Knowledge on Oral Cancer in a Group of Undergraduate Dentistry Students / Conhecimento Sobre Câncer Oral em um Grupo de Acadêmicos de Odontologia

Abstract Oral cancer is a multifactorial disease with a high occurrence rate considered to be an important public health problem. The knowledge of the Dentist is essential in the early diagnosis process, with preparation beginning since graduation to know the pathology, carry out accurate examinations, and act correctly in the face of suspected oral cancer cases. This study aimed to evaluate the knowledge of undergraduate students in Dentistry at a university regarding oral cancer and its risk factors. This was an observational, cross-sectional, qualitative and descriptive study, with use of forms on students from the 4th to the 9th semester. After data collection, the results were submitted for statistical analysis in the IBM SPSS2018 program. The total number of correct answers related to ten questions, nine with a single correct answer and one with six possibly correct answers. The correlation between the number of correct answers and the progress of the semesters (from the 4th to the 9th) was tested with Kendall's tau b coefficient. The analysis for each question used was performed by Fisher's exact test with Monte Carlo approximation. There was no significant difference (p = 0.334; rt = -0.093) in the evolution of knowledge surrounding the questions applied. In the analysis for each question, there was a significant difference in questions two and five (p = 0.000). The level of knowledge of dentistry students was considered good, needing improvement. It is essential to implement continuous educational measures throughout the course. (AU)

Resumo O câncer bucal é uma doença multifatorial com alta incidência, é considerado um problema de saúde pública. O conhecimento do cirurgião-dentista é fundamental no processo de diagnóstico precoce, está preparado desde a graduação para realização de exames precisos, conhecer acerca da patologia e agir corretamente frente aos casos suspeitos de câncer bucal. Este estudo teve como objetivo avaliar o conhecimento dos graduandos em Odontologia da UNIME Lauro de Freitas a respeito do câncer bucal e seus fatores de risco. Metodologia: Tratou-se de estudo observacional, do tipo transversal, qualitativo e descritiva, aplicando formulários a alunos do 4º ao 9º semestre. Após a coleta, os dados foram submetidos à análise estatística no programa IBM SPSS2018. O índice total de acertos relacionados a dez questões, sendo nove com uma única resposta correta e uma com a possibilidade de seis respostas corretas. A correlação entre o número de acertos e o avançar dos semestres (do 4º ao 9º) foi testada com o coeficiente tau b de Kendall. E a análise para cada questão empregada foi realizada pelo teste exato de Fisher com aproximação de Monte Carlo. Não foi observada diferença significante (p=0,334; rt=-0,093) na evolução do conhecimento sobre as questões aplicadas. Na análise para cada questão houve diferença significativa nas questões dois e cinco (p=0,000). O nível de conhecimento dos estudantes de Odontologia foi considerado bom, necessitando melhorar. É imprescindível a implementação de medidas educativas contínuas ao longo do curso. (AU)

Efficacy of photobiomodulation in reducing pain and improving the quality of life in patients with idiopathic burning mouth syndrome. A systematic review and meta-analysis.

Burning mouth syndrome is a chronic condition, which is characterised by a burning sensation or pain in the mucosa of the oral cavity. Treatment options include antidepressants, antipsychotics, anticonvulsants, analgesics, hormone replacement therapies and more recently photobiomodulation. This study aims to perform a systematic review with meta-analysis in order to determine the effect of photobiomodulation on pain relief and the oral health-related quality of life associated with this condition. A bibliographical search of the Pubmed, Embase, Web of Science and Scopus databases was conducted. Only randomised clinical trials were included. Pain and quality of life were calculated as mean difference and pooled at different treatment points (baseline = T0 and final time point = Tf) and laser modality. From a total of 103 records, 7 articles were retrieved for inclusion. PBM group had a greater decrease in pain than control group at Tf with a mean difference = - 2.536 (IC 95% - 3.662 to - 1.410; I2 = 85.33%, p < 0.001). An improvement in oral health-related quality of life was observed in both groups, although this was more significant in the photobiomodulation group mean difference = - 5.148 (IC 95% - 8.576 to - 1.719; I2 = 84.91%, p = 0.003). For the red laser, a greater improvement than infrared was observed, in pain, mean difference = - 2.498 (IC 95% - 3.942 to - 1.053; I2 = 79.93%, p < 0.001), and in quality of life, mean difference = - 8.144 (IC 95% - 12.082 to - 4.206; I2 = 64.22%, p = 0.027). Photobiomodulation, in particular, red laser protocols, resulted in improvement in pain and in quality of life of burning mouth syndrome patients.

