Tratamientos y barreras de protección utilizadas antes y durante la pandemia en entidades de México / Treatments and protective barriers used before and during the pandemic in entities in Mexico

Introducción: los tratamientos bucodentales son procedimientos que requieren de un diagnóstico visual y táctil; existe alto riesgo de contagio por productos biológicos. Objetivo: determinar los tipos de tratamientos y barreras de protección implementados antes y durante la pandemia de COVID-19 en tres entidades de México. Material y métodos: estudio observacional, analítico y longitudinal en odontólogos de atención clínica privada, instituciones educativas y/o de salud, mediante un muestreo no probabilístico por cuotas de 100 odontólogos por entidad. La información fue recopilada en un formulario de Google distribuido vía WhatsApp y correos electrónicos. Los datos se procesaron en el SPSS v. 22. Resultados: los tratamientos implementados antes del periodo pandémico fueron los programados con 87.2%, durante la pandemia de COVID-19, la atención principal continuó programada (90.9%), las barreras de protección que más aumentaron fueron la protección ocular como gafas protectoras (84.8%) y careta facial (83.1%), presentando la sustitución de la mascarilla tricapa por ser de alta filtración KN95 (78.0%) y el traje aislante (53.0%). Conclusión: los tratamientos realizados antes y durante la pandemia fueron programados, las barreras que incrementaron fueron gafas protectoras, careta, mascarilla KN95 y traje aislante (AU)

Introduction: oral treatments are procedures that require a visual and tactile diagnosis, there is a high risk of infection by biological products. Objective: determine the types of treatments and protection barriers implemented before and during the COVID-19 pandemic in three states in Mexico. Material and methods: it was an observational, analytical and longitudinal study in private clinical care dentists, educational and/or health institutions, through a non-probabilistic sampling by quotas of 100 dentists per entity. The information was collected in a Google form distributed via WhatsApp and emails. The data was processed in SPSS v. 22. Results: the treatments implemented before the pandemic period were those scheduled with 87.2%, during the COVID-19 pandemic the main care continued as scheduled (90.9%) where the protection barriers that increased the most were eye protection such as goggles (84.8%) and facial mask (83.1%). Presenting the substitution of the three-layer mask for high filtration KN95 (78.0%) and the disposable suit (53.0%). Conclusion: the treatments carried out before and during the pandemic were programmed, the barriers that increased were googles, face shield, KN95 mask and insulating suit (AU)

Prevalência e características da disfunção temporomandibular de pacientes de uma clínica escola de Odontologia / Prevalence and characteristics of temporomandibular dysfunction of patients in a Dentistry clinic-school

Objetivos: determinar a prevalência da disfunção temporomandibular (DTM) em pacientes de uma clínica escola de Odontologia, descrever o perfil epidemiológico da amostra analisada, caracterizar o grau dessas disfunções e identificar os sinais e sintomas orofaciais mais frequentes. Método: estudo epidemiológico, do tipo transversal, que avaliou pacientes da Clínica Escola de Odontologia da Universidade de Rio Verde, GO. A pesquisa foi realizada através de três questionários: Índice Anamnésico Simplificado de Fonseca (IASF), Questionário para Triagem para Dor Orofacial (QTDO), questionário sociodemográfico e econômico. Resultados: foram analisados 200 pacientes, dentre os quais 78,5% apresentaram algum grau de DTM, sendo o mais prevalente a DTM de leve intensidade, presente em 38% da amostra. Conclusão: nesse cenário, conclui- -se que a maioria dos participantes apresentou DTM, sendo que a intervenção multidisciplinar seria de suma relevância no tratamento, podendo oferecer uma abordagem mais completa e com melhores resultados.(AU)

Objectives: to determine the prevalence of TMD in patients at a dental school clinic, as well as describe its epidemiological profile for the evaluated sample, characterizing the degree of this dysfunction and identifying the most frequent orofacial signs and symptoms. Method: it is an epidemiological, cross-sectional study that evaluated patients at the School of Dentistry clinic, University of Rio Verde, GO, Brazil. The study was carried out using three questionnaires: Simplified Fonseca Anamnesis Index (SFAI), Orofacial Pain Screening Questionnaire (OPSQ), and the socio-demographic and economic questionnaire. Results: 200 patients were evaluated, among which 78.5% had some degree of TMD, the most prevalent being mild TMD, present in 38% of the sample. Conclusion: most participants had TMD, and multidisciplinary intervention would be of paramount importance in the treatment, being able to offer a more complete approach and with better results.(AU)

Point-of-care characterization and risk-based management of oral lesions in primary dental clinics: A simulation model.

OBJECTIVES: Oral potentially malignant disorders (OPMDs) encompass histologically benign, dysplastic, and cancerous lesions that are often indistinguishable by appearance and inconsistently managed. We assessed the potential impact of test-and-treat pathways enabled by a point-of-care test for OPMD characterization. MATERIALS AND METHODS: We constructed a decision-analytic model to compare life expectancy of test-treat strategies for 60-year-old patients with OPMDs in the primary dental setting, based on a trial for a point-of-care cytopathology tool (POCOCT). Eight strategies of OPMD detection and evaluation were compared, involving deferred evaluation (no further characterization), prompt OPMD characterization using POCOCT measurements, or the commonly recommended usual care strategy of routine referral for scalpel biopsy. POCOCT pathways differed in threshold for additional intervention, including surgery for any dysplasia or malignancy, or for only moderate or severe dysplasia or cancer. Strategies with initial referral for biopsy also reflected varied treatment thresholds in current practice between surgery and surveillance of mild dysplasia. Sensitivity analysis was performed to assess the impact of variation in parameter values on model results. RESULTS: Requisite referral for scalpel biopsy offered the highest life expectancy of 20.92 life-years compared with deferred evaluation (+0.30 life-years), though this outcome was driven by baseline assumptions of limited patient adherence to surveillance using POCOCT. POCOCT characterization and surveillance offered only 0.02 life-years less than the most biopsy-intensive strategy, while resulting in 27% fewer biopsies. When the probability of adherence to surveillance and confirmatory biopsy was ≥ 0.88, or when metastasis rates were lower than reported, POCOCT characterization extended life-years (+0.04 life-years) than prompt specialist referral. CONCLUSION: Risk-based OPMD management through point-of-care cytology may offer a reasonable alternative to routine referral for specialist evaluation and scalpel biopsy, with far fewer biopsies. In patients who adhere to surveillance protocols, POCOCT surveillance may extend life expectancy beyond biopsy and follow up visual-tactile inspection.

