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A ozonioterapia engloba o emprego do gás no setor saúde, advindo de suas características analgésicas, imunomoduladoras, antimicrobianas e imunoestimulantes, o que possibilita que ele atue no enfrentamento de inúmeras patologias. O uso do ozônio tem ocorrido nas áreas de Medicina e de Odontologia, advindo do fato de que esse gás é empregado sob concentrações baixas, o que caracteriza esse tipo de terapia como sendo um recurso seguro, que deve proceder por intermédio da aplicação efetuada por um profissional de saúde apto e capacitado para tal. O objetivo do presente artigo foi evidenciar como a ozonioterapia pode ser aplicada em âmbito odontológico. Em Odontologia, pode-se efetuar terapia com esse gás nas áreas de Periodontia, Dentística, Cirurgia e Endodontia. Sua aplicabilidade odontológica advém de suas propriedades antimicrobianas, curativas e imunometabólicas. A ozonioterapia corretamente aplicada e selecionada para uso odontológico pode possibilitar condições de obter-se um melhor desfecho no tratamento preconizado aos pacientes.
Ozone therapy encompasses the use of gas in the health sector, arising from its analgesic, immunomodulatory, antimicrobial and immunostimulant characteristics, which allows it to act in the fight against numerous pathologies. The use of ozone has occurred in the areas of Medicine and Dentistry, arising from the fact that this gas is used at low concentrations, which characterizes this type of therapy as a safe resource, which must proceed through the application carried out by a qualified and qualified health professional. The objective of this article was to show how ozone therapy can be applied in the dental field. In Dentistry, therapy with this gas can be carried out in the areas of Periodontics, Dentistry, Surgery and Endodontics. Its dental applicability comes from its antimicrobial, curative and immunometabolic properties. Ozone therapy correctly applied and selected for dental use can enable conditions to obtain a better outcome in the treatment recommended for patients.
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Terapias Complementares , Assistência Odontológica , Odontologia , OzonioterapiaRESUMO
Os defeitos de esmalte são alterações qualitativas ou quantitativas na estrutura dentária, que originam-se de fatores sistêmicos, locais ou genéticos. A hipoplasia de Turner é um defeito na espessura do esmalte localizado cuja etiologia decorre de um traumatismo ou infecção periapical presente no dente decíduo predecessor, afetando o desenvolvimento do dente permanente. O objetivo do presente estudo foi apresentar um caso clínico de paciente infantil com dente hipoplásico de Turner em pré-molar, que tornou-se não vital sem que houvesse lesão de cárie ou trauma adicional. Em razão das características clínicas e radiográficas do dente afetado, bem como do risco de cárie e do comportamento cooperador da paciente, optou-se pela reabilitação do elemento afetado por meio de tratamento endodôntico e de restauração semidireta em resina composta. Torna-se de fundamental importância o conhecimento da etiologia e a realização de um exame clínico e radiográfico minucioso visando ao diagnóstico precoce e à elaboração de um plano de tratamento adequado para todos os defeitos de desenvolvimento do esmalte, incluindo-se a hipoplasia de Turner, cujo tratamento dependerá da severidade da alteração, do comportamento do paciente e do risco de cárie. Sugere-se a realização de estudos que associem a microestrutura do esmalte hipoplásico com a ausência de vitalidade pulpar.
Enamel defects are qualitative or quantitative changes in the tooth structure originating from systemic, local, or genetic factors. Turner's hypoplasia is a defect in the thickness of the localized enamel whose etiology arises from trauma or periapical infection in the predecessor deciduous tooth, affecting the permanent tooth's development. The objective of the present study was to present a clinical case of a child patient with a hypoplastic Turner premolar tooth, which became non-vital without the occurrence of caries, or additional trauma. Due to the affected tooth's clinical and radiographic characteristics, the risk of cavities, and the patient's cooperative behavior, it was decided to rehabilitate the affected element through endodontic treatment and semidirect restoration in composite resin. It is of fundamental importance to know the etiology and carry out a thorough clinical and radiographic examination aiming at early diagnosis and the development of an adequate treatment plan for all enamel developmental defects, including Turner's hypoplasia, whose treatment will depend on the severity of the change, the patient's behavior and the risk of caries. Studies are suggested to be carried out that associate the microstructure of hypoplastic enamel with the absence of pulp vitality.