The impacts of the COVID-19 pandemic on the teaching of dentistry in Brazil.

A new disease called coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) virus, was discovered in the city of Wuhan in China in December 2019, and has reached, quickly and progressively, several countries on different continents. Even before the World Health Organization recognized the COVID-19 epidemic as a pandemic, the Brazilian Ministry of Health had already declared COVID-19 a national public health emergency due to the confirmation of cases in Brazil. In this scenario, the educational sector was one of the first to suffer the effects of the pandemic soon after the announcement of social distancing as a way to prevent the collapse of the Unified Health System. The aim of this paper is to report how Brazilians dental schools are leading with the new coronavirus pandemic.

Low-level laser therapy in patients with Burning Mouth Syndrome: A double-blind, randomized, controlled clinical trial.

BACKGROUND: Evaluate the effect of LLLT in the treatment of burning mouth syndrome (BMS). MATERIAL AND METHODS: Twenty-one BMS patients were randomly assigned to two groups: 12 in the laser group (LG) and 9 in the control group (CG). Patients in the LG underwent 2-week sessions of LLLT for 4 weeks. The spot tip area of this tool is 0.088cm2, semi-conductor GaAlAs, with a wavelength of 808nm ±5nm (infrared), 200 mW output power, 1.97W/cm2 of power density, 3 J energy per point and application time 15 seconds per point. LLLT was applied punctually, in continuous emissions, on each of the sites where there was a symptom. Symptoms were evaluated with a visual analogue scale (VAS) and patient psychological profiles were assessed using the Hospital Anxiety-Depression Scale. No side effects were recorded. Statistical analysis was carried out via ANOVA and logistic regression analysis. RESULTS: The initial VAS score mean was 8.9 for the LG and 8.3 for the CG (p >0.05). After the eighth session the VAS score was 5.5 and 5.8 respectively, and at two months it was 4.7 and 5.1 respectively. Improvement variables were established by dichotomizing the pain scales. We obtained levels of significance for the improvement variable for the LG at the two-month follow-up (p=0.0038) and for the univariate analysis of the treatment. The improvement was marginally significant in the multivariant analysis of: dry mouth, dysgeusia, pain and the treatment (p=0.0538). CONCLUSIONS: LLLT may be an alternative treatment for the relief of oral burning in patients with BMS. Key words:Burning mouth syndrome, oral pain, laser dentistry, laser therapy, low intensity laser therapy.

Low-level Laser Therapy: A Review of Its Applications in the Management of Oral Mucosal Disorders.

Due to its analgesic, anti-inflammatory, and biostimulating effects, low-level laser therapy (LLLT) has been widely used for oral disorders, such as oral lichen planus (OLP), xerostomia, recurrent aphthous stomatitis (RAS), herpes labialis, burning mouth syndrome (BMS), and oral mucositis (OM). The research team for the present study has reviewed the literature on the subject, with an emphasis on the applicability of LLLT in general and of its various clinical protocols for the management of those oral disorders. In lesions such as the ones occurring in OM, RAS, herpes labialis, and OLP, the course of wound healing and the pain have been shown to decrease, with a few, or most often, no adverse side effects. The literature shows that LLLT can also be effective in reducing symptoms in patients with BMS. For the treatment of hyposalivation and xerostomia, the use of LLLT has been described in the literature, but no consensus has resulted. Very few controlled clinical studies with well-established therapeutic protocols have occurred, except for OM, for which LLLT has been widely researched. Although information on the use of the laser for some lesions has already been consolidated, further research is needed, especially randomized, controlled clinical trials with long-term follow-up. Those studies will allow the safe use of LLLT, permitting the creation of care protocols for the management of oral disorders.

