Actitudes de los psicólogos costarricenses hacia la aplicación de la psicología en la consulta odontológica / Attitudes of Costa Rican Psychologists Towards the Application of Psychology During the Dentistry Consultation

Resumen Estudio exploratorio-descriptivo sobre un grupo de profesionales costarricenses en psicología acerca de sus actitudes hacia la aplicación de los principios psicológicos en la práctica odontológica. La muestra fue de 377 psicólogos (activos en el Colegio de Profesionales en Psicología de Costa Rica). A partir del cuestionario original diseñado por Gómez y Gómez (2007), el cual fue construido para estimar la necesidad de conformar programas universitarios que integren la psicología y la odontología, se aplicó una adaptación consistente en una encuesta de 10 preguntas autoadministradas de selección simple, la cual se efectuó en línea a través del sistema QuestionPro®. Se pudo evidenciar que existe una actitud positiva ante el enfoque interdisciplinario entre la Odontología y la Psicología; se demostró que un 74% de la muestra sostiene que los aspectos psicosociales son "Bastante importantes" en el marco de la atención odontológica. A pesar de ello, la mayoría (57%) de las personas consultadas indicó que no ha tenido ocasión de aplicar sus conocimientos y experiencia en psicología al contexto odontológico. Asimismo, un 72% de los participantes considera "Bastante importante" que los profesionales en Odontología reciban capacitación básica en el área psicológica para la prevención o contención de ciertos síntomas que puedan incidir en la salud mental. Por otra parte, el 80% de quienes respondieron la encuesta indicaron que las iniciativas interdisciplinarias de colaboración científica (investigación) y aplicada (ejercicio profesional) son "Bastante importantes" para producir beneficios tangibles en la prestación de servicios integrales a los pacientes y el bienestar del personal sanitario.

Abstract Exploratory-descriptive study on a group of Costa Rican professionals in psychology about their attitudes towards the application of psychological principles in dental practice. The sample consisted of 377 psychologists (active in the Association of Psychology Professionals of Costa Rica). From the original questionnaire designed by Gómez and Gómez (2007), which was built to estimate the need to create university programs that integrate psychology and dentistry, an adaptation consisting of a survey of 10 self-administered questions of simple selection was applied, which was carried out online through the QuestionPro® system. It was possible to show that there is a positive attitude towards the interdisciplinary approach between Dentistry and Psychology; it was shown that 74% of the sample maintains that psychosocial aspects are "Quite important" in the context of dental care. Despite this, the majority (57%) of the people consulted indicated that they had not had the opportunity to apply their knowledge and experience as psychologists to the dental context. Likewise, 72% of the participants consider it "Quite important" that dental professionals receive basic training in the psychological area for the prevention or containment of certain symptoms that may affect mental health. On the other hand, 80% of the survey respondents indicated that interdisciplinary initiatives of professional scientific (research) and applied (practice) collaboration are "Quite important" to produce tangible benefits in the provision of comprehensive services to patients and wellbeing of health personnel.

Knowledge, Dental Anxiety, and Patient Expectations During the COVID-19 Pandemic

Abstract Objective: To assess the knowledge, dental anxiety, and expectations regarding dental services during the COVID-19 pandemic. Material and Methods: The respondents were Indonesian citizens above 18 years old. An online Google survey was administered using a structured questionnaire with a snowball sampling technique. Survey items comprised knowledge related to COVID-19, dental anxiety assessed using the modified DAS (Dental Anxiety Scale) and expectations regarding dental services using four dimensions of dental service quality. All questionnaires were tested for reliability and indicated acceptable and good agreement. The data were analyzed descriptively. Results: A total of 553 responses were analysed. Most respondents were female (72.9%), 76.7% knew of recommendations to postpone dentist visits and 86.8% knew methods of preventing COVID-19 transmission. More than 70% of respondents knew the precaution procedures in the dental office during COVID-19, and only 27.9% had moderate-severe anxiety. Most respondents' expectations regarding dental services during the pandemic era were related to the quality domain of reliability and responsiveness. Conclusion: Respondents knew about COVID-19 transmission and prevention, emergency conditions warranting a visit to the dentist and the procedures used at the dental office. Most respondents stated that they were not anxious about visiting a dentist during the pandemic. The respondents expect the dentist to provide sufficient information to improve oral health and treatment plan.

