Entrevista motivacional como estrategia de mejoramiento de la salud bucal de niños y cuidadores. Revisión en sombrilla / Motivational interviewing as a strategy to improve the oral health of children and caregivers. Umbrella review

Objetivo: demostrar la efectividad de la entrevista motivacional (EM) en el mejoramiento de algunos indicadores de salud bucal en niños de 0 a 12 años y sus cuidadores. Material y métodos: estudio de revisión en sombrilla (umbrella review). Se realizó búsqueda en bases de datos electrónicas (PubMed, MEDLINE, SCOPUS, EBSCO) y Google Scholar desde el año 2010 hasta el año 2020, con las siguientes palabras clave: ('motivational interviewing' OR 'motivational interview' OR 'motivational interviewing style' OR 'motivational intervention' OR 'motivational counseling' OR 'brief motivational counseling' OR 'maternal counseling' OR 'behavioral intervention') AND (“caries” OR 'dental caries' OR 'tooth decay' OR 'dental decay' OR 'carious lesions' OR 'DMFT index' OR “ICDAS”) AND ('gingival diseases' OR “gingivitis” OR “CPITN” OR 'gingival bleeding' OR 'dental calculus') AND (“children” OR “families” OR “caregivers”). Se incluyeron artículos originales sobre la efectividad de la entrevista motivacional en salud bucal (EMSB) en niños de hasta 12 años y cuidadores, tipo revisión sistemática de la literatura y metanálisis, desde el año 2010 hasta el 2020. Resultados: 69 artículos (2 revisiones sistemáticas y 4 metanálisis). Los indicadores encontrados fueron: cambios en la presentación de caries de la infancia temprana, higiene bucal, condiciones gingivales y frecuencia de visitas a la consulta odontológica, con resultados alentadores y, en otros, contradictorios. Conclusiones: la evidencia sobre la efectividad de la entrevista motivacional en comparación con la educación convencional muestra cambios positivos en indicadores de salud bucal, como mejoramiento de la higiene dental y de la presentación de la caries en la primera infancia. (AU)

Objective: to demonstrate, the effectiveness of motivational interviewing in improving oral health indicators in children aged 0 to 12 years and their caregivers. Material and method: an umbrella review design. Search in electronic databases (PubMed, MEDLINE, SCOPUS, EBSCO) and Google Scholar since 2010 to 2020, with the following keywords: ('Motivational interviewing' OR 'motivational interview' OR 'motivational interviewing style' OR 'motivational intervention' OR 'motivational counseling' OR 'brief motivational counseling' OR 'maternal counseling' OR 'behavioral intervention') AND (“caries” OR 'dental caries' OR 'tooth decay' OR 'dental decay' OR 'carious lesions' OR 'DMFT index' OR “ICDAS”) AND ('gingival diseases' OR “gingivitis” OR “CPITN” OR 'gingival bleeding' OR 'dental calculus') AND (“children” OR “families” OR “caregivers”), original articles on the effectiveness of motivational interviewing in oral health (EMSB) in children between 0 and 12 years of age and caregivers, type systematic review of the literature and metaanalysis. Results: 69 articles were found (2 systematic reviews and 4 metaanalysis). The indicators found: change in early childhood caries, oral hygiene, gingival conditions and frequency of visits to the dental office with promise results and others contradictories. Conclusion: the evidence on the effectiveness of motivational interviewing compared to conventional education shows positive changes in oral health indicators such as improvement in dental hygiene and the presentation of caries in early childhood, among others. (AU)

Asociación entre la adherencia a la dieta mediterránea y las manifestaciones orales auto reportadas en adultos mayores / Association between adherence to the Mediterranean diet and self-reported oral manifestations in older adults

Fundamentos: La Dieta mediterránea (DM) es muy abundante en vitaminas que podrían contribuir al equilibrio en el mantenimiento de la salud cavidad oral. Por ello, es necesario determinar la asociación de la adherencia a la dieta mediterránea con las manifestaciones orales autoreportadas en adultos mayores. Métodos: El diseño del estudio realizado fue observacional de tipo analítico y transversal. Se ejecutó mediante una encuesta de forma virtual en adultos mayores durante el año 2022. Se utilizaron instrumentos validados de adherencia de la DM (MEDAS-14) y un autorreporte sobre manifestaciones orales, además se evaluaron diversas covariables. Para las variables cualitativas se obtuvieron frecuencias relativas y absolutas. En el análisis bivariado se utilizó la prueba estadística Chi-cuadrado. Para la asociación de las variables cualitativas y el cálculo de las razones de prevalencia crudas y ajustadas, se empleó la regresión de Poisson con varianza robusta. Resultado: Se halló que el 90,91% de los encuestados que mantenían una adherencia a la DM alta no manifestaban halitosis. Además, se observó que 57,58% que seguían una dieta mediterránea alta no manifestaba dolor dental. Se encontró en el análisis multivariado asociación estadísticamente significativa entre los encuestados que tenían una adherencia a la DM con ciertas manifestaciones orales tales como presencia de caries dental, dolor dental, halitosis, presencia de sangrado y movilidad dental en los análisis crudo y ajustado. Conclusión: La adherencia a la dieta mediterránea se relaciona a un mejor estado de salud en una población de adultos mayores. (AU)

