de Enfermedad , Encuestas y Cuestionarios , Extracción Dental/psicología , Adulto JovenRESUMEN
AIM: The aim of this study was to investigate the level of dental anxiety and its possible causes among people in Trinidad and Tobago. METHOD: This is a cross-sectional survey of parents and guardians accompanying children who were attending a paediatric dental clinic. Participants completed a questionnaire while in the waiting room, which included the Modified Dental Anxiety Scale (MDAS), age, gender and occupation. An additional item was included which asked participants to rate the anxiety felt on having a tooth extracted. RESULTS: There were 100 participants (81% female). Overall, 40% of participants reported moderate to severe anxiety. Twenty-three per cent of participants had moderate anxiety (MDAS 15-18) and 17% had severe anxiety/phobia (MDAS 19-20). Level of anxiety was related to gender (multiple linear regression, p < 0.05). Proportions of participants were very/extremely anxious of having a tooth drilled (48%), local anaesthetic injection (53%) and extraction (52%). Thirty-six per cent of participants had avoided dental treatment in the past because they were too anxious. CONCLUSION: High levels of dental anxiety were found in this sample of Trinidadian adults. The MDAS was able to detect significant elements of that anxiety. The addition of a question on extraction revealed that this procedure may contribute substantially in anxiety toward dental treatment in the Caribbean.
Asunto(s)
Ansiedad al Tratamiento Odontológico/epidemiología , Preparación de la Cavidad Dental/psicología , Inyecciones/psicología , Extracción Dental/psicología , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Fóbicos , Encuestas y Cuestionarios , Trinidad y Tobago/epidemiología , Adulto JovenRESUMEN
INTRODUCTION: In this study, we evaluated the effects of orthodontic appliances and an extracted maxillary first premolar on the esthetic evaluation of a smiling face according to the perceptions of orthodontists and laypeople. METHODS: Standardized oblique photographs of a young woman with a pleasing smile were taken. The photos were edited by using digital imaging software to produce 10 combinations of presence or absence of orthodontic appliances with either esthetic or metal brackets, rubber bands of different colors, and presence or absence of the maxillary first premolar. Two groups of 50 observers each, 1 of laypeople and the other of orthodontists, evaluated the images and assigned esthetic scores to the smiles according to a visual analog scale. RESULTS: The presence of orthodontic appliances and metal brackets, regardless of rubber band color, had no negative effect on the esthetic evaluation of the smile by either group. Appliances with esthetic brackets were significantly less pleasing for laypeople, whereas for orthodontists they did not affect the esthetic evaluation of the smile. The extraction space had a significantly negative effect on the evaluation of the smile, and only orthodontists thought that the appliance minimized its effect. CONCLUSIONS: The type of bracket used with the orthodontic appliances and a maxillary first premolar extraction space produced different esthetic perceptions in laypeople and orthodontists.
Asunto(s)
Diente Premolar , Estética Dental/psicología , Soportes Ortodóncicos , Extracción Dental , Actitud del Personal de Salud , Femenino , Humanos , Masculino , Maxilar , Ortodoncia , Fotografía Dental , Opinión Pública , Sonrisa/psicología , Extracción Dental/psicología , Adulto JovenRESUMEN
Studies on self-perception have demonstrated that tooth loss is associated with esthetic, functional, psychological and social impacts for individuals. However, not all subjects seek treatment immediately after tooth loss, even when desire for replacement is strongly expressed. The aim of this study was to evaluate the perception of patients submitted to tooth extraction about factors associated with tooth loss and prosthodontic treatment, at the time and after extraction. A convenience sample of 211 consecutive patients were clinically evaluated and answered to a questionnaire about perceived impacts and prosthodontic treatment needs. Data were collected at the time of extraction and after a 3-month time interval. Perceived impacts were high (21 to 76% at the time and 35 to 87% after extraction). From 72.5% patients who expressed intention of immediate replacement of edentulous spaces, only 8.1% had actually been treated. Financial limitation was considered the most important factor that restricted access to treatment. Bivariate statistical analysis showed association between immediate dental replacement and anterior tooth loss (p=0.00) and extension of edentulous space (p=0.01). Position of lost teeth was associated to perceived functional limitation (p=0.03). Worsened appearance was associated to tooth loss in the maxillary arch (p=0.02), and desire of prosthodontic treatment was associated to the extension of edentulous space (p=0.05). Perceived impacts were more frequent in women than men. It was concluded that although patients usually expressed prosthodontic treatment needs, clinical and financial issues are determinant factors for tooth replacement.
