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OBJECTIVE: Knowledge on the parents' catastrophizing of the children's dental pain is lacking. This study aimed to verify whether parental pain catastrophizing influences the relationship between caries and dental pain in early childhood and if the child's age interacts with this relationship. STUDY DESIGN: A cross-sectional study was carried out with 83 dyads of children and their parents/primary caregivers. The parents answered the Brazilian version of the Pain Catastrophizing Scale-Parents and the Dental Discomfort Questionnaire. The children were examined to measure their caries experience. Correlations, simple mediation, and conditional process analyses were performed. RESULTS: The research participants were mostly male children (50.6%) with a mean age of 38 months (Q1 33.0, Q3 48.0). Most of the parents were mothers (n = 73; 88.0%) and had catastrophic thoughts (80.7%). Perceived dental pain in the child was positively correlated with the child's caries experience and parental pain catastrophizing. The parents' catastrophizing did not mediate the relationship between the caries experience and the pain intensity (a * b = 0.05; the lowest level of the confidence interval: -0.01; upper level of the confidence interval: 0.14). The child's age did not moderate the direct or indirect effect of the caries experience on the pain intensity of the children. CONCLUSION: In early childhood, parental catastrophizing of the children's pain and children's age does not influence the direct relationship between children's caries experience reported by the dentist and children's dental pain reported by parents.
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Cárie Dentária , Criança , Feminino , Humanos , Pré-Escolar , Masculino , Estudos Transversais , Dor , Pais , CatastrofizaçãoRESUMO
The incidence of peri-procedural amnesia following procedural sedation in children is unclear and difficult to determine. This study aimed to apply quantitative and qualitative approaches to better understand amnesia following dental sedation of children. After Institutional Review Board Approval, children scheduled for sedation for dental procedures with oral midazolam (OM), oral midazolam and ketamine (OMK), or intranasal midazolam and ketamine (IMK) were recruited for examination of peri-procedural amnesia. Amnesia during the dental session was assessed using a three-stage method, using identification of pictures and an animal toy. On the day following the sedation, primary caregivers answered two questions about their children's memory. One week later, the children received a semi-structured interview. Behavior and level of sedation during the dental session were recorded. Quantitative data were analyzed using descriptive statistics and comparison tests. Qualitative data were analyzed using content analysis. Triangulation was used. Thirty-five children (age: 36 to 76 months) participated in the quantitative analysis. Most children showed amnesia for the dental procedure (82.9%, n = 29/35) and remembered receiving the sedation (82.1%, n = 23/28 for oral administration; 59.3%, n = 16/27 for intranasal administration). The occurrence of amnesia for the dental procedure was slightly higher in the oral midazolam group compared with the other groups (44.8%, n = 13/29 for OM, 13.8%, n = 4/29 for OMK, and 41.4%, n = 12/29 for IMK). Twenty-eight children participated in the qualitative approach. The major theme identified was that some children could remember their procedures in detail. We conclude that peri-procedural amnesia of the dental procedure was common following sedation.
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Outpatient pediatric sedation is challenging. This study aimed to test intranasal dexmedetomidine efficacy as a single drug or combined with ketamine (DK) to sedate children undergoing dental treatment. Children < 7 years were randomized into dexmedetomidine 2 mcg/kg and ketamine 1 mg/kg (DK) or dexmedetomidine 2.5 mcg/kg (D) groups. Videos from the dental sedation allowed the systematic assessment of children's behavior (primary outcome) according to the Ohio State University Behavioral Rating Scale (OSUBRS). Secondary outcomes were parental and dentist satisfaction, adverse events, and recovery time. The data were analyzed descriptively and through regression models. Participants were 88 children (44 per group; 50 boys). The duration of quiet behavior (OSUBRS) was higher than 50% (DK mean 58.4 [standard deviation 38.1]; D 55.2 [39.1]; p = 0.225). Parents (DK 78.0 [32.2]; D 72.7 [35.1]; p = 0.203) and dentists (KD 62.7 [41.0]; D 62.8 [40.1]; p = 0.339) were overall satisfied. Adverse events occurred in 16 cases (DK n = 10, 62.5%; D n= 6, 37.5%; p = 0.104) and were minor. The median recovery time in the DK group was 1.3 times greater than in group D (p < 0.05). Intranasal sedation with dexmedetomidine alone is equally efficacious and satisfactory for pediatric sedation with fewer adverse events and faster recovery than the DK combination.