Perfil dos usuários e necessidades odontológicas dos pacientes atendidos nas clínicas odontológicas da Universidade Franciscana ­ Santa Maria, RS / Users profile and dental needs of patients attending the dentistry clinics of Universidade Franciscana ­ Santa Maria, RS

Objetivo: o modelo de uso de serviços de saúde de um determinado grupo populacional é, em grande parte, explicadopor seu perfil de necessidades em saúde. O conhecimento deste é importante para estabelecer o modocomo a atenção odontológica será ofertada. Métodos: realizou-se um estudo retrospectivo a partir de dados secundários(prontuários) (n=381) de pacientes atendidos nas clínicas odontológicas da Universidade Franciscana(UFN) de Santa Maria, RS. Os dados deste estudo foram obtidos através da análise dos prontuários de pacientesatendidos nas clínicas odontológicas da UFN entre os anos de 2005 e 2019. Apenas prontuários com a assinaturado paciente ou responsável foram inseridos neste trabalho. Para a obtenção dos dados, foi construído uminstrumento de coleta, sendo obtidas informações sociodemográficas (idade, sexo, cor, estado civil, profissão elocal de residência) e sobre o estado de saúde (doenças sistêmicas, uso de medicação, perfil de saúde bucal eCPO-D). Cada sujeito selecionado recebeu uma codificação que garantiu seu anonimato. A análise estatísticafoi do tipo descritiva e foi realizada em software estatístico. Resultados: a maioria dos pacientes atendidos erado sexo feminino (68,5%), sendo que a faixa etária mais prevalente foi entre 31 e 50 anos (44,5%). A maioriados pacientes eram estudantes (20,3%), seguidos de trabalhadores do lar (10,9%) e aposentados (7,8%).A queixa principal mais reportada foi a dor de dente (25,2%). Nos resultados deste trabalho, a presença dedoença preexistente foi reportada por 87 (22,8%) pacientes, sendo todas classificadas como doenças crônicas,de acordo com a classificação proposta por Murow e Oglesby13 (1996); a mais prevalente foi problemas alérgicos,69 (18,1%), seguidos por problemas respiratórios, 42 (11%), e problemas gástricos, 39 (10%). A utilizaçãode medicação de uso contínuo foi relatada por 150 (39,3%) pacientes. Conclusão: os pacientes das clínicasodontológicas da UFN de Santa Maria, RS, são, em sua maioria, estudantes, aposentados e trabalhadores do lar,sendo a dor e a fratura dentária as principais queixas dos usuários. Dessa maneira, acredita-se que os discentesda instituição devem estar aptos a realizarem atendimentos de caráter emergencial. O conhecimento do manejoodontológico de pacientes com doenças crônicas não transmissíveis deve ser uma preocupação para daquialguns anos, visto que o envelhecimento da população é esperado para os próximos 30 anos.(AU)

Objective: the health services use model of a given population group is largely explained by its profile of health needs. The knowledge of this is important to establish how dental care will be offered. Methods: in view of this, a retrospective study was carried out using secondary data (medical records) (n = 381) of patients seen at the dental clinics at the Franciscana University (UFN) in Santa Maria, RS. The data of this study were obtained through the analysis of the medical records of patients seen at dental clinics at Universidade Franciscana, between the years 2005 and 2019. Only medical records with the signature of the patient or guardian were included in this work. To obtain the data, an instrument for collecting and collecting sociodemographic information (age, sex, color, marital status, profession and place of residence) and health status (systemic diseases, use of medication, oral health profile and CPO-D) were obtained. Each selected subject received a code that guaranteed their anonymity. The statistical analysis was descriptive and was performed using statistical software. Results: most of the patients seen were female (68.5%), with the most prevalent age group between 31 and 50 years old (44.5%). Most patients were students (20.3%), followed by household workers (10.9%) and retired (7.8%). The main complaint most reported was toothache (25.2%). In the results of this study, the presence of pre-existing disease was reported by 87 (22.8%) patients, all of whom were classified as chronic diseases, according to the classification proposed by Murow and Oglesby13 (1996). The most prevalent were allergic problems, 69 (18.1%), followed by respiratory problems, 42 (11%), and gastric problems, 39 (10%). The use of medication for continuous use was reported by 150 (39.3%) patients. Conclusion: patients at dental clinics at UFN in Santa Maria / RS are mostly students, retirees and home workers, with dental pain and fracture being the main complaints of users. Thus, it is believed that the institution's students must be able to provide emergency care. Knowledge of the dental management of patients with chronic non-communicable diseases should be a concern for some years to come, since the aging of the population is expected for the next 30 years.(AU)

Clinical Outcomes of Post-exposure Prophylaxis following Occupational Exposure to Human Immunodeficiency Virus at Dental Departments of Hiroshima University Hospital.