Background: The Mediterranean Diet is very abundant in vitamins that could contribute to the balance in the maintenance of oral cavity health. Therefore, it is necessary to determine the association of adherence to the Mediterranean diet with self-reported oral manifestations in older adults. Methods: The study design was observational, analytical and cross-sectional. It was carried out through a virtual survey in older adults during the year 2022. Validated instruments of adherence to the Mediterranean diet (MEDAS14) and a self-report on oral manifestations were used, in addition various covariates were evaluated. For the qualitative variables, relative and absolute frequencies were obtained. In the bivariate analysis, the Chi-square statistical test was used. For the association of the qualitative variables and the calculation of the raw and adjusted prevalence ratios, Poisson regression with robust variance was used. Result: It was found that 90.91% of the respondents who maintained a high adherence to the MD did not manifest halitosis. In addition, it was observed that 57.58% who followed a high Mediterranean diet did not manifest dental pain. In the multivariate analysis, a statistically significant association was found between those surveyed who adhered to the MD with certain oral manifestations such as the presence of dental caries, dental pain, halitosis, presence of bleeding, and dental mobility in the crude and adjusted analyzes. (AU)

The use of E-cigarettes as a risk factor for oral potentially malignant disorders and oral cancer: a rapid review of clinical evidence / El uso de cigarrillos electrónicos como factor de riesgo de trastornos orales potencialmente malignos y cáncer oral: una revisión rápida de la evidencia clínica

Background: The popularity of e-cigarettes has increased rapidly in the last decade, particularly among teens andyoung adults, being advertised as a less harmful alternative to conventional tobacco products. However, in vitroand in vivo studies have evidenced a variable quantity of potentially harmful components and some recognizedcarcinogens which may cause DNA damage in oral cells. Additionally, evidence suggests that e-cigarettes mayplay active roles in the pathogenesis of other malignancies, such as lung and bladder cancers. Therefore, this rapidreview aimed to assess the available clinical evidence about using e-cigarettes as a risk factor for oral potentiallymalignant disorders (OPMD) and oral cancer.Material and Methods: A systematic search for English language articles published was performed in PubMed(MEDLINE), Embase, Scopus, and Web of Science. After the study selection process, the authors included twelveclinical studies about OPMD and oral cancer risk in e-cigarette users.Results: The main findings showed the presence of carcinogenic compounds in saliva and morphologic changes,DNA damage, and molecular pathways related to carcinogenesis in the oral cells of e-cigarette users. However,results were inconsistent compared to tobacco smokers and control groups.Conclusions: the current clinical evidence on this topic is limited and insufficient to support using e-cigarettes asa risk factor for OPMD and oral cancer. Nevertheless, dental care professionals should advise patients responsiblyabout the potentially harmful effects of e-cigarettes on the oral mucosa cells. Future long-term and well-designedclinical studies are needed.(AU)

Epidemiological, clinical, and prognostic analysis of oral squamous cell carcinoma diagnosed and treated in a single hospital in Galicia (Spain): a retrospective study with 5-year follow-up / Análisis epidemiológico, clínico y pronóstico del carcinoma oral de células escamosas diagnosticado y tratado en un único hospital de Galicia (España): un estudio retrospectivo con un seguimiento de 5 años

Background: Oral cancer is a common neoplasm worldwide, mostly corresponding to squamous cell carcinoma(OSCC). Unfortunately, its overall prognosis remains poor, with no improvement in recent decades. In this study,we have analysed the epidemiological, clinical, and prognostic characteristics of OSCC on patients of a specificSpanish region (Galicia), in order to improve its prognosis and apply effective preventive and early diagnosismeasures.Material and Methods: We retrospectively analysed 243 cases of OSCC, diagnosed and treated in a single hospitalcentre in Galicia between 2010 and 2015 (minimum of 5 years of evolution). Overall and specific survival werecalculated (Kaplan-Meier) and associated variables were identified (log rank test and Cox regression).Results: The mean age of the patients was 67 years, with the majority being male (69.5%), smokers (45.9%) andalcohol consumers (58.6%), who lived in non-urban areas (79.4%). Cases diagnosed at advanced stages entailedthe 48.1% of the sample, and 38.7% of cases relapsed. The 5-year overall and disease-specific survival rates were39.9% and 46.1%, respectively. Patients who consumed tobacco and alcohol had a worse prognosis. OSCC casesreferred to hospital by specialist dentists had a better prognosis, as those who were previously diagnosed with anoral potentially malignant oral disorder (OPMD) or received dental care during OSCC treatmen. Conclusions: In view of these findings, we conclude that OSCC in Galicia (Spain) still has a very poor overall prog-nosis, which is mainly related to the advanced age of the patients and the late diagnosis. Our study highlights thebetter survival of OSCC in relation to the referring health professional, the presence of a previous OPMD and thedental care after diagnosis. This demonstrates the importance of dentistry as a health profession involved in the earlydiagnosis and multidisciplinary management of this malignant neoplasm.(AU)

Is it possible to predict neurosensory alterations in impacted lower third molar removal based on preoperative imaging procedures? A prospective cohort study / ¿Es posible predecir alteraciones neurosensoriales en la extracción del tercer molar inferior impactado basándose en procedimientos de imagen preoperatorios? Un estudio de cohorte prospectivo