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BACKGROUND: Dentists need training in the management of children's anxiety (DA), fear (DF) and behaviour management problems (DBMP) but little is known of their competence on this topic. AIM: To report dentists' opinions and attitudes about protective stabilisation and pharmacological techniques for the management of children with DA/DF/DBMP; to propose a postgraduate curriculum focussing on DA/DF/DBMP. DESIGN: A survey of 301 Brazilian dentists and later a modified Delphi process to outline the curriculum in two phases: (a) face-to-face discussions with 33 early career researchers mentored by six researchers, both from UK and Brazil; (b) online discussions by eight early and senior researchers on the knowledge, experience, and competencies necessary for a specialist in paediatric dentistry in Brazil that should be included in the core curriculum of postgraduate courses. RESULTS: Almost all (99.0%) of the survey respondents provide treatment to children with DA/DF/DBMP, and 91.2% do not systematically diagnose these conditions; 94.3% use protective stabilisation, and 20.0%-30.0% have training in pharmacological techniques. The four-domain framework supporting the proposed curriculum is as follows: DA/DF/DBMP assessment, non-pharmacological and pharmacological approaches, and decision-making. CONCLUSION: Dental curricula should be customised to solve the misconceptions and promote a comprehensive and positive attitude to DA/DF/DBMP by paediatric oral healthcare practitioners.
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Ansiedade ao Tratamento Odontológico , Odontopediatria , Brasil , Criança , Comportamento Infantil , Currículo , HumanosRESUMO
BACKGROUND: Dyslipidemia is a major risk factor in triggering cardiovascular events, which can lead to the death of millions of people around the world. Thus, several pharmacological and non-pharmacological therapeutic strategies have been developed in recent decades with the objective of improving lipid profiles, including the use of probiotics. Therefore, the purpose of this protocol is to describe the steps that will guide the construction of an overview to demonstrate the scientific evidence of the efficacy of probiotics in improving the lipid profile of dyslipidemic individuals and to propose specific recommendations regarding their use. METHODS: The search will be conducted in the following databases: MEDLINE/PubMed, EMBASE, PROSPERO, Cochrane Library, CINAHL, JBI Database of Systematic Reviews and Implementation Reports, Google Scholar, and CADTH. Reviewers will select systematic evaluations and data analyses from randomized clinical trials that evaluated the effects of probiotics on lipid profiles. The studies will be analyzed for methodology quality by the AMSTAR 2 tool and risk of bias by ROBIS. The data will be extracted by three independent reviewers based on a data extraction sheet, which will include the most relevant variables for the analysis and interpretation of the results. The variables will be categorized and described in narrative form or in tables. DISCUSSION: There are some systematic reviews about the use of probiotics to prevent and/or treat dyslipidemia; however, their outcomes related to the ability of probiotics to improve lipid profiles are conflicting. So, an overview on this topic is needed to clarify this important issue. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017080328.
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Colesterol/sangue , Dislipidemias/sangue , Dislipidemias/terapia , Probióticos/uso terapêutico , Literatura de Revisão como Assunto , Triglicerídeos/sangue , Humanos , Projetos de Pesquisa , Revisões Sistemáticas como AssuntoRESUMO
BACKGROUND: There is a lack of evidence on the relationship between prematurity and palatal abnormalities. The aim of this study was to evaluate the incidence of palatal groove, the associated factors and the persistence time in preterm infants from birth to 24 months of age. METHODS: The children's data, medical history and eating habits were collected using a questionnaire answered by the legal guardian and updated every dental visit. Natal and neonatal data were obtained from the medical records. During the orofacial examination, the presence or absence of a palatal groove was observed. In order to evaluate for associations between independent variables and the palatal groove, descriptive analyses and bivariate analyses were conducted using the Mann-Whitney, Pearson's chi-squared and Fisher's exact tests, when appropriate. The Poisson regression analysis was used to determine risk and protective factors for the occurrence of palatal groove. The significance level was 0.05. For the persistence of palatal groove, a survival analysis was used (Kaplan Meier method). RESULTS: Seventy-four preterm infants were monitored. Palatal groove occurred in n = 19 (25.7 %) and persisted for an average time of 12 months. Bivariate analysis showed a significantly higher occurrence of palatal groove in girls (68.4 % vs 40 % with non-occurrence of palatal groove) as well as in infants that stayed longer in the neonatal intensive care unit (NICU) (median 37 days vs 20 days), that did not have exclusive breastfeeding (94.7 % vs 69.1 %), were intubated (median five days vs one day) or used an orogastric tube (median 33 days vs 15 days). The quantitative data for 'NICU', 'intubation' and 'orogastric tube' were correlated and estimated as risk factors for palatal groove formation in the unadjusted Poisson regression analysis. CONCLUSIONS: Palatal groove occur transiently in approximately one quarter of preterm infants, especially in infants that stay longer in the NICU, are intubated or use an orogastric tube.