BACKGROUND: Dental professionals have so many opportunities to use injection needles and sharp instruments during dental treatment that they face an increased risk of needlestick injuries. This retrospective study reports the utilization and clinical outcomes of occupational post-exposure prophylaxis (PEP) with anti-retroviral agents after being potentially exposed to HIV at the dental departments of Hiroshima University Hospital. OBJECTIVE: This study reports the utilization and clinical outcomes of occupational post-exposure prophylaxis (PEP) with antiretroviral agents after being potentially exposed to HIV at dental departments of Hiroshima University Hospital. METHODS: Data on the clinical status of HIV-infected source patients and information on HIV-exposed dental professionals from 2007 to 2018 were collected. RESULTS: Five dentists with an average experience of 5.6 years (1-15 years) were exposed. The averaged CD4-positive cell number and HIV-RNA load were 1176 (768-1898) /µl and less than 20 copies/ml, respectively, in all the patients. Two of the five HIV exposed dentists received PEP. Three months after the exposures, all of their results were negative in HIV antibody/antigen tests. CONCLUSION: ; These data might support the concept of "undetectable equals untransmittable", although HIV exposure in this study was not through sexual transmission.

Satisfação dos usuários atendidos na Clínica Integral de Odontologia da Universidade Federal de Pernambuco e fatores associados / Patients satisfaction in Dental School Clinics of the Federal University of Pernambuco and associated factors

Objetivo: avaliar a satisfação dos usuários atendidos nas clínicas integrais do curso de Odontologia da Universidade Federal de Pernambuco e a associação com fatores relacionados ao paciente, ao acesso e ao atendimento. Método: trata-se de um estudo descritivo, quantitativo, de corte transversal, partindo de uma amostra de conveniência, realizado com 81 pacientes adultos, de ambos os sexos. Foi aplicado um questionário semiestruturado com questões do Questionário de Avaliação dos Serviços de Saúde Bucal (QASSAB), uma questão de ansiedade ao tratamento odontológico (Dental Anxiety Question modificada) e dados individuais do paciente, como sexo, idade, escolaridade, local de residência e procedimentos realizados. Resultados: os resultados demonstraram que os usuários consideraram a obtenção de uma vaga como razoável ou fácil (75,3%), e o tempo na fila de espera como razoável ou curto (66,7%). A maioria dos participantes respondeu que o motivo da procura por atendimento na clínica era o fato de não ter dinheiro para pagar o tratamento particular, e 40,7% dos pacientes manifestaram algum sinal de ansiedade. Houve uma avaliação positiva do ambiente físico do serviço por parte dos usuários, para a maioria das variáveis pesquisadas. No entanto, apenas a variável organização foi significativamente associada com a satisfação dos usuários. Conclusão: de forma geral, os resultados encontrados nesta pesquisa indicam um bom nível de satisfação, porém, tornam-se necessárias reavaliações periódicas para obtenção de informações importantes que possibilitem melhorias na estrutura e no atendimento das clínicas.(AU)

Objective: to evaluate patient satisfaction at the Dental School Clinics at the Federal University of Pernambuco, Brazil, and the association with factors related to the patient, access and care. Method: this is a descriptive, quantitative, cross-sectional study, based on a convenience sample, conducted with 81 adult patients, of both sexes. A semi-structured questionnaire was applied with questions from the Oral Health Services Assessment Questionnaire (QASSAB), a question of anxiety to dental treatment (modified Dental Anxiety Question) and individual patient data, such as sex, age, education, place of residence and procedures performed. Results: the results showed that users considered obtaining a place as reasonable or easy (75.3%) and the time in the queue as reasonable or short (66.7%), most participants answered that the reason why they chose theservice was the fact that they did not have the money to pay for private treatment and 40.7% of the patients showed some sign of anxiety. There was a positive evaluation of the physical stucture of the service by users, for most of the variables surveyed. However, only the organization variable was significantly associated with user satisfaction. Conclusion: in general, the results found in this research indicate a good level of satisfaction, however, periodic reassessments are necessary to obtain important information that will allow improvements in the structure and care of clinics.(AU)

Avaliação da atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO) / Evaluation of secondary care in endodontics at a Dental Specialties Center (DSC)

Resumo Objetivou-se avaliar a atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO) de Belo Horizonte (MG). A coleta de dados utilizou dois formulários: (1) sobre o tratamento endodôntico, preenchido pelos endodontistas; (2) sobre o tratamento restaurador, com dados dos prontuários. O programa SPSS 19.0 foi utilizado para analisar os resultados por meio de frequência e percentis. Foram finalizados 452 tratamentos endodônticos em pacientes adultos. Os pacientes apresentaram mediana de 39 anos de idade, a maioria era do sexo feminino (69,7%) e apresentou guia de referência da atenção básica (96,2%). A maior parte dos tratamentos endodônticos foi realizada em pré-molares superiores (23,7%), seguida de molares inferiores (22,3%), utilizando técnica mista (74,1%) e em única sessão (64,2%). O encaminhamento para o tratamento restaurador foi para o CEO em 81,2% dos casos e finalizado em 24,1% casos (n = 109). A contrarreferência após o tratamento restaurador ocorreu em 58,7% dos casos finalizados. É necessário um planejamento conjunto do tratamento odontológico entre a atenção básica e secundária e, dentro desta última, entre as especialidades, além de um adequado processo de referência e contrarreferência, visando garantir a integralidade do cuidado e a eficiência e eficácia do serviço.