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Humanos , Feminino , Criança , Planejamento de Assistência ao Paciente , Reabilitação , Dente Pré-Molar , Assistência Odontológica , Hipoplasia do Esmalte DentárioRESUMO
OBJECTIVE: To assess the influence of conservative or invasive treatments on the appearance of sequelae in permanent successor teeth (SPT) after injuries in the support tissues of anterior deciduous teeth (ISTDT). METHODS: This cohort study accompanied 52 children with ISTDT up to the complete eruption of the permanent successor to investigate the presence or not of SPT. Trauma was clinically evaluated according to the International Association for Dental Traumatology. Sex, age at the time of trauma (ATT), type and severity of trauma, sequelae in anterior deciduous teeth (SDT), treatment type (conservative-without exodontia/ invasive-with exodontia), seeking care (immediate/late), and the caregiver's education level (CEL) were collected. Regression models were performed (p = 0.05). RESULTS: Of the children (ATT = 3.6 ± 1.5 years), boys (52/57.1%) were the majority. The teeth (n = 91) injuries were lateral luxation (26/28.6%), intrusion (22/24.1%), concussion (20/22.0%), subluxation (19/20.9%), and extrusion (4/4.4%), that affected only incisors. Most teeth (63/69.2%) received late care, presented SDT (62/68.1%) and were treated conservatively (73/80.2%). There was no association of sex (p = 0.611), SDT (p = 0.705) and seeking care (p = 0.800) with SPT. The treatment type did not influence the SPT occurrence (p = 0.923), independent of the ATT, trauma severity and the educational level of the caregiver. The lower the ATT (p = 0.026) and the more severe the trauma (p = 0.009), the higher the number of SPT. CONCLUSION: The treatment type of anterior deciduous teeth, mainly considering incisors, did not influence the appearance of SPT, which leads us to always choose the most conservative treatment, independent of the child's age, the injury severity, and the caregiver's educational level.
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PURPOSE: To access and synthesize the existing literature about the effects of compassionate care on oral health outcomes. METHODS: A scoping review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify articles from six electronic databases: MEDLINE via the PubMed interface, Embase, Age-Line, Scopus, CINAHL, and Cochrane. RESULTS: Among 30 studies reporting on compassion in dental treatment, only two reported on the effects of compassionate care on oral health outcomes. One study is cross-sectional and evaluated oral health outcomes in children, while the other is a cohort study evaluating oral health outcomes in older adults. Each study used different tools to assess oral health outcomes. However, both studies used the Jefferson Scale of Physician Empathy (JSPE) to assess empathy among dental students, dentists, or dental hygienists. CONCLUSION: The retrieved studies used different methodologies and had discrepant results. More clinical studies investigating the effects of compassionate care on the outcomes of dental treatment are necessary.
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Empatia , Saúde Bucal , Humanos , Assistência OdontológicaRESUMO
OBJECTIVE: Engagement in preventive dental care is a complex health behaviour and is determined by multiple factors. The study aimed to understand the association of psychosocial determinants with poor dental attendance. METHODS: Survey data from 333 Mexican-identifying adults in California aged 21-40-year were analysed. Poor dental attendance was a composite of time since last dental visit and reason for visit. Responses of 'more than 1 year ago' for last dental visit, or 'something was wrong, bothering or hurting/emergency dental problem' as the reason for last dental visit were categorised as poor dental attendance. Psychosocial determinants including dental anxiety assessed using the Modified Dental Anxiety Scale, participant reported quality of provider interactions, and perceived social support were assessed. Logistic regression analyses examined associations after accounting for covariates. RESULTS: Over half (58%) had poor dental attendance. Among those with poor dental attendance, 22% had high dental anxiety, 41% perceived low quality of dental explanation, and 48% reported provider occasionally/never checked patient understanding. Participants with high anxiety had twice the odds of poor dental attendance (OR = 2.07, 95% CI = 1.01-4.22) than those with low dental anxiety. Additionally, those reporting that providers did not explain oral health status or treatments well had two times higher odds of poor dental attendance than those reporting adequate explanation (OR = 2.06, 95% CI = 1.11-3.83). Checking patient understanding or perceived social support was not significantly associated with dental attendance. CONCLUSION: Dental anxiety and poor provider interactions affect use of dental services. Interventions targeting dental staff should prioritise enhancing communication skills and checking patient understanding to improve their dental attendance.
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Abstract Telehealth, the use of telecommunications technology and electronic information to aid in healthcare delivery, has revolutionized patient care. Health communities have already approved telemedicine for treating certain acute and chronic diseases, while teledentistry has emerged as a distinct field within the broader scope of telemedicine. Numerous trials have demonstrated the value of teledentistry in reducing dental expenses and expanding dental care access to remote and rural areas. With technological advancements, teledentistry holds the potential to further enhance dental services and patient care. The COVID-19 pandemic has brought healthcare to the forefront of public concern. The need for close face-to-face contact with patients largely led to the suspension of dentistry services. However, the increased use of cell phones and related software packages integrated into "teledentistry" has facilitated easier clinical data exchange between patients and clinicians. This technology proved invaluable for dentists managing dental emergencies during lockdowns, providing an innovative means to resume dental practice. As a result, integrating teledentistry into routine dental practice as a complement to the existing dental system is advisable. It has the potential to revolutionize dental care for the better by expanding access to care and decreasing expenses. Given these circumstances, this review discusses the value and implications of teledentistry, highlighting its potential as a game- changing solution for the dental industry.