Background: Surgical extraction of the lower third molar (LTM) may trigger neurosensory injury of the inferioralveolar nerve, making extraction a real challenge. This study set out to assess whether is it possible to predictneurosensory alterations from preoperative imaging.Material and Methods: A total of 99 patients underwent 124 impacted lower third molar (ILTM) surgeries. Priorto surgery, panoramic and CBCT images were evaluated in an attempt to predict a neurosensory disturbance.Preoperative data (ILTM position, panoramic radiograph signs, inferior alveolar nerve (IAN) location and its con-tact with the ILTM roots) and intra/postoperative findings (extraction difficulty and sensitivity alterations) wererecorded. Descriptive and bivariate data analysis was performed. Statistical comparison applied the chi-squaretest, Fisher test, and one-way ANOVA test. Statistical significance was established with a confidence interval (CI)of 95%.Results: In 4.03% of cases, patients experienced neurosensory alterations. Of 124 ILTM positions in panoramicradiographs, 76 cases were considered to exhibit a potential neurosensory risk as they presented two or more typesof superimposed relationships between ILTM and mandibular canal. Of these, alterations were reported in onlythree cases (3.95%). Of the 48 remaining ILTM images presenting only one sign, neurosensory alterations wereobserved in two cases (4.17%). No permanent alterations were recorded in any of the five cases observed.Conclusions: Within the limitations of the present study, prediction of neurosensory alterations prior to ILTMextraction by means of preoperative imaging did not show a significant statistical correlation with post-surgicalincidence. Nevertheless, interruption of the canal´s white line (ICWL) or a diversion of the canal (DC) may predictan increased risk of IAN injury.(AU)

Medication impact on oral health in schizophrenia / Impacto de los medicamentos en la salud bucal en la esquizofrenia

Background: Patients with schizophrenia constitute a particularly vulnerable group for oral diseases. Among thedifferent factors involved, we aimed to examine the evidence of how drugs could contribute to the poorer oralhealth of this population.Material and Methods: An overview of the potential impact of medication on dental/oral health among people withschizophrenia was proposed focusing on selected literature.Results: Studies show a higher dental caries and degree of periodontal diseases in this population and point todrug-induced xerostomia as an important risk factor for oral health deterioration. The risk of dry mouth dependson not only antipsychotics, but also drugs with anticholinergic activity. We hypothesize that antipsychotic inducedglycaemic alterations might contribute to reduced oral health, and that the antimicrobial activity of certain an-tipsychotics could have an impact on oral microbiota affecting oral condition. Pharmacovigilance data show thatinvoluntary movements are caused by typical and some atypical antipsychotics. Dry mouth is most frequentlyreported for quetiapine and olanzapine, while clozapine is more frequently associated with sialorrhea.Conclusions: Literature clearly shows higher caries and periodontal disease in schizophrenic patients. However,overall, there is scarce literature about the potential influence of drugs in these disorders. Health professionalsshould be aware of this issue in order to implement adequate preventive measures in this vulnerable population.(AU)

Clinical practice guideline of the spanish society of oral surgery for oral surgery in patients with coagulation disorders / Guía de práctica clínica de la sociedad española de cirugía bucal para cirugía oral en pacientes con trastornos de la coagulación

Background: The number of patients treated with coagulation disorders, and more specifically with anticoagulanttherapy, has increased worldwide in recent years due to increased life expectancy in developed countries. Theprotocols for managing this type of patient in oral surgery has varied over recent years, especially after the appear-ance of new direct-acting oral anticoagulants (DOACs). The assessment of risk of bleeding in this type of patientwhen undergoing a surgical procedure continues to be a controversial issue for patients, dentists and general prac-titioners. The objective of this document is to offer recommendations, based on evidence, for decision making forpatients with coagulopathies who require dental surgical intervention. Material and Methods: Based on the indications of the “Preparation of Clinical Practice guidelines in the NationalHealth System. Methodological manual”, we gathered a group of experts who agreed on 15 PICO questions basedon managing patients with coagulation disorders in dental surgical procedures, such as fitting of implants or dentalextractions.Results: The 15 PICO questions were answered based on the available evidence, being limited in most cases due tothe lack of a control group. Two of the PICO questions were answered by the experts with a grade C recommendation,while the rest were answered with grade D.Conclusions: The results of this review highlight the need to undertake well designed clinical trials with controlgroups and with a representative sample size.(AU)

Clinical practice guideline of the Spanish society of oral surgery for dental care in patients with oral cancer / Guía de práctica clínica de la sociedad española de cirugía bucal para el cuidado dental en pacientes con cáncer oral

Background: Oral cancer is the sixteenth most common malignant neoplasm worldwide, with a high mortalityrate, greater than 50% at five years, and high morbidity. The effect of oncological treatment in the oral cavity isbroad and has multiple levels, therefore knowing these effects and preventing them is essential for avoiding anincrease in the oral pathology related with oncological therapy, maintaining the quality of life of the patient, andimproving the efficacy of the treatment itself.Material and Methods: A group of experts belonging to the fields of Dentistry, Maxillofacial Surgery and Oncol-ogy of the University of Seville and the Virgen del Rocío University Hospital of Seville in collaboration with theUniversity of Valencia, University of Barcelona, and University of the Basque Country, developed this ClinicalPractice Guideline for the proper clinical management of patients diagnosed with oral cancer. The clinical ques-tions were formulated in PICO format. The databases consulted were Medline/PubMed and Embase/Elsevier. Thesystematic reviews published on the topic were identified on Tripdatabase, Cochrane Library and CRD (Centre forReviews and Dissemination). The recommendations were prepared based on the GRADE methodology.Results: Various recommendations were defined, derived from the 21 PICO questions, referring to prevention,treatment and care for alterations arising from the pathology of oral cancer itself and its treatment.Conclusions: The preparation of this clinical practice guideline allows recommendations to be generated basedon the scientific evidence available, on dentistry actions in patients with oral cancer and undergoing oncologicaltreatment, which may be of use to the multidisciplinary team treating this type of patient.(AU)