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Doenças do Prematuro/etiologia , Doenças Maxilomandibulares/etiologia , Doenças da Boca/etiologia , Palato/patologia , Brasil/epidemiologia , Desenvolvimento Infantil , Pré-Escolar , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/diagnóstico , Doenças do Prematuro/epidemiologia , Terapia Intensiva Neonatal , Intubação Gastrointestinal/efeitos adversos , Intubação Intratraqueal/efeitos adversos , Doenças Maxilomandibulares/diagnóstico , Doenças Maxilomandibulares/epidemiologia , Estimativa de Kaplan-Meier , Masculino , Doenças da Boca/diagnóstico , Doenças da Boca/epidemiologia , Palato/crescimento & desenvolvimento , Estudos Prospectivos , Remissão Espontânea , Fatores de Risco , Fatores de TempoRESUMO
The Brief Coping Orientation to Problems Experienced (COPE) inventory investigates the different ways in which people respond to stressful situations. Knowledge is lacking regarding the coping strategies and styles of people in developing countries, including Brazil. This study aimed to adapt and validate the Brief COPE to Brazilian Portuguese (named COPE Breve) by focusing on dispositional coping. For the cross-cultural adaptation, the original Brief COPE in English (28 items grouped into 14 subscales) was adapted according to a universalistic approach, following these steps: translation, synthesis, back-translation, analysis by an expert panel, and pretest with 30 participants. Then, 237 adults from the community health service responded to the COPE Breve. Psychometric analyses included reliability and exploratory factor analysis. Most of the 14 subscales from the original Brief COPE exhibited problems related to internal consistency. A Velicer's minimum average partial test (MAP) was performed and pointed out 3 factors. Exploratory factor analysis produced a revised 20-item version with a 3-factor solution: religion and positive reframing, distraction and external support. The psychometric properties of the COPE Breve with three factors were appropriate. Limitations of this study as well as suggestions for future studies are presented. The COPE Breve should be used in Brazilian clinics and investigations, but divergences in its psychometrics should be further explored in other contexts.
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Adaptação Psicológica , Adulto , Brasil , Análise Fatorial , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , TraduçãoRESUMO
BACKGROUND: Some sedatives used in children and adolescents can affect memory function. Memory impairment of traumatic experience can minimize the chance of future psychological trauma. Knowledge about the potential of different sedatives to produce amnesia can help in the decision-making process of choosing a sedative regimen. The aim of this systematic review is to evaluate the effect of different sedatives on memory of perioperative events in children and adolescents. METHODS/DESIGN: Electronic databases and other sources, such as trial registers, gray literature, and conference abstracts will be searched. Randomized controlled trials will be included that assess memory of perioperative events in children and adolescents 2-19 years old receiving sedative drugs as premedication or as agents for procedural sedation in a medical or dental settings. The outcomes will be loss of memory after and before sedative administration (anterograde and retrograde amnesia). Two independent reviewers will perform screening, study selection, and data extraction. Disagreement at all levels will be resolved by consensus or by involving a third reviewer. Assessment of the risk of bias of included studies will be performed according to "Cochrane Collaboration's Tool for Assessing Risk of Bias in Randomized Trials." Clinical and methodological heterogeneity across studies will be evaluated to determine if it is possible to combine or not combine study results in a meta-analysis. DISCUSSION: To the best of our knowledge, there is no systematic review that specifically addresses this question. Findings from the review will be useful in the decision-making process about the best sedative for minimizing recall of the medical/dental event and possible psychological trauma. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015017559.