Efficacy of low-level laser therapy for the treatment of burning mouth syndrome: a randomized, controlled trial.

The aim of the present study was to assess the effect of low-level laser therapy (LLLT) in the treatment of burning mouth syndrome (BMS). A diode laser was used in 78 BMS patients who were randomly assigned into four groups: IR1W, n = 20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, LLLT weekly sessions, 10 sessions); IR3W, n = 20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, three LLLT weekly sessions, 9 sessions); red laser, n = 19 (685 nm, 35 mW, 2 J, 72 J/cm2, 58 s, three LLLT weekly sessions, 9 sessions); and control-group (CG), n = 19. Symptoms were assessed at the end of the treatment and eight weeks later; quality of life related to oral health was assessed using the Oral Health Impact Profile (OHIP-14). Statistical analysis was carried out using repeated measures analysis of variance followed by the posthoc Tukey test. There was significant reduction of the symptoms in all groups at the end of the treatment, which was maintained in the follow-up. The scores of the IR1W and IR3W laser groups differed significantly from those of the CG. There was also a decrease in the OHIP-14 scores in the four groups. The IR3W laser group scores differed significantly from those of the CG. LLLT reduces the symptoms of BMS and may be an alternative therapeutic strategy for the relief of symptoms in patients with BMS.

Burning Mouth Syndrome: update.

Burning Mouth Syndrome (BMS) is a chronic disorder that predominately affects middle-aged women in the postmenopausal period. The condition is distinguished by burning symptoms of the oral mucosa and the absence of any clinical signs. The etiology of BMS is complex and it includes a variety of factors. Local, systemic and psychological factors such as stress, anxiety and depression are listed among the possible causes of BMS. BMS may sometimes be classified as BMS Type I, II or III. Although this syndrome is not accompanied by evident organic alterations and it does not present health risks, it can significantly reduce the patient's quality of life. This study analyzes the available literature related to BMS, and makes special reference to its therapeutic management. The pages that follow will also discuss the diagnostic criteria that should be respected, etiological factors, and clinical aspects. We used the PubMed database and searched it by using the keywords "burning mouth syndrome", "BMS and review", and "burning mouth and review", in the title or abstract of the publication. BMS treatment usually steers towards the management of the symptoms; however, the specific local factors that could play a significant role in worsening the oral burning sensation should be eradicated. The most widely accepted treatment options that show variable results include tricyclic antidepressants, benzodiazepines and antipsychotic drugs; nevertheless there are other therapies that can also be carried out. Professionals that work in the field of dentistry should formulate standardized symptomatic and diagnostic criteria in order to more easily identify the most effective and reliable strategies in BMS treatment through multidisciplinary research.

Oral granuloma gravidarum: a retrospective study of 41 cases in Southern Brazil.

Granuloma gravidarum (GG) is an inflammatory lesion, which develops in the oral mucosa of pregnant women in response to chronic low-grade irritants, under the influence of hormonal factors. Objective To characterize GG clinically by means of a retrospective study of the cases of the Oral Medicine Division, São Lucas Hospital, Brazil. Material and Methods Cases of GG diagnosed between 1980 and 2012 were analyzed. Data were obtained referring to the age of the patients, lesion location, clinical features, as well as the presence of local irritants. The gestation period in which the lesion developed was also investigated. Results Forty-one cases of GG were found. The lesions developed predominantly in the third trimester of pregnancy (51.22%) and the mean age of the patients was 28 years. Most GG was found in the gingiva (73.17%), was reddish color and had a mean diameter of 1.5 cm. Local irritants were involved in 75.6% of the cases. Conclusions The hormonal conditions of pregnancy can have an impact on the oral cavity, predisposing the patient to inflammatory lesions such as GG.