Atypical histological presentation of bone regeneration after insertion of cryoprotected allogeneic bone graf / Presentación histológica atípica de la regeneración ósea después de la inserción de un injerto óseo alogénico crioprotegido

Background: To evaluate bone regenerative capacity of cryoprotected corticocancellous allogeneic bone graftperformed in type II and III post-extraction sockets for ridge preservation after twelve weeks in-vivo.Material and Methods: Twenty-seven type II or III bony-walled extraction sockets (mandible and maxilla) wereselected for this study. Following atraumatic tooth-extraction a cryoprotected corticocancellous allogeneic bonegraft material and a resorbable porcine-derived collagen membrane were used for ridge preservation. Duringre-entry surgery at approximately 12 weeks, bone core biopsies were obtained using a 3.2 mm trephine drill andsamples were histologically processed and subjected to qualitative and quantitative histomorphometric analysis.Quantitative data was analyzed using a general linear mixed model with results presented as mean values with thecorresponding 95% confidence interval values. Results: Healing without incident and ridge preservation allowed for the placement of dental implants after 12 weeksin 25 out of the 27 treated socket sites. Analyses yielded an average of ~21.0±7% of old/native bone, ~17±5.5% ofnewly regenerated bone (total of ~38±12.8% for all bone), 0.23±0.14% of new bone presenting with nucleating siteswithin the matrix, ~52±5.12% of soft tissue, and 3.6±2.09% of damaged bone. The average regenerated bone wasstatistically analogous to that of old/native bone (p=0.355). Furthermore, an atypical histological pattern of boneregeneration was observed, with newly formed bone exhibiting “infiltration-like” behavior and with new bone nucle-ating sites observed within the demineralized bone matrix.Conclusions: Cryoprotected corticocancellous allogeneic bone-graft demonstrated osteoconductive, osteoinductive,and osteogenic properties, yielding unique healing patterns which does warrant further investigation.(AU)

Oral squamous cell carcinoma arising from areas of Graft-versus-host disease: A systematic review / Carcinoma oral de células escamosas que surge de áreas de enfermedad de injerto contra huésped: una revisión sistemática

Background: Graft-versus-host disease (GVHD) is an immune system reaction that occurs in patients with ahistory of hematopoietic stem cell transplantation (HSCT), in which the grafted donor's cells attack those of thehost. The objective of this systematic review was to present a study on oral squamous cell carcinoma (OSSC) thatdeveloped from GVHD areas in patients undergoing HSCT.Material and Methods: An electronic search was conducted in the databases PUBMED, WEB OF SCIENCE,SCOPUS, MEDLINE and SCIENCE DIRECT, according to PRISMA guidelines. Results: Of the 1582 results, 23 articles were included, resulting in 81 cases. The most common underlying diseasefor performing the transplant was Myeloid Leukemia (55.6%). The mean age was 39 years, with a predilection formales (64.2%). The tongue was the site of GVHD that most frequently underwent transformation to SCC (59.3%).The average time between transplantation and the development of GVHD was of approximately of 8 months, whilethe average period of development between transplantation and the development of OSCC was of approximately of111 months. The most common treatment to GVHD was cyclosporine associated with corticosteroids.Conclusions: OSCCs arising from areas of GVHD present a different evolution from conventional oral carcinomas,since they affect younger patients, smoking and alcohol are not important etiological factors and finally because theypresent good prognosis, but further studies with larger number cases followed are needed to confirm our findings.(AU)

Evaluation of the efficacy of hydroxyl radical (OH) release for disinfection of the air and surfaces in the dental clinic: an in vitro study / Evaluación de la eficacia de la liberación de radicales hidroxilo (OH) para la desinfección del aire y superficies en la clínica dental: un estudio in vitro

Background: Concerning about the quality of room air has increased exponentially. Specially in dental clinicswhere diary practice is characterized by the important generation of aerosols.Material and Methods: An in vitro model was used in which samples were collected from the surfaces and roomair of a dental clinic before and after the use of an OH˙ radical generator.Results: A total of 1260 samples were collected for bacteriological analysis and 14 samples for the detection ofSARS-CoV-2. Following OH˙ treatment, the tested surface samples showed a decrease in the number of colonyforming units (CFUs) of 76.9% in TSA culture medium. The circulating room air samples in turn showed adecrease in CFUs of 66.7% in Sabouraud medium and 71.4% in Mannitol agar medium. No presence of SARS-CoV-2 was observed on the surface of the face shield.Conclusions: The disinfectant technology based on the use of hydroxyl radicals (OH˙) is effective in reducing thepresence of moulds and yeasts and Staphylococcus in the air, and in reducing total aerobic bacteria on the testedsurfaces.(AU)