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Amnésia/induzido quimicamente , Sedação Consciente/métodos , Hipnóticos e Sedativos/efeitos adversos , Adolescente , Criança , Pré-Escolar , Tomada de Decisão Clínica , Humanos , Hipnóticos e Sedativos/uso terapêutico , Revisões Sistemáticas como Assunto , Adulto JovemRESUMO
OBJECTIVES: The Dental Discomfort Questionnaire (DDQ), which is an observational instrument that assesses dental pain in preschool children, has not been extensively tested for its ability to identify dental treatment needs in this population. This study aimed to explore the accuracy of the Brazilian version of the DDQ (DDQ-B) to identify preschool children needing dental treatment. METHODS: The participants were 326 children (57.7% boys), aged 15-72 months [mean 49.8, standard deviation (SD) 14.8], who were examined to assess their dental treatment needs at the same time that their parents filled out the DDQ-B. The DDQ-B median score (outcome variable) was compared to the median index of dental treatment needs or categories (nonparametric tests). The area under the receiver operating characteristic (ROC) curve (AUC) and diagnostic tests were performed to test the DDQ-B accuracy for identifying preschoolers with untreated teeth needing dental treatment. The data were analysed using SPSS 19.0, and the significance level was set at 5%. RESULTS: Overall, 326 questionnaires were completed and considered for analyses. Additionally, 63.5% of children had untreated teeth needing dental care. The median DDQ-B score, 2.0 (first-third quartile 1.0-5.0), was positively associated with the median index for needing dental care, 3.0 (0.0-5.0) (ρ = 0.49, P < 0.001). Children with more invasive intervention needs, such as pulp therapy, 5.0 (2.0-7.0), and extraction, 6.0 (4.0-8.5), had the highest DDQ-B scores (P < 0.001). The DDQ-B could identify children with more invasive dental care needs [AUC 0.86, 95% confidence interval (CI) 0.80-0.91, P < 0.001]. A score of 5 or higher was a reliable cut-off point to confirm that children who were screened with caries-related toothache by the DDQ-B do, in fact, have untreated teeth needing dental treatment, especially for pulpal care and extraction. CONCLUSIONS: The DDQ-B is an accurate observational tool for identifying preschool children with dental treatment needs; children who scored 5 or higher require dental care for more invasive procedures.
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Cárie Dentária/epidemiologia , Dente Decíduo , Odontalgia/epidemiologia , Brasil/epidemiologia , Pré-Escolar , Assistência Odontológica para Crianças/estatística & dados numéricos , Cárie Dentária/complicações , Cárie Dentária/diagnóstico , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Reprodutibilidade dos Testes , Inquéritos e Questionários , Odontalgia/diagnóstico , Odontalgia/etiologiaRESUMO
BACKGROUND: Children dental pain recognition is pointed as a priority in paediatric dentistry, but little is known about dentists' perception of pre-schoolers' dental pain. AIM: To understand paediatric dentists' viewpoint on dental pain (toothache) in pre-schoolers and to identify the associated factors. DESIGN: Mixed-methods with two phases: (i) preliminary qualitative study (focus group of paediatric dentists), with responses analysed by content analysis and (ii) quantitative survey (self-administered questionnaire answered by 223 paediatric dentists), with the main outcome 'perception' assessed as 'feel or not prepared' to identify a pre-schooler with dental pain. Triangulation was used to discuss the results of each approach. RESULTS: (i) Paediatric dentists can observe dental pain in pre-schoolers when there are normative signs; this pain is related to the changes in a child's behaviour and in dental planning. (ii) Participants were 40.1 ± 8.4 years old, 17.1 ± 8.3years since graduation, 65.9% did not feel prepared to identify a pre-schooler with dental pain. This feeling of unpreparedness was associated with younger specialists (P = 0.01) and less time since graduation (P < 0.01). Triangulation showed a convergence of the qualitative and quantitative approaches. CONCLUSION: Noticing dental pain in pre-schoolers was associated with specialists' experience and the need for visible signs; dentists do not always feel completely prepared to recognise pain in pre-schoolers.