Resumen La tele salud, el uso de la tecnología de telecomunicaciones e información electrónica para ayudar en la prestación de atención médica, ha revolucionado la atención al paciente. Las comunidades sanitarias ya han aprobado la telemedicina para el tratamiento de ciertas enfermedades agudas y crónicas, mientras que la teledentología ha surgido como un campo distinto dentro del alcance más amplio de la telemedicina. Numerosos ensayos han demostrado el valor de la teledentología en la reducción de los gastos dentales y la ampliación del acceso a la atención dental en las zonas remotas y rurales. Con los avances tecnológicos, la teledentología tiene el potencial de mejorar aún más los servicios dentales y la atención al paciente. La pandemia de COVID-19 ha puesto a la atención de la salud en el primer plano de la preocupación pública. La necesidad de un contacto cercano cara a cara con los pacientes condujo en gran medida a la suspensión de los servicios odontológicos. Sin embargo, el aumento del uso de teléfonos celulares y paquetes de software relacionados integrados en la "teledentistry" ha facilitado el intercambio de datos clínicos entre pacientes y médicos. Esta tecnología resultó inestimable para los dentistas que gestionan emergencias dentales durante los bloqueos, proporcionando un medio innovador para reanudar la práctica dental. Por consiguiente, es aconsejable integrar la teledentología en la práctica dental de rutina como complemento del sistema dental existente. Tiene el potencial de revolucionar la atención dental para el mejor, ampliando el acceso a la atención y disminuyendo los gastos. Dadas estas circunstancias, esta revisión discute el valor y las implicaciones de la teledentología, destacando su potencial como una solución que cambia el juego para la industria dental.
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Hereditary Spherocytosis (HS) is a type of hemolytic anemia characterized by a defect in the membrane of red blood cells, which causes them to assume a spherical shape, become osmotically fragile, and be prone to early hemolysis. While it is relatively well understood in the medical field, there is limited evidence regarding the dental management of patients with this condition. Therefore, this report aims to present a case involving the extraction of permanent teeth before splenectomy in a child with HS who had been hospitalized. Additionally, treatment guidelines for these patients are proposed and developed. The patient was scheduled to undergo a total splenectomy due to splenomegaly resulting from severe hemolytic anemia. Prior to the surgery, the child was referred to the hospital's dental clinic with a chief complaint of dental pain. An intraoral examination revealed carious lesions with pulpal involvement in the first molars, and extraction was recommended to minimize the risk of post-splenectomy infection. Hematological support was provided during dental treatment since partial control of the anemia was necessary for the extraction procedure. Developing dental treatment guidelines for patients with HS is essential to ensure their safety.
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Esferocitose Hereditária , Esplenectomia , Extração Dentária , Humanos , Esferocitose Hereditária/cirurgia , Esferocitose Hereditária/complicações , Esplenectomia/métodos , Criança , Masculino , Assistência Odontológica para Doentes Crônicos , Guias de Prática Clínica como Assunto , Cárie Dentária/terapia , Cárie Dentária/cirurgia , FemininoRESUMO
This study aimed to determine the time elapsed since the last dental care visit and its associated factors among older adults in Peru from 2019 to 2021. This was an analytical cross-sectional study utilizing secondary data analysis. The population comprised 210,862 records of older adults from 2019 to 2021, with a final sample of 11,215 records. The dependent variable was the time elapsed since the last dental care visit, while the independent variable was the year, with population characteristics included as covariates. Both bivariate and multivariate analyses were employed. The mean time elapsed since the last dental care visit was 7.93 years (SD = 8.03) in 2019, 7.93 years (SD = 7.28) in 2020, and 7.76 years (SD = 8.01) in 2021, with non-statistically significant difference between medians (p = .050). Hierarchical multiple linear regression analysis indicated that a model incorporating year, health, geographic, and socio-demographic characteristics demonstrated a greater determination coefficient (R 2% = .90) and validity (p < .001). The mean time elapsed since the last dental care visit among older adults in Peru was 7.93 years in both 2019 and 2020, and 7.76 years in 2021; geographic characteristics, wealth index, and age were identified as associated factors.