Cuestionario de autoevaluación CAMBRA como método de cribado poblacional del riesgo de caries sin métodos exploratorios: un estudio piloto observacional transversal / Modified CAMBRA questionnaire as a method for population-based caries risk screening without exploratory methods: a cross-sectional observational pilot study

Fundamentos: Caries Management by Risk Assessment (CAMBRA) es un cuestionario de diagnóstico del riesgo global de caries dental. Este estudio tuvo como objetivo presentar un cuestionario de autoevaluación basado en CAMBRA que, a diferencia del original, es cumplimentado por padres/madres/cuidadores, sin necesidad de una exploración odontológica, permitiendo establecer un diagnóstico de presunción en menores de siete años excluidos del programa de salud oral del Sistema Nacional de Salud, con el fin de instaurar recomendaciones individualizadas al riesgo de caries y su inclusión precoz en programas preventivos del Servicio Madrileño de Salud (Madrid, España). Métodos: Se llevó a cabo un estudio observacional transversal basado en las recomendaciones STROBE, empleando por primera vez un cuestionario de autoevaluación basado en CAMBRA en niños/as de tres a seis años de una escuela infantil de Madrid (España). Los resultados se analizaron mediante una estadística descriptiva y para el estudio de la relación entre variables cualitativas se utilizó el estadístico exacto de Fisher. Resultados: El cuestionario fue respondido por padres de 120 niños, de los cuales, el 40,8% presentó, a priori, un riesgo de caries bajo, el 42,5% un riesgo moderado y el 16,7% un riesgo alto de caries. Conclusiones: El presente estudio permite la identificación de pacientes en riesgo de presentar y/o desarrollar caries. No obstante, futuros estudios han de evaluar su sensibilidad y especificidad mediante su comparativa frente a un diagnóstico de confirmación tras una exploración odontológica. Pese a ello, el cuestionarioCAMBRA modificado podría ser una herramienta útil para el cribado poblacional, facilitandoel acceso de la población en riesgo de caries y en riesgo de exclusión a planes preventivos y comunitarios.(AU)

Background:Caries Management by Risk Assessment (CAMBRA) is a questionnaire used to diagnose the patient’s overall caries risk. This study aimed to present a self-assessment questionnaire based on CAMBRA which, unlike the original, is completed by parents/caregivers, without the need for a dental examination, allowing a presumptive diagnosis to be established in children under seven years of age excluded from the oral health programme of the National Health System to establish individualised recommendations for caries risk and their early inclusion in preventive programmes of the Madrid Health Service (Madrid, Spain). Methods: A cross-sectional observational study was carried out following STROBE guidelines using for the first time a self-assessment questionnaire based on CAMBRA in a population of children aged from three to six years from a nursery school in Madrid (Spain). The results were analysed using descriptive statistics and Fisher’s exact statistic was used to study the relationship between qualitative variables. Results: The questionnaire was answered by the parents of 120 children (response rate=53.1%), of whom 40.8% presented a low a priori caries risk, 42.5% a moderate risk and 16.7% a high caries risk. Conclusion: The present study allow the identification of patients at risk of presenting and/or developing caries. However, future studies should evaluate its sensitivity and specificity by comparing it with a confirmatory diagnosis after a dental examination. Nevertheless, the modified CAMBRA questionnaire could be a useful tool for population screening, facilitating the access of the population at risk of caries and risk of exclusion to preventive and community plans.(AU)

Estilo de vida, hábitos de higiene oral y autopercepción del estado anímico en estudiantes de Odontología de la Comunidad de Madrid durante la pandemia de la COVID-19: ¿pudo la pandemia tener algún efecto favorable? / Lifestyle, oral hygiene habits and self-perception of mood in Dental students of the Community of Madrid during the COVID-19 pandemic: could the pandemic have any favorable effect?

Fundamentos: La pandemia de la COVID-19 y sus medidas de control parecen haber alterado la dinámica vital de la población. Fue justificable, por tanto, tratar de precisar el impacto sobre el estilo de vida, la higiene bucodental y el estado anímico, en grupos específicos, como estudiantes universitarios de Odontología de Madrid, que nos eran accesibles.Métodos: Se realizó un estudio observacional transversal anónimo y voluntario en la primera quincena de diciembre de 2021, mediante cuestionario online ad hoc, en estudiantes de Odontología de universidades de la Comunidad Autónoma de Madrid (CAM). Se realizó análisis descriptivo de las variables y se valoraron las asociaciones y significación con Chi-cuadrado y T-student. Resultados: Se recibieron setenta y dos encuestas. El 82% eran mujeres y el 18% varones, con 23±3 años de media. El 94% tenía buenos hábitos de higiene oral, que mejoraron con la pandemia. Su dieta habitual era variada y completa. Las mujeres consumían menos carne (p=0,014) y más fruta (p=0,066), hábitos que mantenían, y mejoraron los varones con incremento en frutas (p<0,002), verduras y legumbres (p<0,003) en la pandemia. El consumo de tabaco (23,4%) y alcohol (54%) disminuyó en confinamiento y subió en postconfinamiento. Un 36% aumentó, especialmente en postconfinamiento, su actividad física, antes baja. Conclusiones: Los estudiantes de la muestra tienen buenos hábitos de higiene oral y alimentación que mantienen e incluso mejoran con la pandemia, incluido un incremento del ejercicio físico en una fracción importante de la muestra. El confinamiento afecta al estado anímico y las relaciones sociales, llegando a alterar el sueño de las mujeres, con aumento de despertares nocturnos, sobre todo, en postconfinamiento.(AU)