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Atitude do Pessoal de Saúde , Relações Dentista-Paciente , Odontólogos/psicologia , Manejo da Dor , Medição da Dor , Odontalgia , Adulto , Pré-Escolar , Assistência Odontológica para Crianças , Feminino , Grupos Focais , Humanos , Masculino , Inquéritos e QuestionáriosRESUMO
Many parents rely on emergency services to deal with their children's dental problems, mostly pain and infection associated with dental caries. This cross-sectional study analyzed the factors associated with not doing an oral procedure in preschoolers with toothache attending public dental emergency services. Data were obtained from the clinical files of preschoolers treated at all nine dental emergency centers in Goiania, Brazil, in 2011. Data were children's age and sex, involved teeth, oral procedures, radiography request, medications prescribed and referrals. A total of 531 files of children under 6 years old with toothache out of 1,108 examined were selected. Children's mean age was 4.1 (SD 1.0) years (range 1-5 years) and 51.6% were girls. No oral procedures were performed in 49.2% of cases; in the other 50.8%, most of the oral procedures reported were endodontic intervention and temporary restorations. Primary molars were involved in 48.4% of cases. With the exception of "sex", the independent variables tested in the regression analysis significantly associated with non-performance of oral procedures: age (OR 0.7; 95% CI 0.5-0.8), radiography request (OR 3.8; 95% CI 1.7-8.2), medication prescribed (OR 7.5; 95% CI 4.9-11.5) and patient referred to another service (OR 5.7; 3.0-10.9). Many children with toothache received no oral procedure for pain relief.
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Assistência Ambulatorial , Assistência Odontológica para Crianças , Serviços Médicos de Emergência , Odontalgia/epidemiologia , Assistência Ambulatorial/estatística & dados numéricos , Brasil/epidemiologia , Pré-Escolar , Estudos Transversais , Assistência Odontológica para Crianças/estatística & dados numéricos , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Humanos , Lactente , Masculino , Odontalgia/etiologiaRESUMO
A atuação do cirurgião-dentista no ambiente hospitalar é uma perspectiva recente no contexto brasileiro, sendo pouco investigada e sistematicamente relatada. Este estudo descritivo retrospectivo objetivou descrever as atividades desenvolvidas por cirurgiões-dentistas residentes, inseridos em uma equipe multiprofissional de um hospital universitário de referência. Buscou-se os registros e fichas clínicas dos pacientes atendidos pelos residentes em Odontologia da área de Atenção à Saúde Materno-Infantil do Hospital das Clínicas, da Universidade Federal de Goiás, na cidade de Goiânia-GO, entre fevereiro de 2011 e julho de 2012, para caracterizar os pacientes e descrever os procedimentos odontológicos executados. Os dados foram analisados por meio de estatística descritiva. Foram atendidos 740 pacientes no período analisado e 1290 consultas odontológicas foram realizadas. Uma diversidade de alterações sistêmicas foi verificada em 29% da amostra atendida (n=207 pacientes). As atividades educativo-preventivas (n=706) foram mais frequentes do que as atividades curativas (n=66). No período analisado, as atividades multiprofissionais foram realizadas foram estudos de casos (n=18), grupos de educação em saúde (n=49) e reuniões de planejamento multiprofissional (n=17). Concluiu-se que: o cirurgião-dentista pode atuar de forma abrangente no contexto hospitalar; considerando a área materno-infantil, as atividades educativo-preventivas ocorreram em maior número do que as curativas; o cirurgião-dentista deve ser estimulado, desde a graduação, a compreender os aspectos diferencias do contexto hospitalar no planejamento do tratamento odontológico e no trabalho multiprofissional.
The responsibility of the dentist in the hospital environment is a recent perspective in the Brazilian context, and this subject is rarely systematically investigated and reported. This retrospective descriptive study aimed to describe the activities performed by dental residents, entered into a multidisciplinary team of a university hospital. We selected records of patients seen by dental residents in the area Maternal and Child Health, in the Clinical Hospital, Federal University of Goiás, Goiânia-GO, between February 2011 and July 2012, to characterize them and describe dental procedures performed. Data were analyzed using descriptive statistics. A total of 740 patients were seen in that specific period and 1,290 dental consultations were held. A variety of systemic disorders were observed in 29% of the sample (n = 207 patients). Educative-preventive activities (n = 706) were more frequent than curative activities (n = 66). Over that period, the multidisciplinary activities were case studies (n = 18), heal the education for particular groups (n = 49), and planning meetings (n = 17). We concluded that: dentists have a broad spectrum of activities in hospitals; regarding the maternal and child health, educational and preventive activities were more frequent than therapeutic ones; dentists should be encouraged since undergraduation to understand the aspects of the hospital context that influence in treatment planning and multidisciplinary work.