Abstract This study aimed to evaluate secondary endodontic care at a Dental Specialties Center (DSC) in Belo Horizonte, MG. Data collection used two forms: (1) on endodontic treatment, completed by the endodontists (2) on the restorative treatment, with data from the medical records. The SPSS 22.0 program was used to analyze the results using frequency and percentiles. In total, 452 endodontic procedures were completed in adult patients. The patients had a median of 39 years of age, most were female (69.7%) and had a primary care referral order (96.2%). Most endodontic treatments were performed in upper premolars (23.7%) followed by lower molars (22.3%), using a mixed technique (74.1%) and in a single session (64.2%). The referral for restorative treatment was for the DSC in 81.2% of cases and finished in 24.1% (n = 109). The counter-referral following restorative treatment occurred in 58.7% of the completed cases. It is necessary to jointly plan the dental treatment between primary and secondary care and, within the latter, among the specialties, in addition to an adequate referral and counter-referral process aimed at ensuring comprehensive care and efficient and effective service.

Evaluation of Dental Anxiety and Fear in Patients who Admitted to the Faculty of Dentistry: Which Patients are More Risky in terms of Dental Anxiety.

BACKGROUND: Dental anxiety and fear make the dental operation and the treatment difficult. Beside that it causes the delays or absence in the dental appointments so it leads to problems for oral and dental health. The aim of this study was to investigate the frequency of dental anxiety, the factors affecting dental anxiety and the effects of dental anxiety on oral dental health of the participants. METHODOLOGY: We conducted a hospital-based, cross-sectional study among 342 patients attending the outpatient clinic of a tertiary dentistry hospital. Dental anxiety and trait anxiety levels of the participants measured using MDAS and STAI scales. We conducted the student t-test, One-way Anova and Tukey's post hoc for the analysis of our data. The Pearson's correlation analysis has been used for the analysis of two different quantitative data obtain from MDAS and STAI scales. RESULTS: The age average of 342 participant of our research was 34,41±11,78. 59,1% of our participants was women. (n=202) Dental anxiety was existing in the 42,1% of the participants (n=144). 56,4% of the participants have had a hard and painful dental treatment experiences. 15,2% of our participants (n=52) had MDAS 19 point or more. CONCLUSIONS: High and statistically significant dental anxiety scores have been detected for the patients who are women, housewives, who had uneasy and painful dental treatment stories, who have personel inclinations to the anxiety. Examinations directed to the factors which would increase the dental anxiety, may prevent possible complications and also the risk carried by the patients related to the dental health may be estimated with the help of this kind of examinations.

Características de pacientes com cárie severa da infância: análise de pacientes atendidos em centro de referência / Characteristics of patients with severe childhood caries: analysis of patients assisted in a reference center

Objetivo: verificar a correlação dos fatores comportamentais na ocorrência de cárie severa. Sujeitos e método: a amostra foi composta de 25 crianças de 6 a 71 meses, atendidas na Clínica Materno Infantil da Faculdade de Odontologia da Universidade de Passo Fundo. O estudo foi realizado em duas etapas: entrevista e exame clínico. A entrevista avaliou os hábitos alimentares e de higiene bucal, as variáveis demográficas e o acesso ao flúor. O exame clínico avaliou a presença de cárie severa (incluindo manchas brancas). Resultados: as principais características das crianças da amostra foram idade superior a 24 meses, menor escolaridade materna, prática da amamentação natural e uso da mamadeira, inclusive com sacarose, além daqueles indivíduos que não realizavam escovação noturna. Não houve diferença estatisticamente significativa na média de ceo-d para nenhum dos fatores em estudo. Conclusão: pode-se concluir que há a necessidade de formar profissionais voltados não apenas ao tratamento, mas também à prevenção das doenças na cavidade oral, como a cárie, mas, para que isso ocorra, é de extrema importância que se conheça o perfil das crianças que necessitam de maior cuidado. (AU)

Objective: verify the correlation of behavioral factors on the occurrence of severe caries. Subjects and method: the sample consisted of 25 children aged six through 71 months, assisted at the Maternal and Child Clinic of the Faculty of Dentistry of the University of Passo Fundo, Brazil. The study was performed in two stages: interview and clinical examination. The interview evaluated food and oral hygiene habits, demographic variables, and access to fluoride. The clinical examination evaluated the presence of severe caries (including white spots). Results: the main characteristics of the children from the sample were age over 24 months, lower maternal level of education, breastfeeding, and bottle-feeding including sucrose, in addition to those who did not perform nighttime brushing. There was no statistically significant difference in the mean of ceo-d for any of the factors studied. Conclusion: it may be concluded that there is a need for training professionals who are focused on both treatment and prevention of diseases in the oral cavity, such as caries. However, to achieve this, it is extremely important to acknowledge the profile of children in need of extended care. (AU)

Fatores associados às faltas em tratamentos ortodônticos em centro de especialidades odontológicas / Factors associated with absences from orthodontic treatment at a dental specialty center

Resumo O objetivo deste estudo foi identificar os fatores associados ao não comparecimento dos usuários ao tratamento ortodôntico, em três centros de especialidades odontológicas regionais (CEO-R) localizados no estado do Ceará. Metodologia: Os dados foram extraídos de prontuários de pacientes que concluíram o tratamento ortodôntico. Foi calculada a taxa de ausências, com o objetivo de estabelecer um coeficiente de faltas entre os municípios. A fim de descrever o padrão geográfico da ocorrência, foram construídos mapas temáticos baseados nas distribuições. Para as associações entre a variável desfecho (falta ao tratamento) e as independentes (sexo, idade, quebra de aparelho, mudança de profissional, renda e local de residência do usuário), utilizou-se a análise de regressão logística múltipla com p ≤ 0,05. Resultados: Foram examinados 237 prontuários em 20 municípios, com 8.283 consultas ortodônticas realizadas e 2.665 (32,17%) faltas. Apresentou diferença estatisticamente significativa a variável mudança de profissional. Conclusão: O maior número de faltas foi associado à mudança de profissional.