Ensino em saúde LGBTQI+ para alunos de odontologia: uma revisão sistemática / LGBTQI + healtheducation for dental students: a systematic review

Objetivo: investigar, na literatura odontológica, estudos que abordem diferentes aspectos do ensino de temas LGBTQI+ (Lésbicas, Gays, Bissexuais, Transexuais, População Quer, Intersexo e outros) nos cursos de odontologia e quais são as abordagens pedagógicas sugeridas para reduzir preconceitos e discriminação no atendimento odontológico. Metodologia: uma busca foi conduzida nas bases de dados PubMed, Scopus, Web of Science e BVS/Bireme, até julho de 2017. Após a remoção de duplicatas, dois revisores independentes conduziram a seleção dos artigos. Resultados: a busca inicial resultou em 924 títulos. Após leitura completa, apenas oito completaram os critérios de inclusão. Os artigos incluídos nesta revisão demonstraram que alunos, lideranças estudantis e administradores reconhecem medidas de suporte, apoio e inclusão existentes. Algumas instituições apresentaram em seu currículo temas relacionados com a população LGBTQI+, porém, relacionadas frequentemente com doenças. Essa cobertura é apontada como fraca e insuficiente para o atendimento qualificado. Apenas dois estudos apresentaram métodos para o ensino de questões LGBTQI+; entretanto, apenas um avaliou qualitativamente seus resultados. Conclusão: existe uma grande carência de estudos que descrevam abordagens e métodos de ensino de temas LGBTQI+ na odontologia.(AU)

Objective: to investigate in the dental literature studies addressing different aspects of LGBTQI+ (Lesbians, Gays, Bisexuals, Transsexuals, Queer Population, Intersex and others) education topics and the approaches used to reduce inequalities and prejudices in dental care. Methods: a search was conducted in the PubMed, Scopus, Web of Science and BVS/Bireme databases, until July 2017. After removing duplicates, two independent reviewers conducted the selection of articles. Results: the initial search resulted in 924 titles. After complete reading, eight studies completed the inclusion criteria. The articles included in this review demonstrated that students, student leaders and administrators recognize support and inclusion measures. Some institutions presented topics related to the LGBTQI+ population in their curriculum, but often related to diseases. This approach was identified as weak and insufficient for a qualified service. Only two studies presented methods for teaching LGBTQI+, but only one assess qualitative results. Conclusions: there is a lack of studies that approach the education of LGBTQI+ topics mainly related to teaching methodologies.(AU)

O sofrimento psicológico de pacientes com patologias bucais à perspectiva da Psicologia / Psychological distress of patients with oral pathologies in the perspective of Psychology

Objetivo: Investigar as naturezas do sofrimento psicológico ocasionado por problemas bucais. Métodos: Esta pesquisa adotou uma abordagem qualitativa e caráter exploratório-descritivo, utilizando-se da entrevista semiestruturada e da observação assistemática como instrumentos de coleta de dados. Para a análise dos dados da pesquisa foi utilizada a análise do conteúdo e a amostra da pesquisa foi de 25 participantes, entre homens e mulheres, que buscaram atendimento odontológico em uma clínica de Manaus, Amazonas, Brasil nos meses de maio e junho de 2020. Resultados: todos os participantes foram afetados psiquicamente pela existência de problemas bucais, o que gerou problemas de autoestima e autoimagem. Com o início do tratamento, os participantes relataram uma melhora na autoestima, não minimizando, contudo, outros tipos de sentimentos provenientes do problema bucal, como desconforto, dores e bullying. Conclusão: Problemas bucais podem gerar sofrimento psicológico aos pacientes, prejudicando sua autoimagem, acarretando, muitas das vezes, no isolamento e dificuldade em relacionar-se com outras pessoas. Portanto, um sorriso harmonioso é importante não somente por questões estéticas, mas para que o indivíduo se sinta bem consigo mesmo.

Aim:To investigate the nature of psychological distress caused by oral problems. Methods: This research adopted a qualitative approach and exploratory-descriptive design, employing, as data collection tools, a semi-structured interview and an unsystematic observation. For the research's data analysis, content analysis was used, and the research sample featured 25 participants, between men and women, who sought out dental care in a Manaus, Amazonas, Brazil dental clinic between May and June 2020. Results: All the participants were affected psychologically by the existence of oral problems, which led to self-esteem and self-image problems. With the start of treatment, the participants reported an improvement in self-esteem and self-image, not minimizing, however, other types of feelings that come with oral problems, like discomfort, pain, and bullying. Conclusion: Oral problems can cause psychological pain to the patients, harming their self-esteem and self-image, often leading to isolation and trouble interacting with other people. Therefore, a harmonious smile is important not only for esthetic reasons, but also for individuals to feel good about themselves.