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Community-based educational activities have been introduced into health education programs across the world. However, research on students' perceptions of their experiences in these settings has been limited. The objectives of this study were to assess a group of Brazilian dental students' views of their experiences in a service-learning program focusing on pediatric dental care and to explore changes in their perceptions over the course of the program. Data were collected from fifty-five fourth-year dental students, who submitted a total of 185 reports at four points in time. The students spent sixteen of the 128 hours of their pediatric dentistry course in community-based education developing activities linked to pediatric dental care. Two professors rated each report as a positive or negative experience (Kappa 0.7) and recorded whether the students' reports reflected one or more of five types of response. The response types concerned dental treatment practice, multidisciplinary activities, observation of infant/toddler consultations, commitment of the outreach health team, and change of plans due to technical problems. The data showed that the students had a positive first impression after a short stay in a community-service program, but there was a decrease in the students' positive experiences over time (p<0.001). The students' perceptions of the outreach health team as "being not committed" (OR 6.82, 95 percent CI 2.12-21.90) and experiences of a "no change of plans due to technical problems" (OR 0.09, 95 percent CI 0.04-0.20) associated with negative student experiences.
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Odontologia Comunitária/educação , Educação em Odontologia/métodos , Odontopediatria/educação , Estudantes de Odontologia/psicologia , Adulto , Brasil , Relações Comunidade-Instituição , Currículo , Feminino , Humanos , Funções Verossimilhança , Modelos Lineares , Masculino , Satisfação Pessoal , Estudos Retrospectivos , Faculdades de Odontologia , Estatísticas não Paramétricas , Adulto JovemRESUMO
PURPOSE: This study, conducted in ambulatory surgical centers, was a response to queries from pediatric dentists who wondered if postoperative discomfort in their patients treated for early childhood caries under general anesthesia was related to specific dental procedures. The purpose of this study was to identify factors related to the occurrence and severity of postoperative discomfort. METHODS: Subjects were children younger than 7 years old. The faces, legs, activity, cry, consolability pain assessment tool measured discomfort immediately postoperatively; the dental discomfort questionnaire (DDQ-8) measured discomfort preoperatively and after treatment. Data was analyzed with bivariate tests and hierarchical linear multiple regression. RESULTS: Of the 160 participants (52.9±15.0 months old), approximately 51% had preoperative dental discomfort (DDQ-8 score=>3). The proportion with discomfort had significantly decreased to 27% by days 2 to 5. Immediate discomfort in recovery was influenced by number of crowns and space maintainers and inversely by the length of postoperative sleep. Dental discomfort in the first week postoperatively was predicted by amount of preoperative discomfort, length of sleep in recovery, and not resuming a regular diet on Day 1. CONCLUSION: In these children, discomfort after treatment was mild, decreased over time, and, other than immediately postoperatively, was not related to specific dental procedures.