Abstract The aim of this study was to identify the factors associated with the users failing to keep orthodontic treatment appointments (absences), in three regional dental specialty centers (CEO-R) located in the State of Ceará. Methodology: This was a cross-sectional epidemiological study with secondary data source of 3 CEO-R, from which 237 medical records of complete orthodontic treatments were examined, with 8.283 appointments and 2.665 (32.17%) missing appointments. Data collection was standardized by an electronic questionnaire.. Factors associated with users missing appointments were calculated by means of absence rates and thematic maps were constructed based on distributions of the geographical pattern of occurrence. To evaluate the association between the outcome variable (absence from treatment) and the independent variables (sex, age, breakage of appliance, change of professional, income and place of user's residence) multiple logistic regression analysis was used with p ≤ 0.05. Results: There were high absence rates for both city headquarters and non-headquarter CEO-Rs. The variable change of professional showed statistical significance, in relation to the number of absences. Conclusion: The highest number of absences was associated with change of professional.

Awareness of Mouth Cancer Among Adult Dental Patients Attending the Kuwait University Dental School Clinic.

In Kuwait, the age-standardized incidence rate (per 100,000) for oral cancer is 1.5 and the mortality rate is 0.4. Early detection of oral cancer combined with appropriate treatment greatly improves the chances of cure and the quality of life. However, little is known about patient awareness of this disease and the ability to identify early signs, particularly among high-risk groups. Hence, the aim of this study is to assess dental patients' awareness and knowledge of mouth cancer and beliefs and perceptions about risk factors. A self-administered questionnaire was used to collect information from a convenience sample of outpatients attending the dental admission clinic. The questionnaire included questions to ascertain information on socio-demographic characteristics, knowledge of risk factors, and signs of oral cancer as well as sources of information regarding the same. Data were analyzed using the Statistical Package for the Social Sciences for Windows 19.0. A total of 160 questionnaires were distributed out of which 136 completed questionnaires were returned and used for the study. The mean knowledge score for oral cancer risk factors was found to be 5.2 ± 2.7 out of ten while that of signs and symptoms was 3.4 ± 2.7 out of eight. When the knowledge of risk factors of oral cancer was taken into consideration along with variables, significant difference was seen only in sex with women having better knowledge (p = 0.03). Knowledge about signs and symptoms of oral cancer revealed a highly significant difference with the level of education (p = 0.03). Family, friends, and colleagues were mentioned as the main source of information regarding oral cancer. Our findings suggest that knowledge regarding oral cancer risk factors, signs, and symptoms was found to be lacking among the dental patients which emphasizes the need for patient education at the dental centers as well as public awareness programs.

Dynamics of the seasonal airborne propagation of Staphylococcus aureus in academic dental clinics

Abstract Objective Staphylococcus aureus strains can be disseminated during dental treatments and occasionally lead to the contamination and infection of patients and dentists, which is an important public health problem. The dynamics of the airborne propagation and the genetic diversity of S. aureus isolated in an academic dental clinic environment were investigated using isoenzyme typing. Material and Methods The isoenzymes of 44 previously reported isolates were obtained from fresh cultures and extracted using glass beads. Nine isoenzymes were investigated using multilocus enzyme electrophoresis (MLEE). The genetic diversity and relationship among the strains (electrophoretic type - ET) were determined using statistics previously described by Nei25 (1972) and the SAHN grouping method (UPGMA algorithm). Results Clonal pattern analyses indicated a high level of genetic polymorphism occurring among the 33 ETs, which were grouped into five taxa. Each taxon presented one or more clusters that were moderately related and that contained two or more identical/highly related isolates, revealing seasonal airborne propagation in these dental clinic environments. Conclusions These data suggest the occurrence of active microevolutionary processes in S. aureus as well as the possibility of environmental propagation during a 14-month time span. Such findings are important to show that multiuser academic dental clinics can retain certain strains that are spreadable to different niches.

Use of dental clinics and oral hygiene practices in the Kingdom of Saudi Arabia, 2013.

OBJECTIVES: We conducted a large household survey in 2013 to determine the current status of oral health practices and use of oral health services in the Kingdom of Saudi Arabia (KSA). METHODS: The Saudi Health Information Survey is a national multistage survey of individuals ≥ 15 years of age. We used a backward elimination multivariate logistic regression model to measure the association between having been to a dental clinic during the last year, and sex, age, marital status, education, time since last routine medical examination, history of diagnosis with a cardiovascular chronic condition, brushing or flossing teeth and use of Miswak (a chewing stick). RESULTS: Between April and June 2013, 10,735 participants completed the survey (89.4% of the households contacted). An estimated 1.5 million (11.5%) and 6.3 million (48.6%) Saudi Arabian people, ≥ 15 years of age, had visited a dental clinic for a routine check-up and for a complaint during the last year, respectively. In total, 16.3%, 85.0% and 52% of Saudi Arabian people never brush their teeth, never floss their teeth or never use Miswak, respectively. The probability of visiting a dental clinic increased with education, among individuals who brushed or flossed their teeth and who used Miswak. CONCLUSIONS: Oral hygiene practices are not common among Saudi Arabian people, and use of health care for prevention of oral disease is limited. Hence, the need for oral health promotion is pressing. The KSA Ministry of Health should develop and implement programmes, through its primary health clinics, to increase the awareness of the importance of good oral health.