Oral granuloma gravidarum: a retrospective study of 41 cases in Southern Brazil

Granuloma gravidarum (GG) is an inflammatory lesion, which develops in the oral mucosa of pregnant women in response to chronic low-grade irritants, under the influence of hormonal factors. Objective To characterize GG clinically by means of a retrospective study of the cases of the Oral Medicine Division, São Lucas Hospital, Brazil. Material and Methods Cases of GG diagnosed between 1980 and 2012 were analyzed. Data were obtained referring to the age of the patients, lesion location, clinical features, as well as the presence of local irritants. The gestation period in which the lesion developed was also investigated. Results Forty-one cases of GG were found. The lesions developed predominantly in the third trimester of pregnancy (51.22%) and the mean age of the patients was 28 years. Most GG was found in the gingiva (73.17%), was reddish color and had a mean diameter of 1.5 cm. Local irritants were involved in 75.6% of the cases. Conclusions The hormonal conditions of pregnancy can have an impact on the oral cavity, predisposing the patient to inflammatory lesions such as GG. .

Prevention and management of oral complications ofhead and neck cancer treatment / Prevenção e administração das complicações bucais do tratamentooncológico de cabeça e pescoço

Introduction: Radiotherapy (RT) and chemotherapy (CT) are therapeutic methods widely used in patients with malignancies in the head and neck regions. However, these therapies are able to induce significant acute and late toxicities to oral structures and surrounding tissues. Objective: To describe the acute and chronic oral complications of RT and CT in head and neck, showing the way the dentist can handle them. Materials and methods: Virtual Health Library (VHL) – Bireme: LILACS, IBECS, MEDLINE and BBO, PubMed, SciELO, Brazilian Digital Library of Theses and Dissertations (BDTD), Capes database journals and renowned oral medicine books. The search strategies used included the following words: radiotherapy, chemotherapy, adverse effects and treatment. Thirty-two references were selected between 1990 and 2012 for the development of this study. Results: Both therapies are associated with adverse effects that significantly affect the patients’ quality of life. Their adverse effects are dose-dependent and may occur from the first week of treatment. Among the most important complications are included the oral mucositis, radiodermatitis, hypossialia, hypogeusia, radiation caries, opportunistic infections, developmental abnormalities, osteoradionecrosis and trismus. A preliminary evaluation of the oral health status and the accompanying by the dentist during treatment may act to prevent and reduce the damage to oral tissues. Conclusion: The multidisciplinary treatment, including medical team, dental surgeon, speech therapist, psychologist and nutritionist is the best alternative to minimize or even prevent many complications resulting from physical and psychological anticancer treatment.

Introdução: A radioterapia (RT) e a quimioterapia (QT) são terapias amplamente empregadas em pacientes portadores de neoplasias malignas em região de cabeça e pescoço. No entanto, são métodos capazes de provocar toxicidades significativas às estruturas orais e tecidos adjacentes. Objetivo: Descrever as complicações bucais agudas e crônicas da RT e QT em cabeça e pescoço, evidenciando a maneira com que o cirurgião-dentista (CD) pode abordá-los. Materiais e métodos: Biblioteca Virtual em Saúde (BVS) – Bireme: LILACS, IBECS, MEDLINE e BBO - PubMed, SciELO, Biblioteca Digital Brasileira de Teses e Dissertações (BDTD), Base Periódicos Capes e livros renomados da área estomatológica. A estratégia de busca utilizada incluiu as seguintes palavras: radioterapia, quimioterapia, efeitos adversos e tratamento. Foram selecionadas 32 referências entre 1990 e 2012 para o desenvolvimento deste estudo. Resultados: Ambas as terapias estão associadas a reações adversas que afetam de forma significativa a qualidade de vida dos pacientes. Seus efeitos adversos são dose-dependentes e podem manifestar-se a partir da primeira semana de tratamento. Entre as complicações orais mais importantes estão a mucosite, radiodermite, hipossialia, hipogeusia, cárie de radiação, infecções oportunistas, anormalidades do desenvolvimento, osteorradionecrose e trismo. A avaliação prévia da condição bucal e o acompanhamento pelo CD durante o tratamento podem atuar na prevenção e redução dos danos causados aos tecidos bucais. Conclusão: O tratamento multidisciplinar, incluindo equipe médica, cirurgiãodentista, fonoaudiólogo, nutricionista e psicólogo é a melhor alternativa para minimizar ou mesmo prevenir diversas complicações físicas e psicológicas advindas do tratamento antineoplásico.