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Purpose: An association between the use of chlorhexidine in mechanically ventilated patients for the purpose of oral hygiene and the prevention of ventilator-associated pneumonia (VAP) lacks conclusive evidence in the literature. Therefore, this study aims to assess the clinical impact of such practice. This evaluation will consider that retention factors, infection foci, and oral biofilm will be regularly removed by a dentist. Patients and Methods: In this retrospective cohort study, a comparison was made between two groups, one using chlorhexidine and the other using saline solution. Patients from both groups included in this study were admitted between January 2016 to March 2018. Data such as the incidence of VAP, duration of mechanical ventilation (DMV), length of stay (LOS), and mortality rate (MR) were collected and compared between the groups. Only patients aged 18 or older, under mechanical ventilation for more than 48 consecutive hours were included. Were excluded from this study patients with a diagnosis of VAP or other pulmonary infection upon admission or within the first 48 hours of hospitalization. Also not included were those who stayed in the ICU for less than 48 hours. Dental treatment was carried out addressing the regular removal of retention factors, potential oral infection foci, and oral biofilm by a dentist. Additionally, at each appointment, the visible biofilm was removed by the dentist themselves, and the maintenance of oral hygiene was performed daily by the nursing staff. For the statistical analysis the non-parametric Mann-Whitney test was used for comparisons between groups regarding LOS and DMV. Additionally, the associations between groups and VAP, outcomes (discharge or death), and diseases were analyzed using the chi-square test and Fisher's exact test. A significance level of 5% was assumed. Results: In both evaluated groups, each consisting of 36 patients, the incidence of VAP was identical at 2.8%. Specifically, the chlorhexidine group had an incidence of 2.105 VAP cases per 1000 days of mechanical ventilation (MV), while the placebo group had 2.865 VAP cases per 1000 days of MV (p = 1.000). No significant difference between groups regarding LOS (p = 0.5694) and DMV (p = 0.1136) was found. There was also no significant association between the MR in the two groups (47.2% chlorhexidine, 36.1% placebo) (p=0.3390). Conclusion: When intensive oral care is performed, the use of chlorhexidine shows no significant change in VAP incidence, MR, LOS, and DMV. Therefore, the dentist, as part of the multiprofessional team, should decide on its use.
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OBJECTIVES: To describe the trends in antibiotic prescribing by dental practitioners and to investigate the relationship between these trends and some factors of public oral health services in Minas Gerais (MG), Brazil. METHODS: This was a time-series analysis of antibiotics prescribed by dental practitioners between January 2011 and December 2021. The outcome variables were number of defined daily doses (DDD) and DDD/1000 population/year in a sample of cities in MG. Covariates were public oral healthcare factors, such as coverage, estimates of dental procedures, and frequency of dental pain. Linear time-series regression models were used to examine trends and the influence of covariates on antibiotic prescribing. RESULTS: Overall, the number of prescriptions increased by 334.69% between 2011 and 2021, with amoxicillin being the most commonly prescribed drug (78.53%). The number of DDD for all antibiotics increased from 17,147.13 to 77,346.67 and the average DDD/1000 inhabitants/year was 126.66 (SD: 130.28). The linear time-series regression model showed that for each one-year increase, the average log DDD/1000 inhabitants increased by 0.35 (standard error = 0.07, p < 0.001). No covariates were found to be associated with the outcome. CONCLUSIONS: In Minas Gerais, Brazil, a significant upward trend was observed in the number of prescriptions and the number of DDD of antibiotics prescribed by dental practitioners. No influence of factors related to public oral healthcare services on the outcome was observed, thereby emphasizing the need for further research on factors influencing medication use in dental practice.
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Antibacterianos , Padrões de Prática Odontológica , Brasil/epidemiologia , Antibacterianos/uso terapêutico , Humanos , Padrões de Prática Odontológica/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Odontólogos/estatística & dados numéricosRESUMO
OBJECTIVE: To verify whether factors associated with Autism Spectrum Disorder (ASD) would have impact on the dental-caries prevalence. MATERIALS AND METHODS: All ASD-individuals receiving care in a specialized center with minimum of 4y old were recruited. Demographic, socioeconomic and behavioral characteristics, level of support/commitment (Childhood Autism Rating Scale), mealtime behavior (Brief Autism Mealtime Behavior Inventory) and medication use were answered by ASD-individual's parents. Behavior during dental care was evaluated from Frankl scale. Dental-caries prevalence was the primary outcome. Three examiners calibrated/trained collected the data. Chi-square test was used to compare the variables impact on the dental-caries prevalence. RESULTS: 61 ASD-individuals were potentially eligible, and the all parents/guardians consent to participate. Dental-caries prevalence was 42.9%, which was statistically associated with lower toothbrushing frequency, higher level of support/commitment, and worse behavior at meals and during in dental care. Dental-caries prevalence was approximately higher twice in ASD-individuals: (i) uncooperative with dental care when compared those cooperative (62% versus 32%, respectively); (ii) with severe level of support when compared to those with mild/moderate level (58% versus 28%, respectively); and (iii) with worse mealtime behavior when compared to those with better behavior (59% versus 28%, respectively). A medium statistical correlation was observed between support level and mealtime behavior (rS=0.39). The BAMBI component statistically associated with dental-caries prevalence was the food refusal (capture problem when a child rejects a presented food, crying, spitting out food). CONCLUSION: higher required level of support, worse mealtime behavior and uncooperative profile in dental care negatively affect the dental-caries prevalence. CLINICAL RELEVANCE: our findings provide evidence of the need of specialized, preventive and individualized dental care among ASD-individuals.