Telemedicine Consultations in Oral and Maxillofacial Surgery: A Follow-Up Study.

PURPOSE: The purpose of this study was to follow up on the previous study in evaluating the efficiency and reliability of telemedicine consultations for preoperative assessment of patients. MATERIALS AND METHODS: A retrospective study of 335 patients over a 6-year period was performed to evaluate success rates of telemedicine consultations in adequately assessing patients for surgical treatment under anesthesia. Success or failure of the telemedicine consultation was measured by the ability to triage patients appropriately for the hospital operating room versus the clinic, to provide an accurate diagnosis and treatment plan, and to provide a sufficient medical and physical assessment for planned anesthesia. Data gathered from the average distance traveled and data from a previous telemedicine study performed by the National Institute of Justice were used to estimate the cost savings of using telemedicine consultations over the 6-year period. RESULTS: Practitioners performing the consultation were successful 92.2% of the time in using the data collected to make a diagnosis and treatment plan. Patients were triaged correctly 99.6% of the time for the clinic or hospital operating room. Most patients (98.0%) were given sufficient medical and physical assessment and were able to undergo surgery with anesthesia as planned at the clinic appointment immediately after telemedicine consultation. Most patients (95.9%) were given an accurate diagnosis and treatment plan. The estimated amount saved by providing consultation by telemedicine and eliminating in-office consultation was substantial at $134,640. CONCLUSION: This study confirms the findings from previous studies that telemedicine consultations are as reliable as those performed by traditional methods.

Survey of dental clinic patients: smoking and preferences for cessation support.

BACKGROUND: Smoking cessation interventions delivered by dental practitioners can be as effective as those delivered by general medical practitioners. However, concern that addressing smoking may cause offence to their patients is a reason cited by dental practitioners for not regularly addressing patient smoking behaviours, despite believing they should play a role in smoking cessation. This study aimed to elicit the smoking behaviour and smoking cessation preferences of dental patients to determine if these concerns accurately reflect patient attitudes. METHODS: We surveyed 726 adult dental patients attending The University of Queensland's School of Dentistry dental clinics, Brisbane Dental Hospital and four private dental practices in South-East Queensland. RESULTS: Most (80%) current daily smokers had tried to quit smoking. Smokers and non-smokers both agreed that dentists should screen for smoking behaviour and are qualified to offer smoking cessation advice (99% and 96% respectively). Almost all participants (96%) said they would be comfortable with their dentist asking about their smoking and that if their smoking was affecting their oral health their dentist should advise them to quit. CONCLUSIONS: Patients are receptive to dental practitioners inquiring about smoking behaviour and offering advice on quitting. Smoking patients showed considerable motivation and interest in quitting smoking, particularly in the context of health problems related to smoking being identified. These results should encourage dentists to raise the issue with their patients.

Assessment of volatile organic compounds and particulate matter in a dental clinic and health risks to clinic personnel.

This study was conducted to assess (1) levels of volatile organic compounds (VOCs) and particulate matter (PM) in a dental clinic in southern Taiwan and (2) dental care personnel's health risks associated with due to chronic exposure to VOCs. An automatic, continuous sampling system and a multi-gas monitor were employed to quantify the air pollutants, along with environmental comfort factors, including temperature, CO2, and relative humidity at six sampling sites in the clinic over eight days. Specific VOC compounds were identified and their concentrations were quantified. Both non-carcinogenic and carcinogenic VOC compounds were assessed based on the US Environmental Protection Agency's Principles of Health Risk Assessment in terms of whether those indoor air pollutants increased health risks for the full-time dental care professionals at the clinic. Increased levels of VOCs were recorded during business hours and exceeded limits recommended by the Taiwan Environmental Protection Agency. A total of 68 VOC compounds were identified in the study area. Methylene methacrylate (2.8 ppm) and acetone (0.176 ppm) were the only two non-carcinogenic compounds that posed increased risks for human health, yielding hazard indexes of 16.4 and 4.1, respectively. None of the carcinogenic compounds increased cancer risk. All detected PM10 levels ranged from 20 to 150 µg/m(3), which met the Taiwan EPA and international limits. The average PM10 level during business hours was significantly higher than that during non-business hours (P = 0.04). Improved ventilation capacity in the air conditioning system was recommended to reduce VOCs and PM levels.

Avaliação retrospectiva de 25 anos sobre condições sistêmicas e bucais de pacientes atendidos em clínica estomatológica / Twenty five years retrospective evaluation of systemic and oral conditions of patients treated in stomatological service

Foram avaliados 624 prontuários clínicos, pertencentes a uma Clínica particular de Estomatologia localizada na cidade de Lins-SP, os quais foram confeccionados no período de 1989 a 2014. Procurou-se investigar a prevalência de alterações sistêmicas e de alterações bucais, buscando-se ainda determinar o índice de correlação entre estas duas alterações, em função do gênero, de grupo étnico-racial, dos fatores de risco (tabagismo e etilismo) e da faixa etária. Os dados coletados foram submetidos à análise estatística, tendo sido estabelecido um intervalo de confiança de 95% e nível de significância de 5%. Utilizou-se o teste do Qui Quadrado para avaliar a associação entre variáveis e a Regressão Logística Binária para determinar os fatores preditores das principais alterações bucais observadas nesta população deste estudo, as neoplasias, as lesões precursoras e as alterações glandulares. Foi constatado que houve uma maior procura pelos serviços estomatológicos por indivíduos do gênero feminino (63,5%), leucodermas (84,3%), não fumantes (64,9%) e não etilistas (86,7%), sem prevalência de idade. Em um total de 1.902 doenças sistêmicas houve prevalência das doenças oftálmicas (54%), alterações imunológicas (38,5%), distúrbios neurológicos (36,4%) e alterações cardiovasculares (35,1%). As doenças bucais apresentaram um total de 866 alterações patológicas, abrangendo 99,52% da amostra, com prevalência das doenças inflamatórias (27,4%), lesões traumáticas (24,0%), variações da normalidade (22,4%) e doenças glandulares (19,1%). Foram verificadas as associações entre neoplasias benignas bucais e neoplasias em geral, de neoplasias malignas bucais e doenças cardiovasculares, ou com as alterações imunológicas. Foram calculados os índices de correlação entre alterações glandulares bucais e cardiovasculares, distúrbios neurológicos, doenças infectocontagiosas, geniturinárias, ósseas, distúrbios hematológicos e neoplasias. As lesões traumáticas foram associadas com alterações...