Effect of an herbal compound for treatment of burning mouth syndrome: randomized, controlled, double-blind clinical trial.

OBJECTIVE: This randomized, double-blind, placebo-controlled clinical study aimed at evaluating the effect of the systemic use of an herbal compound (Catuama) on the symptoms of burning mouth syndrome (BMS). STUDY DESIGN: Seventy-two patients with BMS were randomly allocated into test (n = 38) and control (n = 34) groups. Patients were instructed to take 2 capsules each day for 8 weeks. They were reassessed at 4, 8, and 12 weeks after treatment onset using a faces scale (FS) and a visual numeric scale (VNS). RESULTS: Although both groups demonstrated a reduction in symptoms, the improvement observed in the test group was significantly greater than in the control group after 4 (FS: P = .010) and 8 (VNS: P = .03; FS: P < .001) weeks of treatment. This significant reduction was maintained 12 weeks after treatment onset (FS, VNS: P = .001). CONCLUSIONS: The systemic administration of Catuama reduces the symptoms of BMS and may be a novel therapeutic strategy for the treatment of this disease.

Aetiology and therapeutics of burning mouth syndrome: an update.

OBJECTIVE: To provide a review on the aetiology and therapeutic options for the management of patients with burning mouth syndrome (BMS). BACKGROUND: BMS is a chronic disorder that frequently affects women and is characterised by burning symptoms of the oral mucosa without clinical signs. This syndrome has a complex and multifactorial characteristics, but its aetiology remains unknown and this makes it difficult with regard to the treatment and management of such patients. Despite not being accompanied by evident organic changes and not presenting risks to health, BMS can significantly reduce the quality of life for patients. METHODS AND MATERIALS: The article reviews the literature regarding aetiologic factors, clinical implications and treatment of BMS. CONCLUSION: involvement of neurological, emotional and hormonal alterations is proposed in BMS aetiology. However the mechanisms of its development are complex and not completely understood. Tricyclic antidepressants, benzodiazepines and antipsychotic drugs are the most accepted options in treatment and show variable results. The correct diagnosis of BMS and the exclusion of possible local or systemic factors that can be associated with the symptoms are fundamental. It is also important to evaluate the quality of life for these patients to recognise the potential impact of this condition on their lives.

Impact of burning mouth syndrome on quality of life / Impacto da síndrome da ardência bucal na qualidade de vida

OBJECTIVE: To determine the impact of Burning mouth syndrome (BMS) on the quality of life of patients by means of the World Health Organization Abbreviated Instrument for Quality of Life Assessment (WHOQOL-26). METHODS: A total of 116 patients were selected, 58 with BMS and 58 controls. Individuals with changes in the hemogram and in the blood levels of glucose, iron, folic acid and vitamin B12 were excluded, as well as those who used antidepressant and/or anxiolytic drugs or who showed a salivary flow rate of less than 0.1 mL/min. RESULTS: The overall score of the WHOQOL-26 was significantly lower in the group with the disorder (P<0.001). The patients with BMS also displayed significantly lower scores when compared to controls in relation to the psychological and physical domains of the instrument (P=0.005 and P<0.001, respectively). There was no significant difference between BMS and control patients with respect to scores of the social and environment domains. CONCLUSIONS: BMS interferes with the quality of life of patients in a negative way, and therefore, its management is a challenge for the clinicians, who should treat the individual with this disorder in a broader context.