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Transtorno do Espectro Autista , Cárie Dentária , Humanos , Estudos Transversais , Prevalência , Feminino , Masculino , Cárie Dentária/epidemiologia , Pré-Escolar , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologia , Refeições , Comportamento Alimentar , Inquéritos e Questionários , Assistência OdontológicaRESUMO
The present study aimed to compare the prevalence of oral problems between individuals with rare genetic diseases that affect skeletal development and individuals without rare diseases. A cross-sectional study was conducted with 210 individuals between two and fifty-four years of age: 105 with rare genetic diseases (27 with mucopolysaccharidosis [MPS] and 78 with osteogenesis imperfecta [OI]) and 105 without rare diseases. The rare genetic disease group was recruited from hospital units that provide care for patients with MPS and OI in five states of Brazil, and the other group was recruited from the same location. The participants were examined with regards to malocclusion, dental anomalies, dental caries, and gingivitis. A questionnaire was administered addressing individual, sociodemographic, and behavioral characteristics as well as dental history. A descriptive analysis was performed, followed by unadjusted and adjusted binary logistic regression analyses. The mean age was 14.1 ± 12.2 years. Individuals with a rare disease were 12.9-fold more likely to have some type of oral problem (95% CI: 3.7-44.7) compared to the group without rare diseases. The prevalence of oral problems was higher among Brazilians with MPS and OI compared to normotypical individuals.
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Osteogênese Imperfeita , Doenças Raras , Humanos , Brasil/epidemiologia , Masculino , Feminino , Adulto , Estudos Transversais , Criança , Pré-Escolar , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Osteogênese Imperfeita/epidemiologia , Osteogênese Imperfeita/genética , Prevalência , Doenças Raras/epidemiologia , Doenças Raras/genética , Mucopolissacaridoses/epidemiologia , Mucopolissacaridoses/genética , Doenças da Boca/epidemiologia , Má Oclusão/epidemiologia , Cárie Dentária/epidemiologiaRESUMO
OBJECTIVE: To explore older adults' perceptions, motivations and reasons for using and not replacing old and worn complete dentures over prolonged periods. MATERIALS AND METHODS: In-depth, semi-structured interviews were conducted with Brazilian edentulous older adults who were wearing complete dentures which were at least 20 years old. A purposive sampling method was used to recruit participants from an existing waiting list of those referred to a hospital clinic for new dentures. The interviews were video-recorded, transcribed verbatim and analysed using thematic analysis. RESULTS: Sixty-two individuals were assessed and nine were included in the study, aged from 61 to 77 years (mean = 65.4), with seven (77.8%) of them women. The reported time using their current dentures ranged from 22 to 45 years (mean = 28). Content analysis revealed three main themes: the perception of the current dentures' condition after prolonged use; reasons for the prolonged use and non-replacement; and unsuccessful attempts to replace the dentures. Overall, participants acknowledged the poor condition of their dentures and did recognise the need for replacement. Several factors had prompted them to delay or temporarily forego replacement, with financial constraints being the main barrier. Some reported failed attempts to replace the dentures in the past years or months; however, challenging adaptation to the new prostheses led to them reverting back to their old dentures as a fallback solution. CONCLUSION: Factors influencing prolonged denture use in older adults include a complex interplay of financial aspects, treatment awareness, access and personal factors. Dental professionals can play a pivotal role in promoting timely denture adjustment or replacement by addressing these factors through patient education and personalised care.
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Introdução:A inserção das equipes de saúde bucal na Estratégia Saúde da Família, embora tardia, representa um avanço significativo para a ampliação da cobertura e da qualidade dos serviços odontológicos no Brasil. No entanto, aindaexistem muitosdesafiosnas práticas do cirurgião-dentista na Estratégia Saúde da Família. A atuação majoritariamente clínica prejudica a realização deum trabalho humanístico, resolutivo, interdisciplinar e multiprofissional. Objetivo:Relatar a experiência de atuação de uma cirurgiã-dentista residente na Atenção Primária em Saúde no município de Santo Estêvão, Bahia, Brasil, durante o Programa de Residência Multiprofissional em Saúde da Família da Universidade Estadual de Feira de Santana. Metodologia:Trata-se de um estudo qualitativo, do tipo relato de experiência, que visa descrever as atividades desenvolvidas durante o Programa de Residência Multiprofissional em Saúde da Família, da Universidade Estadual de Feira de Santana, no município de Santo Estêvão, Bahia, Brasil, no período de março de 2022 a novembro de 2023. Resultados:As atividades descritas abrangem as diferentes possibilidades de trabalho do cirurgião-dentista na Atenção Primária, envolvendo ações assistenciais através das consultas individuais e levantamento epidemiológico, educação permanente e em saúde com atuação nos grupos operativos e capacitações com os profissionais da rede e as ações de planejamento e gestão, através do desenvolvimento de estratégias para fortalecer a rede de atenção à saúde. Conclusões:É preciso motivar os profissionais de saúde bucal a repensarem suas práticas, tendo como ponto de partida o investimento e o estímulo à educação permanente e continuada. A especialização em saúde da família permite que cirurgiões-dentistas que atuam ou têminteresse em trabalhar no serviço público desenvolvam habilidades e práticas voltadas para uma assistência integral e multiprofissional da saúde, contribuindo para a consolidação do Sistema Único de Saúde (AU).