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Anestesia Geral , Cárie Dentária/terapia , Restauração Dentária Permanente/efeitos adversos , Dor Pós-Operatória/etiologia , Instituições de Assistência Ambulatorial , Anestesia Dentária/métodos , Criança , Pré-Escolar , Coroas/efeitos adversos , Dieta , Feminino , Humanos , Modelos Lineares , Masculino , Medição da Dor , Período Pós-Operatório , Estudos Prospectivos , Sono , Inquéritos e QuestionáriosRESUMO
Objetivo: o objetivo deste estudo foi avaliar a efetividade antimicrobiana de medicações intracanal em dentina infectada de dentes decíduos e permanentes. Métodos:blocos de dentina foram inoculados com Enterococcus faecalis a cada 72 horas durante 60 dias; após, foram irrigados,secos e completamente preenchidos com uma das misturas a seguir: 1) pó de hidróxido de cálcio, própolis e propilenoglicol, 2) pó de hidróxido de cálcio e propilenoglicol,3) pó de hidróxido de cálcio e água destilada,4) própolis e propilenoglicol, 5) própolis e água destilada.Após 30 dias, as amostras foram lavadas com água destilada esterilizada, imersas em Letheen broth e incubadas por 48 horas a 37ºC. Resultados e Conclusão: a hipótese de que a associação do hidróxido de cálcio com própolis poderia ser mais eficaz do que os outros medicamentos não foi confirmada, pois os resultados indicaram que todas as misturas testadas não foram capazes de inibir o biofilme de E. faecalis, tanto nos blocos de dentina de dentes decíduos como permanentes
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Biofilmes , Hidróxido de Cálcio , Enterococcus faecalis , PrópoleRESUMO
OBJECTIVE: There is little information regarding the mesiodistal angulation of permanent teeth in mixed dentition. The aim of this study was to evaluate mesiodistal root angulation of permanent incisors, canines and first molars of 100 Brazilian children, using a new horizontal reference plane based on the midpoint of the intercuspation of primary canines and permanent first molars in panoramic radiographs during the mixed-dentition phase. MATERIAL AND METHODS: Children were equally divided between the genders with a mean age of 8.9 years (SD=0.76), normal occlusion and no eruptive disturbances. RESULTS: The angulation of the permanent maxillary first molars was close to the vertical, whereas the mandibular molars presented approximately 25 degrees of distal root angulation. The maxillary canines were the most distally angulated teeth, whereas the permanent mandibular canines were vertically positioned. The evaluation of the anterior maxillary area showed vertical position of permanent lateral, and central incisors with a slight distal angulation, whereas the permanent mandibular incisors tended to a mesial radicular convergence. CONCLUSIONS: The proposed reference line could be useful in mixed dentition root angulation evaluation; there was a slight asymmetry in the mesiodistal angulation among homologous teeth, and also a small variation between the male and the female groups, but no difference between 8-and 10-year-old children.
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Criança , Feminino , Humanos , Masculino , Dentição Mista , Raiz Dentária/anatomia & histologia , Dente/anatomia & histologia , Oclusão Dentária , Radiografia Panorâmica , Valores de Referência , Fatores Sexuais , Erupção Dentária , Raiz Dentária , DenteRESUMO
OBJECTIVE: There is little information regarding the mesiodistal angulation of permanent teeth in mixed dentition. The aim of this study was to evaluate mesiodistal root angulation of permanent incisors, canines and first molars of 100 Brazilian children, using a new horizontal reference plane based on the midpoint of the intercuspation of primary canines and permanent first molars in panoramic radiographs during the mixed-dentition phase. MATERIAL AND METHODS: Children were equally divided between the genders with a mean age of 8.9 years (SD=0.76), normal occlusion and no eruptive disturbances. RESULTS: The angulation of the permanent maxillary first molars was close to the vertical, whereas the mandibular molars presented approximately 25 degrees of distal root angulation. The maxillary canines were the most distally angulated teeth, whereas the permanent mandibular canines were vertically positioned. The evaluation of the anterior maxillary area showed vertical position of permanent lateral, and central incisors with a slight distal angulation, whereas the permanent mandibular incisors tended to a mesial radicular convergence. CONCLUSIONS: The proposed reference line could be useful in mixed dentition root angulation evaluation; there was a slight asymmetry in the mesiodistal angulation among homologous teeth, and also a small variation between the male and the female groups, but no difference between 8-and 10-year-old children.