OBJETIVO: Avaliar o impacto da Síndrome da Ardência Bucal (SAB) na qualidade de vida dos pacientes por meio do Instrumento Abreviado de Avaliação de Qualidade de Vida da Organização Mundial de Saúde (WHOQOL-26). MÉTODOS: Foram selecionados 116 pacientes de ambos os sexos, com idade mínima de 40 anos, 58 portadores de SAB e 58 indivíduos-controle. Indivíduos com alterações no hemograma, nas concentrações de glicose, ferro, ácido fólico e vitamina B12 foram excluídos, bem como aqueles que utilizassem fármacos antidepressivos, ansiolíticos ou que apresentassem velocidade de fluxo salivar inferior a 0,1 mL/min. RESULTADOS: O escore geral do WHOQOL-26 foi significativamente inferior no grupo com a doença (P<0,001). Os pacientes com SAB também apresentaram escores significativamente inferiores em relação aos domínios psicológico e físico do instrumento (P=0,005 e P<0,001, respectivamente). Não houve diferença significativa entre os grupos quanto aos escores dos domínios social e ambiental do questionário. CONCLUSÃO: A SAB interfere de forma negativa na qualidade de vida dos pacientes, por isso, é importante que o cirurgião-dentista avalie o paciente com a doença dentro de um contexto mais amplo.

Aspectos clínicos da periodontite agressiva: revisão / Clinical aspects of the aggressive periodontitis: review

A periodontite agressiva é caracterizada como doença de baixa prevalência e de rápida progressão,acometendo principalmente jovens e adultos sistemicamente sadios. O tecido gengival pode apresentarcoloração e textura normais. Observa-se a ocorrência de perda de inserção severa, com formação debolsas periodontais profundas (superiores a 5 mm) e destruição óssea localizada em incisivos e primeirosmolares ou ainda mais generalizada, envolvendo um maior número de dentes. Não há correlação comacúmulo de placa e cálculo. As características radiográficas são bastante distintas, com perda óssea angularna região de incisivos e primeiros molares, geralmente bilateral e simétrica. A mobilidade com consequentemigração dentária é comum e representa um fator de grande desconforto estético para os pacientes; quandodeixada ao curso natural da doença, pode resultar em perdas dentárias. O objetivo deste trabalho é revisaras principais características clínico-patológicas da periodontite agressiva, além abordar as medidas terapêuticas.

Aggressive periodontitis is a disease of low prevalence and rapid progression that occurs primarily inhealthy young and adult people. The gingival tissues may present normal characteristics. The occurrenceof severe attachment loss is observed, associated with deep pockets (up to 5 mm) and also bone destructionin incisive and first molars or even involving a large number of teeth. The attachment loss is notproportional to the presence of plaque and calculus. Radiographic characteristics are singular andpresent bilateral and symmetric bone loss in the incisive and first molars areas. Mobility with consequentdental migration is common and may cause aesthetic dissatisfaction among patients. If not treated, thenatural course of the disease may lead to high tooth mortality. The aim of this sudy is to review theclinical-pathological characteristics of aggressive periodontitis and its therapeutic approach.

Freqüência de tabagismo entre estudantes da FO-UFPEL-RS no ano de 2005 / Frequency of tobacco use among students-during 2005

Objetivos: Estabelecer a prevalência do tabagismo entre os alunos da Faculdade de Odontologia da Universidade Federal de Pelotas no ano de 2005. Método: Utilizou-se um questionário aplicado aos alunos após a aprovação do Comitê de Ética em Pesquisa. A amostra foi composta por 222 alunos de todos os semestres e a análise dos resultados demonstrou que 12,16% destes eram fumantes e que a maioria dos entrevistados desconhecia os malefícios do cigarro para a saúde bucal. Resultados e Conclusão: Os dados revelam que o hábito de fumar não é comum entre os discentes da Faculdade de Odontologia da Universidade Federal de Pelotas, ao mesmo tempo que sugerem que estratégias de esclarecimento sobre as doenças bucais relacionadas ao cigarro devem ser desenvolvidas, contribuindo para que cada vez mais os futuros profissionais atuem como desencorajadores deste hábito.