Background: The COVID-19 pandemic and its control measures seem to have altered the vital dynamics of the population. It was justifiable, therefore, to try to specify the impact on lifestyle, oral hygiene and mood, in specific groups, such as dental university students in Madrid, who were accessible to us. Methods: An anonymous and voluntary cross-sectional observational study was carried out in the first fortnight of December 2021, through an ad hoc online questionnaire, in dentistry students from the Autonomous Community of Madrid. Descriptive analysis of the variables was performed and the associations and significance were assessed using Chi-square and T-student. Results: There were received seventy-two surveys. 82% were women and 18% men, with 23±3 years of mean age. 94% had good oral hygiene habits that improved with the pandemic. Their usual diet was varied and complete. Women consumed less meat (p=0.014) and more fruit (p=0.066), habits that they maintained, and men have improved with an increase in fruits (p<0.002), vegetables and legumes (p<0.003) in the pandemic. Tobacco (23,4%) and alcohol (54%) consumption decreased in confinement and increase in post-confinement. 36% increased their physical activity, initially low, especially in post-confinement. Conclusions: The students in the sample have good oral hygiene and eating habits, which they keep and even improve with the pandemic, including an increase in physical exercise in a significant fraction of the sample. The confinement affect the mood and social relationships, even altering the sleep of women, with an increase in night awakenings, especially in post-confinement.(AU)

Cuidados de higiene bucal al paciente intubado orotraqueal: Factores influyentes. Revisión sistemática de la literatura / Oral hygiene care to the orotracheally Intubated patient: Influencing Factors. Systematic Review

Objetivos: Identificar evidencias científicas primarias sobre los principales factores que interfieren en la prestación de cuidados de higiene bucal, desarrollados por enfermeros, a usuarios intubados orotraquealmente en unidades de cuidados intensivos. Método: Estudio de revisión sistemática de la literatura, desarrollado según el protocolo del Instituto Joanna Briggs. Para la obtención de los artículos se utilizaron los motores de búsqueda B-On y PubMed. Los términos utilizados en la búsqueda tuvieron en cuenta el vocabulario indexado a la base de datos Medical Subject Headings (MeSH), habiéndose estructurado según operadores booleanos, con la siguiente combinación, en inglés: “Oral Hygiene” AND “Pneumonia, Ventilator-Associated” OR “Pneumonia, Ventilator Associated” Y “Critical Care Nursing”. Se definieron como limitantes artículos publicados entre diciembre de 2017 y diciembre de 2020, en inglés, portugués y español, disponibles en su totalidad, publicados en revistas científicas revisadas por pares (peer review) y que se ajustan a la pregunta PICO desarrollada para el estudio. Resultados: Después de aplicar los criterios de inclusión y exclusión, se incluyeron en la revisión ocho artículos de carácter primario y cualitativo que abordan los factores que influyen en la prestación de cuidados de higiene bucal por parte de los enfermeros a pacientes sometidos a intubación orotraqueal. Conclusión: Las prácticas de cuidado de la higiene bucal brindadas a los usuarios en intubación orotraqueal, por parte de los enfermeros, son influenciadas por sus conocimientos, actitudes, recursos disponibles, capacitación y políticas institucionales, así como por factores relacionados al usuario que se relacionan principalmente con las dificultades de acceso a la cavidad oral. (AU)

Aims: Identify factors that interfere in the provision of oral hygiene care, developed by nurses, to orotracheally intubated patients in intensive care units, on primary scientific evidence. Methods: A systematic literature review study, developed according to the Joanna Briggs Institute protocol. To obtain the articles, a search on B-On and PubMed was made. The terms used in the search took into account the vocabulary indexed to the Medical Subject Headings (MeSH) database, having been structured according to Boolean operators, with the following combination in English: “Oral Hygiene” AND “Pneumonia, Ventilator-Associated” OR “Pneumonia, Ventilator Associated” AND “Critical Care Nursing”. Articles published between December 2017 and December 2020, in English, Portuguese and Spanish, available in full, published in peer-reviewed scientific journals (peer review) and which fit the PICO question developed for the study, were defined as limiting. Results: After applying the inclusion and exclusion criteria, eight articles of a primary and qualitative nature were included in the review that address the factors that influence the provision of oral hygiene care by nurses to patients undergoing orotracheal intubation. Conclusions: The oral hygiene care practices provided to users under orotracheal intubation, by nurses, are influenced by their knowledge, attitudes, available resources, training and institutional policies, as well as by factors related to the user that are mainly related to difficulties in access to the oral cavity. (AU)

Conocimientos, actitudes y prácticas enfermeras en materia de higiene bucal de los pacientes hospitalizados dependientes / Knowledge, attitudes and practices of nurses regarding oral hygiene of dependent inpatients