A total of 624 clinical records belonging to a private Clinic of Stomatology located in Lins - SP were evaluated, which were made in the period of 1989 to 2014. We sought to investigate the prevalence of systemic diseases and oral changes, seeking to determine the correlation index between these two changes, depending on gender, ethnic and racial group, the risk factors (smoking and drinking) and age group. Data were statistically analyzed, having been established a confidence interval of 95% and 5% significance level. We used the Chi square to evaluate the association between variables and Binary Logistic Regression to determine the predictors of major oral changes observed in this population study, neoplasms, precursor lesions and glandular changes. It was found that there was a greater demand for Stomatological services by female subjects (63.5%), Caucasian (84.3%), non-smokers (64.9%) and non-alcoholic (86.7%) without prevalence of age. In a total of 1,902 systemic diseases, there was prevalence of ophthalmic diseases (54%), immunological disorders (38.5%), neurological disorders (36.4%), cardiovascular disorders (35.1%). The oral diseases were a total of 866 pathological changes, including 99.52% of the sample, with a prevalence of inflammatory diseases (27,4%), traumatic injuries (24.0%), normal variation (22.4%) and glandular disease (19.1%). Associations were found between oral cancer and benign neoplasms in general, mouth cancers and cardiovascular diseases, or immune changes. The correlation ratios between oral and cardiovascular glandular changes were calculated, neurological disorders, infectious, genitourinary and bone diseases, hematological disorders and neoplasms. Traumatic injuries have been associated with cardiovascular, bone diseases and ophthalmic diseases. Age higher than 50 years and alcohol consumption seemed predictive factors for oral cancer and immunological changes being protective factors. As for the mouth...

Avaliação retrospectiva de 25 anos sobre condições sistêmicas e bucais de pacientes atendidos em clínica estomatológica / Twenty five years retrospective evaluation of systemic and oral conditions of patients treated in stomatological service

Foram avaliados 624 prontuários clínicos, pertencentes a uma Clínica particular de Estomatologia localizada na cidade de Lins-SP, os quais foram confeccionados no período de 1989 a 2014. Procurou-se investigar a prevalência de alterações sistêmicas e de alterações bucais, buscando-se ainda determinar o índice de correlação entre estas duas alterações, em função do gênero, de grupo étnico-racial, dos fatores de risco (tabagismo e etilismo) e da faixa etária. Os dados coletados foram submetidos à análise estatística, tendo sido estabelecido um intervalo de confiança de 95% e nível de significância de 5%. Utilizou-se o teste do Qui Quadrado para avaliar a associação entre variáveis e a Regressão Logística Binária para determinar os fatores preditores das principais alterações bucais observadas nesta população deste estudo, as neoplasias, as lesões precursoras e as alterações glandulares. Foi constatado que houve uma maior procura pelos serviços estomatológicos por indivíduos do gênero feminino (63,5%), leucodermas (84,3%), não fumantes (64,9%) e não etilistas (86,7%), sem prevalência de idade. Em um total de 1.902 doenças sistêmicas houve prevalência das doenças oftálmicas (54%), alterações imunológicas (38,5%), distúrbios neurológicos (36,4%) e alterações cardiovasculares (35,1%). As doenças bucais apresentaram um total de 866 alterações patológicas, abrangendo 99,52% da amostra, com prevalência das doenças inflamatórias (27,4%), lesões traumáticas (24,0%), variações da normalidade (22,4%) e doenças glandulares (19,1%). Foram verificadas as associações entre neoplasias benignas bucais e neoplasias em geral, de neoplasias malignas bucais e doenças cardiovasculares, ou com as alterações imunológicas. Foram calculados os índices de correlação entre alterações glandulares bucais e cardiovasculares, distúrbios neurológicos, doenças infectocontagiosas, geniturinárias, ósseas, distúrbios hematológicos e neoplasias. As lesões traumáticas foram associadas com alterações...