Introduction:The oral health team inclusion in the Family Health Strategy represents a significant advance in expanding the coverage and quality of dental services in Brazil. However, there arestill many challenges in the dental surgeons practices in the Family Health Strategy. The ppredominantly clinical approach hinders the achievement of ahumanistic, problem-solving, and interdisciplinary and multidisciplinary. Objective:To report the experience of a dental surgeon resident in Primary Health Care in the city of Santo Estêvão, Bahia, Brazil, during the Multidisciplinary Residency Program in Family Health at the Universidade Estadual de Feira de Santana. Methodology:This is a qualitative study, experience report type, which aims to describe the activities developed during the Multidisciplinary Residency Program in Family Health at the Universidade Estadual de Feira de Santana, in the city of Santo Estêvão, Bahia, Brazil, from March 2022 to November 2023. Results:The activities described cover the different work possibilities of dental surgeons in Primary Care, involving assistance actions through individual consultations and epidemiological surveys, ongoing health education with work in operative groups and training with network professionals, and planning and management actions through the development of strategies to strengthen the health care network. Conclusion:It is necessary to motivate oral health professionals to rethink their practices, with investment and encouragement for permanent and continuing education as a starting point. Specialization in family health allows dental surgeons who work or are interested in working in the public service to develop skills and practices aimed at comprehensive and multidisciplinary health care, contributing to the consolidation of the Unified Health System (AU).
Introducción: La inclusión de los equipos de salud dental en la Estrategia de Salud Familiar, aunque tardía, representa un avance significativo en la ampliación de la cobertura y la calidad de los servicios dentales en Brasil. Sin embargo, los cirujanos dentistas siguen enfrentándose a muchos retos em la Estrategia de Salud Familiar. El enfoque mayoritariamente clínico obstacualiza la realización de um enfoque humanista, resolutivo, interdisciplinario y multiprofesional.Objetivo:Reportar la experiencia de un cirujano dentista residente en Atención Primaria de Salud en el ayuntamiento de Santo Estêvão, Bahía, Brasil, durante el Programa de Residencia Multiprofesional en Salud Familiar de la Universidad Estadual de Feira de Santana.Metodología:Se trata de un estudio cualitativo, del tipoinforme de experiencia, que tiene como objetivo describir las actividades desarrolladas durante el Programa de Residencia Multiprofesional en Salud Familiar de la Universidad Estadual de Feira de Santana, en el ayuntamiento de Santo Estêvão, Bahía, Brasil, de marzo de 2022 a noviembre de 2023. Resultados:Las actividades descritas abarcan las diferentes posibilidades de trabajo del cirujano dentista en la Atención Primaria, implicando actividades asistenciales mediante consultas individuales y encuestas epidemiológicas, educación sanitaria continuada con actuación en los grupos operativos y capacitaciones con los profesionales de la red y actividades de planificación y gestión mediante el desarrollo de estrategias de fortalecimiento de la red de atención sanitaria.Conclusiones:Es necesario motivar a los profesionales de la salud dental a replantear sus prácticas, con la inversión y el fomento de la formación permanente y continua como punto de partida. La especialización en salud familiar permite a los cirujanos dentistas que trabajan o están interesados en trabajar en el servicio público desarrollar competencias y prácticas dirigidas a la atención sanitaria integral y multiprofesional, contribuyendo a la consolidación del Sistema Único de Salud (AU).