Objetivo: Valorar los conocimientos, actitudes y prácticas enfermeros en materia de higiene bucal en pacientes hospitalizados. Métodos: Estudio cuantitativo, descriptivo y transversal. Los datos se recogieron mediante un cuestionario autoadministrado, aplicado a 100 enfermeras de los servicios médicos de internación de dos hospitales del norte de Portugal, que evaluó tres dimensiones: conocimientos, actitudes y prácticas en materia de higiene bucal, que se resumieron en descripciones estadísticas que incluyen porcentajes, frecuencias, medias y desviaciones estándar, utilizando para el análisis de datos SPSS versión 23. Resultados: La puntuación media de conocimiento fue de 13,98 sobre 22, y la puntuación de las actitudes de los participantes hacia la higiene bucal fue de 48,35 sobre 60 puntos. Todos los participantes reconocen la importancia del cuidado de la higiene bucal para los pacientes hospitalizados, y el 96% asocian la falta de cuidado con la enfermedad sistémica. En cuanto a las prácticas, el 90% de los participantes evalúan la necesidad de cuidados de higiene bucal para las personas hospitalizadas en las primeras 24horas y el 61% documentan el resultado de esta evaluación. Conclusión: Los resultados muestran que, aunque los participantes son conscientes de la importancia de la salud bucal, los conocimientos y las prácticas no son consistentes. En cuanto a las prácticas de salud bucal, es urgente reducir la brecha entre la evidencia y la práctica y promover la estandarización del cuidado bucal.(AU)

Objective:Assess nurses’ knowledge, attitudes and practices towards oral hygiene of dependent inpatients. Methods: Quantitative, descriptive, and cross-sectional study. Data were collected through a self-administered questionnaire applied to 100 nurses from internal medicine wards of two hospitals in Northern Portugal, which assessed three dimensions: knowledge, attitudes, and practices regarding oral hygiene. Knowledge, attitudes, and practices in oral care were summarized in statistical descriptions including percentages, frequencies, means, and standard deviations using SPSS version 23 for data analysis. Results: The mean total knowledge score was 13.98 out of 22 and the participants’ mean score of the attitudes towards oral care was 48.35 out of 60 points. All participants acknowledge the importance of oral care for inpatients, with 96% associating poor oral hygiene with systemic disease. As for practices, 90% of participants assess the need for oral care of inpatients in the first 24hours, and 61% document the result of this assessment. Conclusion: The results show that although participants are aware of the importance of oral care, knowledge and practices are not consistent. Concerning oral health practices, it is urgent to narrow the gap between evidence and practice and promote oral care standardization.(AU)

Higiene y cuidado dental en recetarios hispanos de los siglos XIV-XVI / Hygiene and dental care in Hispanic recipe books from the 14th-16th centuries

Numerosos recetarios de época bajomedieval y moderna contienen información sobre tratamientos destinados al cuidado del cuerpo, en especial del cabello, la piel o la dentadura. Se trata de textos misceláneos, donde los contenidos de medicina se mezclan con los de dietética, salud y belleza, motivo por el que en ocasiones han sido llamados “libros de mujeres”, debido a su vinculación con costumbres del grupo femenino. Tales textos incluyen indicaciones para la preparación de compuestos destinados a la limpieza de dientes y a combatir el mal aliento, recetas que incorporan materias antisépticas y de efecto bactericida disueltas en agua, o usadas en forma sólida para frotar directamente las encías, como dentífricos con que cepillar los dientes y la lengua. También compuestos destinados a encarnar las encías y a prevenir sus enfermedades, o a calzar los dientes débiles y faltos de raíz. Y detallan la forma de aplicación de dichos polvos y letuarios, que suele efectuarse frotando los dientes o mediante enjuague bucal. El artículo estudia estas recetas y analiza tanto las propiedades de las materias que las integran como los procedimientos seguidos para su aplicación. (AU)

Prácticas culturales de higiene bucal y lavado de manos en escolares de una zona urbano marginal / Práticas culturais de higiene bucal e lavagem das mãos em escolares de uma área urbana marginal / Cultural practices of oral hygiene and hand washing in schoolchildren from a marginal urban area

Introduction: Some inappropriate cultural practices cause long-term diseases prevalent inchildhood such as: acute respiratory, diarrheal, dermal and parasitic. Objectives: To describe anddiscuss the cultural practices of oral hygiene and hand washing in schoolchildren in a marginalurban area. Methodology: Qualitative research, with a descriptive approach, the scenario was thehomes of schoolchildren aged 9 to 11 years, who reside in marginal urban areas of Ferreñafe, Peru;the sample was, 8 schoolchildren and 8 mothers, delimited by saturation and redundancy and nonprobabilistic sampling selected by snowball. Data were collected through semi-structured interviews and processed according to content analysis, applying triangulation of subjects, prior informed consent of the participants and approval of a Research Ethics Committee. Results: a) Cultural practices of oral hygiene and b) Cultural practices of hand washing. Conclusions: Participants know the correct procedure of oral hygiene and hand washing, key moments, use basic andcultural materials and recognize diseases caused by lack of healthy practices. Their assessment is necessary to achieve effective intercultural interventions. (AU)

