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A ansiedade do responsável pode ser um fator determinante na ansiedade infantil durante a prática odontológica, levando a criança a apresentar comportamentos não colaborativos. Objetivou-se identificar a ansiedade dos responsáveis de pacientes com deficiência ­ Grupo 1 (G1) - atendidos na FOUFRJ, diante do tratamento odontológico de seus filhos, sua relação com Traço e Estado de ansiedade e com o comportamento na consulta, comparando com responsáveis de pacientes sem deficiência ­ Grupo 2 (G2). 128 responsáveis (64 do G1 e 64 do G2) responderam a 3 questionários: 2 validados (Escala de Ansiedade Odontológica (DAS) e Inventário de Ansiedade Traço/Estado) e o terceiro criado pela autora para coleta de dados pessoais e relacionados a percepção de ansiedade frente ao atendimento odontológico do filho (Kappa = 0,96). A maioria do G1 (93,79%) e do G2 (90,63%) era do sexo feminino, com média de idade similar. O comportamento negativo foi mais frequente no G1 com 31,2% contra 9,49% no G2 (p=0,002, Qui²). Ansiedade na 1ª consulta foi relatada em 54,7% no G1 e 48,4% no G2, tendo essa persistindo nas consultas posteriores em 20% do G1, no qual teve médias de DAS (p=0,002) e Estado (p=0,001) maiores nos mais ansiosos; e em 19,6% do G2, com maiores média de Estado (p=0,02) nos mais ansiosos. O comportamento ruim não foi relacionado a maiores valores DAS, Traço ou Estado, mas, nos que permanecem ansiosos, 63,6% das crianças tiveram comportamento ruim no G1 contra 15,4% no G2 (p=0,033). Responsáveis por pacientes com e sem deficiência apresentam ansiedade odontológica semelhante, no entanto a presença de um comportamento ruim está relacionada a ansiedade de responsáveis apenas no grupo dos pacientes com deficiência. (AU)

The caregiver's anxiety can be a determining factor in childhood anxiety during dental practice, leading the child to exhibit non-collaborative behaviors. The objective of this study was to identify the anxiety of those caregivers of patients with disabilities - Group 1 (G1) - treated at the School of Dentistry of the Federal University of Rio de Janeiro, about their children's dental treatment, the relationship with Trait and State anxiety, and with the behavior at the appointment, comparing it with caregivers of non-disabled patients - Group 2 (G2). 128 guardians (64 from G1 and 64 from G2) answered three questionnaires: two validated (Dental Anxiety Scale (DAS) and State-Trait Anxiety Inventory) and the third created by the author to collect personal and related data about the perception of anxiety regarding the child's dental care (Kappa = 0.96). The majority of G1 (93.79%) and G2 (90.63%) were female, with a similar mean age. The negative behavior was more frequent in G1 with 31.2% against 9.49% in G2 (p = 0.002, Qui²). Anxiety in the first visit was reported in 54.7% in G1 and 48.4% in G2, persisting in subsequent visits in 20% of G1, in which the mean DAS (p = 0.002) and State (p = 0.001) was higher in the more anxious; and in 19.6% of G2, with the highest mean State (p = 0.02) in the most anxious. The bad behavior was not related to higher DAS, Trait or State values, but in those who remain anxious, 63.6% of the children had a bad behavior in G1 versus 15.4% in G2 (p = 0.033). Caregivers for patients with and without disabilities have similar dental anxiety; however, the presence of a bad behavior is related to the anxiety of the parents of patients with disabilities. (AU)

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AIM: Evaluate factors associated with pain and analgesic consumption following non-surgical periodontal therapy. MATERIALS AND METHODS: The sample consisted of 218 patients with chronic periodontitis, submitted to non-surgical scaling and root planing under local anaesthesia at a public dental service in southern Brazil. The data collection instruments included a demographic questionnaire, as well as State-Trait Anxiety Inventory, Corah's Dental Anxiety Scale, Visual Analogue Scale, Numerical Rating Scale and Verbal Rating Scale. The presence and intensity of pain were evaluated at 2, 6, 12, 24 and 48 hr after scaling and root planing. RESULTS: A total of 52.3% of the patients reported mild intensity pain at some point during the 48 hr after scaling and root planing with local anaesthesia. Smoking (PR = 1.47; 95% CI = 1.16-1.65), severe periodontal inflammation (PR = 1.31; 95% CI = 1.09-1.58) and dental anxiety (PR = 1.24; 95% CI = 1.03-1.49) were associated with postoperative pain after adjusting for age, gender and state and trait anxiety scores. Moreover, 46.8% of the subjects used analgesics at some time during the 48-hr follow-up period and dental anxiety was the only factor associated with postoperative analgesic use. CONCLUSIONS: Smoking, severe periodontal inflammation and dental anxiety were identified as factors associated with pain after non-surgical scaling and root planing with local anaesthesia. Dental anxiety was also a factor associated with postoperative analgesic use.