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Humanos , Feminino , Assistência Odontológica , Odontólogos , Equipe de Saúde Bucal , Internato e Residência , Atenção Primária à Saúde , Estratégias de Saúde Nacionais , Pesquisa QualitativaRESUMO
Introducción: La salud bucal en niños es esencial para su desarrollo, habla, nutrición y autoestima. Además, previene problemas odontológicos graves en la edad adulta y evita costosos tratamientos futuros. Objetivo: Determinar el nivel de conocimiento, actitud y práctica sobre salud oral en niños de 6 a 12 años de una escuela del área metropolitana de Asunción. Resultado: Participaron 202 niños, donde el 51,0% correspondió al sexo masculino, con edad media de 9 ± 4,24 años. El 55% de los niños presentó gingivitis. El 35,6% posee caries en dientes primarios mientras que el 48,9% presenta caries en dientes permanentes. El 98,02% de los participantes respondió correctamente la pregunta sobre alimentos perjudiciales para los dientes. Sobre la práctica de higiene bucal, en la mayoría de los niños la enseñanza de la técnica de cepillado estuvo a cargo de los padres, sin embargo, reportan que estos no siempre los controlan. Conclusión: Los niños tuvieron buen conocimiento, actitud positiva y prácticas adecuadas de higiene bucal, sin embargo, la mitad de ellos presentaba caries en dientes permanentes. Se sugiere que la falta de supervisión diaria por parte de los padres en la técnica de cepillado podría ser un factor contribuyente.
Introduction: Oral health is crucial for children's development, speech, nutrition, and self-esteem. Maintaining good oral health during childhood prevents serious dental issues in adulthood and reduces the need for costly treatments later on. Objective: To assess the knowledge level, attitudes, and practices regarding oral health among children aged 6 to 12 years at a school located in the metropolitan area of Asunción. Results: A total of 202 children participated in the study, of whom 51.0% were male, with a mean age of 9 years (SD = 4.24 years). Approximately 55% of the children had gingivitis. Primary teeth cavities were present in 35.6% of the participants, while 48.9% had cavities in their permanent teeth. Regarding dietary knowledge, 98.02% of the participants correctly identified foods harmful to dental health. Most children learned brushing techniques from their parents; however, consistent parental supervision was reportedly lacking. Conclusion: Despite demonstrating good knowledge and generally adequate oral hygiene practices, nearly half of the children had cavities in their permanent teeth. The data suggest that the lack of regular parental supervision of brushing techniques could be a significant contributing factor to dental caries.
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BACKGROUND: To assess the reporting of the certainty of the evidence using the GRADE approach in systematic reviews of interventions in pediatric dentistry. METHODS: The inclusion criteria were systematic reviews of randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs) in pediatric dentistry that reported the certainty of the evidence through the GRADE approach. Paired independent reviewers screened the studies, extracted data, and appraised the methodological quality using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool. The certainty of the evidence was extracted for each outcome. A descriptive analysis was conducted. RESULTS: Around 28% of pediatric dentistry reviews of interventions used the GRADE approach (n = 24). Twenty reviews reported 112 evidence outcomes from RCTs and 13 from NRSIs using GRADE evidence profile tables. The methodological quality was high (16.7%), moderate (12.5%), low (37.5%), and critically low (33.3%), fulfilling the majority of the AMSTAR 2 criteria. The certainty of the evidence for outcomes generated from RCTs and NRSIs was very low (40.2% and 84.6%), low (33.1% and 7.7%), moderate (17.8% and 7.7%), and high (9.8% and 0.0%). The main reasons to downgrade the certainty were due to (for RCTs and NRSIs, respectively): risk of bias (68.8% and 84.6%), imprecision (67.8% and 100.0%), inconsistency (18.8% and 23.1%), indirectness (17.8% and 0.0%), and publication bias (7.1% and 0.0%). CONCLUSION: The proportion of systematic reviews assessing the certainty of the evidence using the GRADE approach was considered small, considering the total initial number of published pediatric dentistry reviews of intervention. The certainty of the evidence was mainly very low and low, and the main problems for downgrading the certainty of evidence were due to risk of bias and imprecision. REGISTRATION: PROSPERO database #CRD42022365443.
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Odontopediatria , Humanos , Abordagem GRADE , Revisões Sistemáticas como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Odontologia Baseada em Evidências , Projetos de Pesquisa/normas , Literatura de Revisão como Assunto , CriançaRESUMO
INTRODUCTION: Medication-associated osteonecrosis of the jaws (MRONJ) is characterized by the presence of exposed bone or an intraoral or extraoral fistula in the maxillofacial region in patients with a history of treatment with anti-resorptive and anti-angiogenic drugs, such as monoclonal antibodies, and without a history of radiotherapy or metastatic diseases in the area. OBJECTIVE: The aim of this study is to report a case of a pathological mandibular fracture in an area of MRONJ in a patient diagnosed with Crohn's disease treated with infliximab. CASE REPORT: A 53-year-old male patient, an active smoker for 35 years, diagnosed with Crohn's disease, undergoing intravenous administration of infliximab 300 mg for 1 year and 3 months, with no previous history of anti-angiogenic or anti-resorptive medication, presenting with an extraoral fistula in the submandibular region for 4 months, with painful symptoms, diagnosed as MRONJ. He was initially treated conservatively, using antimicrobial photodynamic therapy (aPDT), antibiotic therapy, and the PENTO protocol. However, the patient evolved with a pathological fracture in the mandibular parasymphysis, requiring surgical reconstruction. FINAL CONSIDERATIONS: Pathological fracture of the mandible is a complication of MRONJ that compromises the patient's quality of life. The management of patients with MRONJ is complex and challenging.