Algunas prácticas culturales inadecuadas ocasionan a largo plazo enfermedades prevalentes en la infancia como: respiratorias agudas, diarreicas, dérmicas y parasitarias. Objetivos: Describir y discutir las prácticas culturales de higiene bucal y lavado de manos en escolares de una zonaurbano marginal. Metodología: Investigación cualitativa, con abordaje descriptivo, el escenario fueron los hogares de los escolares en edades de 9 a 11 años, quienes residen en zonas urbano marginales de Ferreñafe, Perú; la muestra fue, 8 escolares y 8 madres, delimitada por saturación y redundancia y el muestreo no probabilístico seleccionada por bola de nieve. Los datos se recolectaronmediante entrevista semiestructurada y procesados según el análisis de contenido, aplicando triangulación de sujetos, previo consentimiento informado de los participantes y aprobación de un Comité de ética en investigación. Resultados: a) Prácticas culturales de higiene bucal y b) Prácticasculturales de lavado de manos. Conclusiones: Los participantes conocen el procedimiento correctode la higiene bucal y lavado de manos, los momentos claves, emplean materiales básicos y culturalesy reconocen enfermedades ocasionadas por falta de prácticas saludables. Siendo necesarios su valoración para lograr intervenciones interculturales efectivas. (AU)

Introdução: Algumas práticas culturais inadequadas causam doenças a longoprazo predominantes na infância, tais como: respiratória aguda, diarreia, dérmica e parasitária. Objetivos: Descrever e discutir as práticas culturais de higiene oral e lavagem dasmãos em crianças em uma área urbana marginal. Metodologia: Investigação qualitativa,com uma abordagem descritiva, o cenário foram as casas de estudantes dos 9 aos 11 anos,que residem em zonas urbanas marginais de Ferreñafe, Peru; a amostra foi, 8 estudantese 8 mães, delimitadas por saturação e redundância e amostras não probabilísticas selecionadas por bola de neve. Os dados foram recolhidos através de entrevistas semi-estruturadas e processados de acordo com a análise de conteúdos, aplicando a triangulação de indivíduos, consentimento prévio informado dos participantes e aprovação de uma Comissão de Ética da Investigação. Resultados: a) Práticas culturais de higiene oral e b) Práticasculturais de lavagem manual. Conclusões: Os participantes conhecem o procedimentocorreto de higiene oral e lavagem das mãos, momentos-chave, utilizam materiais básicose culturais e reconhecem doenças causadas pela falta de práticas saudáveis. A sua avaliação é necessária para conseguir intervenções interculturais eficazes. (AU)

Factores asociados al nivel de conocimiento de la población sobre el uso, cuidado e higiene en pacientes portadores de prótesis dentales removibles / Factors associated with the level of knowledge of the population about the use, care and hygiene in patients with removable dental prostheses

Introducción: El edentulismo parcial o total genera alteraciones en la calidad vida de los pacientes, por ende, el plan de rehabilitación se da a través de prótesis dentales que están diseñadas para mejorar la calidad de vida del paciente, devolviendo la función masticatoria y estética facial. Objetivo: Determinar los factores asociados al nivel de conocimiento de la población sobre el uso, cuidado e higiene en pacientes portadores de prótesis dentales removibles. Materiales y métodos: Es un estudio tipo básico de diseño no experimental descriptivo, correlacional, transversal. Se empleó una encuesta validada por expertos con una buena confiabilidad de consistencia interna (Cronbach a = 0.857) la cual fue distribuida por Facebook y WhatsApp. La muestra del estudio consistió en 573 portadores de prótesis dentales removibles, siendo 324 mujeres (56,54 %) y 249 hombres (43,45 %). Resultados: Se muestra un conocimiento bajo en el 52.4% y alto en el 47.6% de la población, además, se observa que los factores asociados al nivel de conocimiento de la población sobre el uso, cuidado e higiene en pacientes portadores de Prótesis Dentales Removibles son la edad (x2= 12.834 y un p-valor= 0.005) y la ubicación de la prótesis (x2= 12.834 y p-valor= 0.005), para el sexo y tipo de prótesis el valor p es mayor a 0.05, por lo cual no resulta significativo. Conclusión: Existe una falta de conocimiento sobre el cuidado de las PDR en la mayor parte de la población estudiada, esto indica la necesidad de incrementar la educación y el asesoramiento sobre el cuidado de las prótesis para mejorar la calidad de vida en los pacientes portadores por parte de los profesionales de la salud odontológica. (AU)

Introduction: Partial or total edentulism generates alterations in the quality of life of patients, therefore, the rehabilitation plan is given through dental prostheses that are designed to improve the quality of life of the patient, returning the masticatory function and facial aesthetics. Objective: To determine the factors associated with the level of knowledge of the population about the use, care and hygiene in patients with removable dental prostheses. Materials and methods: It is a basic type study of non-experimental descriptive, correlational, cross-sectional design. A survey validated by experts with good internal consistency reliability (Cronbach α = 0.857) was used, which was distributed by Facebook and WhatsApp. The study sample consisted of 573 removable dental prosthesis wearers, 324 women (56.54%) and 249 men (43.45%). Results: Low knowledge is shown in 52.4% and high in 47.6% of the population, in addition, it is observed that the factors associated with the level of knowledge of the population about the use, care and hygiene in patients with Removable Dental Prostheses are age (x2= 12.834 and p-value= 0.005) and the location of the prosthesis (x2= 12.834 and p-value= 0.005), for sex and type of prosthesis the p-value is greater than 0.05, therefore which is not significant. Conclusion: There is a lack of knowledge about the care of PDR in most of the population studied, this indicates the need to increase education and advice on the care of prostheses to improve the quality of life in patients with prosthetics. Part of dental health professionals. (AU)