Asunto(s)
Actitud Frente a la Salud , Prótesis Dental/psicología , Evaluación de Necesidades , Autoimagen , Pérdida de Diente/psicología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Prótesis Dental/economía , Ingestión de Alimentos/fisiología , Estética Dental , Femenino , Estudios de Seguimiento , Costos de la Atención en Salud , Accesibilidad a los Servicios de Salud/economía , Estado de Salud , Humanos , Relaciones Interpersonales , Arcada Edéntula/psicología , Arcada Edéntula/rehabilitación , Arcada Parcialmente Edéntula/psicología , Arcada Parcialmente Edéntula/rehabilitación , Masculino , Masticación/fisiología , Persona de Mediana Edad , Salud Bucal , Estudios Prospectivos , Factores Sexuales , Extracción Dental/psicología , Pérdida de Diente/rehabilitación , Adulto JovenRESUMEN
Studies on self-perception have demonstrated that tooth loss is associated with esthetic, functional, psychological and social impacts for individuals. However, not all subjects seek treatment immediately after tooth loss, even when desire for replacement is strongly expressed. The aim of this study was to evaluate the perception of patients submitted to tooth extraction about factors associated with tooth loss and prosthodontic treatment, at the time and after extraction. A convenience sample of 211 consecutive patients were clinically evaluated and answered to a questionnaire about perceived impacts and prosthodontic treatment needs. Data were collected at the time of extraction and after a 3-month time interval. Perceived impacts were high (21 to 76 percent at the time and 35 to 87 percent after extraction). From 72.5 percent patients who expressed intention of immediate replacement of edentulous spaces, only 8.1 percent had actually been treated. Financial limitation was considered the most important factor that restricted access to treatment. Bivariate statistical analysis showed association between immediate dental replacement and anterior tooth loss (p=0.00) and extension of edentulous space (p=0.01). Position of lost teeth was associated to perceived functional limitation (p=0.03). Worsened appearance was associated to tooth loss in the maxillary arch (p=0.02), and desire of prosthodontic treatment was associated to the extension of edentulous space (p=0.05). Perceived impacts were more frequent in women than men. It was concluded that although patients usually expressed prosthodontic treatment needs, clinical and financial issues are determinant factors for tooth replacement.
Estudos de autopercepção têm demonstrado que a ausência de dentes pode resultar em impactos estéticos, funcionais, psicológicos e sociais, embora nem todos os indivíduos demandam por tratamento protético imediato após a perda dentária. O objetivo do estudo foi avaliar a percepção de pacientes submetidos a exodontia em relação a fatores associados à perda e ao tratamento protético, no momento e após a perda dos dentes. Uma amostra de conveniência de 211 pacientes consecutivos foi avaliada quanto à condição clínica, autopercepção dos impactos orais e necessidade de tratamento, por meio de exame clínico e questionário, no momento e após 3 meses da exodontia. A percepção de impactos da perda dentária foi alta (21-76 por cento no momento e 35-87 por cento após a exodontia). Dos 72,5 por cento pacientes que relataram pretender a reposição protética imediata apenas 8,1 por cento realizaram o tratamento. A motivação financeira foi relatada como o maior impedimento para o tratamento. A análise univariada mostrou associação entre reposição imediata e localização anterior da perda (p=0,00) e extensão do espaço desdentado (p=0,01), entre localização da perda e limitação funcional percebida (p=0,03). O incômodo com a aparência foi relacionado à localização da perda no arco superior (p=0,02), o desejo por tratamento protético foi relacionado à extensão do espaço desdentado (p=0,05). Na maioria dos aspectos avaliados a percepção de problemas associados à perda foi maior no sexo feminino. Conclui-se que, embora a necessidade percebida de tratamento protético seja alta, fatores clínicos e sócio-econômicos são determinantes para a realização do tratamento.