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Infliximab , Fraturas Mandibulares , Osteonecrose , Humanos , Masculino , Pessoa de Meia-Idade , Infliximab/uso terapêutico , Infliximab/efeitos adversos , Osteonecrose/induzido quimicamente , Osteonecrose/terapia , Doença de Crohn/tratamento farmacológicoRESUMO
AIMS: This study aims to assess the concordance between in-person clinical and virtual oral examinations among hospitalized older adults. METHODS: A single examiner performed an in-person clinical examination, recorded systemic health history and oral health indices, clinically documented the Bedside Oral Exam (BOE), and captured photographs for subsequent analysis during a virtual examination. Following a 90-day washout period, a virtual examination was repeated by the same examiner and by a second examiner. Descriptive analysis and a Kappa test were used to compare proportions and evaluate the agreement between results. RESULTS: Intra-examiners presented high percentage of agreement in all domains of BOE (80%-86%), with an exception for gingiva (78%). Kappa's intra-examiners presented moderate scores in saliva, mucous membrane, gingiva and teeth/dentures domains and a strong score in the tongue domain (0.839). Inter examiners presented moderate agreement in lips and gingiva, saliva, mucous membrane, and teeth/dentures domains. Inter examiners Kappa scores were weak for lips (0.395) and gingiva (0.498) domains; moderate for saliva (0.703), mucous membrane (0.769) and teeth/dentures (0.714) domains and strong for the tongue domain (0.872). CONCLUSION: In this study, a moderate level of agreement was observed between clinical and virtual oral examinations among older hospitalized patients. These findings are encouraging and warrant further investigation about how teledentistry can be used to enhance oral health access to this vulnerable population.
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Telemedicina , Humanos , Idoso , Feminino , Masculino , Idoso de 80 Anos ou mais , Assistência Odontológica para Idosos , Odontologia Geriátrica , Hospitalização , Diagnóstico Bucal , Avaliação Geriátrica/métodosRESUMO
PURPOSE: This study aimed to examine health-related quality of life (HRQoL) in head and neck cancer patients at 1 and 5 years after successful treatment of their tumors, and to explore the usefulness of 2 instruments for assessing the need of dental care services. METHODS: This cross-sectional pilot study included 20 adult patients with head and neck cancer who completed the Functional Assessment of Cancer Therapy-Head and Neck (FACT H&N) Symptom Index and the European Organization for Research and Treatment of Cancer Quality of Life Head and Neck Module (EORTC QLQ-H&N43) after 1 and 5 years of treatment. RESULTS: Mean (standard deviation, SD) scores of the FACT H&N Symptom Index were higher (better HRQoL) at 5 years than at 1 year (24.1 [4.4] vs. 21.1 [6.4]; p = 0.236). Only three of the ten items of FACT H&N (swallow, pain in mouth/throat or neck, and solid foods) evaluated oral health. In the EORTC QLQ-H&N43 questionnaire, scores were lower at 5 years (better HRQoL) in almost all multi- and single-item symptoms. This questionnaire includes four multi-item scales (pain in the mouth, social eating, swallowing, and problems with teeth) measuring dental and orthodontic needs. CONCLUSION: HRQoL in patients with head and neck cancer improved with the length of follow-up. The EORTC QLQ-H&N43 has more items addressing oral health compared to the FACT H&N Symptom Index and may be more adequate to assess the need of dental therapy in clinical practice.
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AIM: The aim of this study was to evaluate outpatient and inpatient dental care for patients with disabilities from 2014 to 2023. MATERIAL AND METHODS: A time series analysis was carried out with data from Brazil's public healthcare system, considering the outpatient productivity of Special Needs Dentistry specialists and hospitalizations (inpatient admissions) of patients with disabilities for dental procedures, both normalized to every 100,000 inhabitants (incidence). The significance level was set at 5%. RESULTS: In the last 10 years, 22,420,859 procedures were carried out and 89,380 hospitalizations were approved. Trend analysis showed no significant temporal variation in the incidence of both variables. Regarding the procedures, the majority were low-complexity (82.1%, p < .001) and clinical (71.2%, p < .001). Periodontal (19.9%) and restorative (19.5%) procedures were the most frequent. Considering the hospitalizations, almost (R$) 40 million was allocated, and the majority were classified as elective (71.9%, p = .002) and of short duration (less than a day). CONCLUSION: Dental care for patients with disabilities presented patterns related to the types of procedures, complexity and circumstance, in addition to not showing significant temporal variation over the last 10 years.