Assuntos
Dentição Mista , Raiz Dentária/anatomia & histologia , Dente/anatomia & histologia , Criança , Oclusão Dentária , Feminino , Humanos , Masculino , Radiografia Panorâmica , Valores de Referência , Fatores Sexuais , Dente/diagnóstico por imagem , Erupção Dentária , Raiz Dentária/diagnóstico por imagemRESUMO
BACKGROUND: Anesthesia care has been provided by diverse health professionals worldwide, but little is known about anesthesiologists' views about this. Using a survey, we sought the opinions of a group of Brazilian anesthesiologists regarding nitrous oxide/oxygen and oral minimal/moderate sedation performed by dentists. METHODS: A 3-part postal questionnaire was sent to 206 physician anesthesiologists working in the state of Goias, in Central Western Brazil. Part 1 consisted of 4 questions describing respondents' characteristics: gender, time elapsed since completion of the residency program, and experience in providing sedation and general anesthesia for dental treatment. In Part 2, respondents were asked to give their opinions on 11 statements about sedation performed by dentists. Possible responses ranged from total disagreement to total agreement (minimum score = 11 and maximum score = 55). Part 3 was a section for general comments. Data were analyzed by k-means clusters, chi(2), and Student's t-test. RESULTS: The response rate was 53.8% (111 questionnaires). Most anesthesiologists (85.6%) had rarely or never provided sedation or general anesthesia for dental treatment, and 92.8% disagreed with the statement that dentists can administer moderate sedation in the dental office. Two clusters representing more favorable (n = 21) or less favorable (n = 90) opinions were established. Anesthesiologists in the "less favorable" group had more experience with dental sedation (P = 0.006) and dental general anesthesia (P = 0.008) than those in the "more favorable" group. Gender and time elapsed since residency completion did not significantly affect anesthesiologists' opinions. CONCLUSIONS: Many anesthesiologists in Central Western Brazil do not sedate dental patients and are not confident that dentists are able to do it. Dental sedation is an issue that still needs to be clarified in this region; the respective roles of physicians and dentists need to be determined to benefit the population.
Assuntos
Anestesia Dentária , Sedação Consciente , Odontólogos , Médicos , Adulto , Anestesia Dentária/efeitos adversos , Anestésicos Inalatórios , Atitude do Pessoal de Saúde , Brasil , Sedação Consciente/efeitos adversos , Interpretação Estatística de Dados , Ansiedade ao Tratamento Odontológico , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Relações Interprofissionais , Masculino , Pessoa de Meia-Idade , Óxido Nitroso , Oxigênio/administração & dosagem , Padrões de Prática Odontológica , Qualidade da Assistência à Saúde , Inquéritos e QuestionáriosRESUMO
Dental students have little understanding about medical emergencies, and there is very little in-depth data about the importance they place on this important area that is fundamental to their professional training. This study aimed to identify the perceptions of a group of undergraduate dental students about the dentistry-medical emergency interface. Twenty undergraduate dental students at the Federal University of Goias, Brazil, took part in this study. The data were collected through in-depth interviews with these students and were interpreted using qualitative content analysis. Two themes emerged from this data analysis: dentistry as a comprehensive health science, and students' knowledge, feelings, and attitudes about medical emergencies in the dental office. Based on the students' perceptions, an interface between dentistry and medical emergencies in the dental office was proposed that is comprised of the following intertwined concepts: 1) dentistry is a health science profession that should focus on the whole patient instead of being limited to the oral cavity; 2) medical emergencies do occur in the dental office, but students' minimal knowledge about these incidents and their etiology causes feelings of insecurity, dissatisfaction, and a limited appreciation of the dentists' responsibility; and 3) the inability to perform proper basic life support (BLS) technique in the dental office is the ultimate consequence. Undergraduate health courses need to develop strategies to teach professionals and students appropriate behavior and attitudes when facing life-threatening emergencies.
Assuntos
Atitude do Pessoal de Saúde , Emergências , Estudantes de Odontologia/psicologia , Adolescente , Brasil , Competência Clínica , Assistência Odontológica Integral , Consultórios Odontológicos , Educação em Odontologia , Medicina de Emergência/educação , Tratamento de Emergência , Feminino , Humanos , Entrevistas como Assunto , Cuidados para Prolongar a Vida , Masculino , Segurança , Adulto JovemRESUMO
Very little is known about mothers' beliefs concerning children's refusal of dental treatment. This qualitative study aimed to explore mothers' perceptions of their children's refusal to submit to dental treatment. Semistructured interviews were conducted with 14 mothers of 4-12-yr-old children resistant to dental treatment who were attending two pediatric dentists. Thematic content analysis was used to interpret the data. From this, three categories were developed and labeled origins of child behavior, caregiver attitudes, and the culture of resistance. The origins of the children's behavior were related to the childs' temperament, behavior disorders, lack of affection, level of development, and refusal to submit to health procedures or other situations. Caregiver's attitudes included discipline, protection, incoherence, partnership in dental treatment, and mother-child feeling. The culture of resistance referred to the parents' or guardians' refusal of dental treatment and the mothers' recognition of this. In conclusion, the wide variety of mothers' accounts reinforced the idea that every child is unique, and it is not possible to standardize child behavior models in a dental setting.