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BACKGROUND: Few prospective studies on the anxiety of children in the dental office have been published. AIMS: To monitor dental anxiety levels in children with and without previous experience with toothache over a period of six consecutive visits. DESIGN: A longitudinal study was carried out involving 167 children treated at a public dental service. Levels of anxiety in the dental setting were assessed in children without toothache (G1) and those with toothache (G2) using the modified Venham picture test (VPT). Data acquisition was carried out over a 6-week period, with each child treated in the dental office once a week. Six assessments of anxiety were performed in the waiting room prior to dental treatment. RESULTS: A significant reduction in anxiety scores occurred between appointments in both groups. In the inter-group comparison, G2 had significantly higher anxiety scores than G1. Although statistically significant reductions in anxiety scores occurred through to the fifth appointment, a tendency toward stagnation in anxiety scores was observed beginning with the fourth appointment. CONCLUSIONS: Dental anxiety scores were reduced over the course of six appointments. Children with toothache had higher levels of dental anxiety than those that had never experienced toothache.

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A frequência e a natureza das arritmias cardíacas desencadeadas ou predispostas por procedimentos odontológicos já foram discutidas diversos estudos. Sabe-se que determinadas drogas usadas rotineiramente em procedimentos ambulatoriais e cirúrgicos, além de provocar arritmia, interagem com os fármacos antiarrítmicos. Alguns equipamentos também são capazes de atrapalhar o funcionamento de dispositivos cardíacos eletrônicos implantáveis. Além disso, o estresse desenvolvido frente ao procedimento tem papel importante neste quadro; e padrões de cárie dentária já foramcorrelacionados a arritmia.

The frequency and nature of cardiac arrhythmias caused or predisposed by dental procedureshave already been discussed in several studies. It is known that certain drugs used in both ambulatoryand surgical procedures, besides leading to arrhythmia, interact with antiarrhythmic medication. Someof the equipment in the dental office is capable to interfere with cardiac implantable electronic devices.Also, the emotional stress developed when facing the dentist might have an important role in thatpicture, and patterns of tooth caries have been correlated with arrhythmia.

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Se analiza las definiciones de miedo, ansiedad, dolor con una evolución física con plantemaientos de items que deben ser aplicados, se plantean las ventajas de las diferentes vías utilizadas para producir sedación. Oral, sublingual, intranasal, intra-muscular, inhalatoria . Se analizan las causas de agitación del paciente durante la sedación, las técnicas de sedación, analgesia. Se describen las diferetes drogas a utilizarse, la vigilancia que se debe realizar.

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En este trabajo de revisión se recogen las definiciones sobre los conceptos de miedo, ansiedad y fobia dental. Se recoge la prevalencia y la incidencia de estos trastornos en distintas poblaciones. Se indican las principales consecuencias en el cuidado y salud bucodental y los problemas dentales más importantes que padecen los pacientes que presentan niveles más altos de miedo, ansiedad y fobia dental. Se revisan tanto en niños como en adultos, los antecedentes de estos trastornos, el modo de adquisición y las variables que influyen en su mantenimiento. Se indican los elementos y componentes del tratamiento dental que más miedo y ansiedad producen en los pacientes (AU)

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En este trabajo de revisión se recogen las definiciones sobre los conceptos de miedo, ansiedad y fobia dental. Se recoge la prevalencia y la incidencia de estos trastornos en distintas poblaciones. Se indican las principales consecuencias en el cuidado y salud bucodental y los problemas dentales más importantes que padecen los pacientes que presentan niveles más altos de miedo, ansiedad y fobia dental. Se revisan tanto en niños como en adultos, los antecedentes de estos trastornos, el modo de adquisición y las variables que influyen en su mantenimiento. Se indican los elementos y componentes del tratamiento dental que más miedo y ansiedad producen en los pacientes

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