A total of 624 clinical records belonging to a private Clinic of Stomatology located in Lins - SP were evaluated, which were made in the period of 1989 to 2014. We sought to investigate the prevalence of systemic diseases and oral changes, seeking to determine the correlation index between these two changes, depending on gender, ethnic and racial group, the risk factors (smoking and drinking) and age group. Data were statistically analyzed, having been established a confidence interval of 95% and 5% significance level. We used the Chi square to evaluate the association between variables and Binary Logistic Regression to determine the predictors of major oral changes observed in this population study, neoplasms, precursor lesions and glandular changes. It was found that there was a greater demand for Stomatological services by female subjects (63.5%), Caucasian (84.3%), non-smokers (64.9%) and non-alcoholic (86.7%) without prevalence of age. In a total of 1,902 systemic diseases, there was prevalence of ophthalmic diseases (54%), immunological disorders (38.5%), neurological disorders (36.4%), cardiovascular disorders (35.1%). The oral diseases were a total of 866 pathological changes, including 99.52% of the sample, with a prevalence of inflammatory diseases (27,4%), traumatic injuries (24.0%), normal variation (22.4%) and glandular disease (19.1%). Associations were found between oral cancer and benign neoplasms in general, mouth cancers and cardiovascular diseases, or immune changes. The correlation ratios between oral and cardiovascular glandular changes were calculated, neurological disorders, infectious, genitourinary and bone diseases, hematological disorders and neoplasms. Traumatic injuries have been associated with cardiovascular, bone diseases and ophthalmic diseases. Age higher than 50 years and alcohol consumption seemed predictive factors for oral cancer and immunological changes being protective factors. As for the mouth...

[Analysis of outpatient care in Brazilian municipalities with and without specialized dental clinics, 2010]. / Análise da produção ambulatorial em municípios com e sem centros de especialidades odontológicas no Brasil em 2010.

The aim of this study was to describe the production of specialized outpatient dental services and associated factors in Brazilian municipalities (counties) with and without Specialized Dental Clinics (SDC). Data were collected from the following sources: Information Technology Department of the Unified National Health System, Human Development Atlas for Brazil, and Brazilian Institute of Geography and Statistics. Zero-inflated negative binomial regression was used to fit rates of endodontic procedures, primary care, periodontics, and surgery. After controlling for socio-demographic factors, municipalities with SDC showed higher rates for the above-mentioned procedures than those without, except for primary care. In the final model, including service structure variables, municipalities with type III SDC showed a rate of endodontic procedures that was 2.08 times higher (95%CI: 1.26; 3.44) than those without. Among the structural variables, municipalities with higher health expenditures and more dentists in the Unified National Health System showed consistently higher rates for all types of procedures. The SDC appear to have a positive effect on the local production of specialized procedures (especially endodontic), an effect not explained by structural variables.

Análise da produção ambulatorial em municípios com e sem centros de especialidades odontológicas no Brasil em 2010 / Analysis of outpatient care in Brazilian municipalities with and without specialized dental clinics, 2010 / Análisis de la producción ambulatoria en municipios con y sin centros de especialidades dentales en Brasil, 2010

O objetivo foi descrever a produção de serviços especializados em municípios brasileiros com e sem Centros de Especialidades Odontológicas (CEO) e estudar fatores associados. Para a coleta de dados, foram consultados: o Departamento de Informática do SUS, dados do Atlas de Desenvolvimento Humano do Brasil e do Instituto Brasileiro de Geografia e Estatística. Utilizou-se regressão binominal negativa inflada de zeros para modelar taxas de procedimentos de endodontia, atenção básica, periodontia e cirurgia. Após controle por fatores sociodemográficos, os municípios com CEO apresentaram taxas maiores do que os sem, exceto para taxas de atenção básica. No modelo final, com variáveis de estrutura dos serviços, os municípios com CEO do tipo III tiveram uma taxa de procedimentos de endodontia 2,08 (IC95%: 1,26; 3,44) vezes maior que sem CEO. Das variáveis de estrutura, mais gastos em saúde e maiores taxas de dentistas no SUS estavam consistentemente associados a maiores taxas de quaisquer procedimentos. Os CEO parecem ter um efeito positivo na produção municipal de procedimentos especializados, particularmente para a taxa de procedimentos de endodontia, e esse efeito não é explicado por variáveis de estrutura.

The aim of this study was to describe the production of specialized outpatient dental services and associated factors in Brazilian municipalities (counties) with and without Specialized Dental Clinics (SDC). Data were collected from the following sources: Information Technology Department of the Unified National Health System, Human Development Atlas for Brazil, and Brazilian Institute of Geography and Statistics. Zero-inflated negative binomial regression was used to fit rates of endodontic procedures, primary care, periodontics, and surgery. After controlling for socio-demographic factors, municipalities with SDC showed higher rates for the above-mentioned procedures than those without, except for primary care. In the final model, including service structure variables, municipalities with type III SDC showed a rate of endodontic procedures that was 2.08 times higher (95%CI: 1.26; 3.44) than those without. Among the structural variables, municipalities with higher health expenditures and more dentists in the Unified National Health System showed consistently higher rates for all types of procedures. The SDC appear to have a positive effect on the local production of specialized procedures (especially endodontic), an effect not explained by structural variables.

El objetivo fue describir la producción de los servicios especializados en los municipios brasileños con y sin Centros Especializados Dentales (CEDs) y estudiar los factores asociados. Los datos fueron recogidos a partir de los siguientes sistemas: Departamento de Informática del SUS, Atlas del Desarrollo Humano y el Instituto Brasileño de Geografía y Estadística. Fueron utilizadas regresiones binomiales negativas infladas con ceros para ajustar las tasas de los procedimientos de endodoncia, atención primaria, periodoncia y cirugía. Después de controlar los factores sociodemográficos, los municipios con CEDs presentan tasas más altas que los sin CEDs, excepto para la tasa de atención primaria. En el modelo final, incluyendo los factores de la estructura de servicio, municipios con CEDs tipo III mostraron una tasa de procedimientos de endodoncia 2,08 (IC95%: 1,26; 3,44) veces mayor. Entre estos factores, los municipios con mayor gasto en salud y mayores tasas de dentistas en el sistema público se asociaron con tasas más altas de todos los procedimientos. Se concluye que los centros parecen tener un efecto positivo en la producción ambulatoria, principalmente para endodoncia y este efecto no se explica por las variables de estructura.