Imaginarios, creencias y actitudes que influyen en la consulta odontopediátrica en menores de 3 años / Social imaginary, beliefs and attitudes that influence the pediatric dental consultation in children under 3 years old

Los niños menores de 3 años son llevados a la consulta médica de forma rutinaria. Sin embargo, la consulta odontológica es muy infrecuente a esta edad. Por otro lado, los elementos que median en la decisión de consultar o no al dentista en esta etapa son hasta el momento poco conocidos. El objetivo de este estudio cualitativo fue identificar imaginarios, creencias y actitudes que podrían intervenir en la decisión de realizar una consulta odontopediátrica en pacientes menores de 3 años. Se aplicaron 10 entrevistas semi-estructuradas a mujeres profesionales, madres de niños entre 8 y 36 meses. Luego, se realizaron 4 entrevistas grupales en profundidad a 13 mujeres que no habían participado en la entrevista inicial. A pesar del alto nivel educativo de las madres se detectó un importante desconocimiento en temas de salud oral. Las madres sub-dimensionan el potencial de la consulta odontopediátrica en esta etapa. En segundo lugar, las madres consideran que una consulta odontopediátrica en este período es abrumadora considerando las altas demandas de esta etapa de la maternidad. Es importante mejorar los conocimientos de salud oral en este grupo de la población y modificar estrategias de prevención y promoción de la salud en preescolares.

Parents of children under 3 years old frequently take their children to medical check-ups. However, dental check-ups are infrequent at this age. The reasons behind this behavior are not well known. The present qualitative study aimed to identify social imaginary, attitudes and beliefs that may influence the decision to consult a pediatric dentist in parents of children under 3 years old. Semi-structured interviews were applied to 10 working mothers that had children between 8 and 36 months. These interviews allowed the identification of the most significant issues to be explored in this study. Afterwards, a total of 13 mothers who did not participate in the initial interviews were divided in 4 groups and in-depth group interviews were performed. Mothers involved in this study had a high educational level. However, their knowledge concerning oral health issues was very poor. Moreover, a frequent finding in this study was the notion that a dental consultation at this stage is considered to be overwhelming by these women because of their very demanding duties . It is important to increase the knowledge regarding oral health topics in this group and to modify policies about oral health at this stage of a child's life.

Choosing the Criteria for Clinical Evaluation of Composite Restorations: An Analysis of Impact on Reliabilty and Treatment Decision

Abstract Objective: To assess the reproducibility of two clinical criteria for the evaluation of restorations in primary teeth and the impact on treatment decision. Material and Methods: A cross-sectional study was performed selecting 71 resin-based composite restorations placed in primary molars of children who had sought dental treatment at a dental school. Two trained examiners evaluated independently the restorations using modified FDI and USPHS criteria. All restorations were assessed separately with each system in random order to avoid memory bias. Kappa statistics were used to determine inter-examiner reliability considering each parameter of both criteria and score final about treatment decision. McNemar test was used to compare the treatment decision with two criteria. The significance level was set at 5%. Results: Kappa values ranged from 0.28 to 0.93 with USPHS and 0.28 to 0.88 with FDI, considering each parameter separately. Inter-examiner agreement for treatment decision was excellent for both criteria (Kappa: 0.85-0.90). For clinical decision-making, no difference between criteria was found, irrespective of examiner. Conclusion: Low inter-examiner agreement for evaluation of each parameter of USPHS and FDI criteria does not reflect on reproducibility for treatment decision. Both criteria may be suitable for evaluation of composite restorations in primary teeth.

Dor, ansiedade e qualidade de vida relacionada à saúde bucal de pacientes atendidos no serviço de urgência odontológica / Pain, anxiety and quality of life related to the oral health of patients treated in a dental emergency clinic

Resumo O objetivo deste estudo foi avaliar associação entre dor pré-operatória, ansiedade e impacto da condição bucal na qualidade de vida dos pacientes atendidos no serviço de Urgência Odontológica da Universidade Federal dos Vales do Jequitinhonha e Mucuri. Estudo transversal retrospectivo foi conduzido avaliando dados clínicos de 240 prontuários de pacientes com idades entre 18 e 65 anos. A dor foi mensurada pela Heft-Parker Visual Analogue Scale; ansiedade, pela Corah's Detal Anxiety Scale e qualidade de vida, pelo Oral Health Impact Profile (OHIP-14). Associações foram analisadas pelo Teste qui-quadrado de Pearson (p < 0,05). Foi observada associação estatisticamente significante entre dor e pior qualidade de vida, com impacto nos domínios desconforto psicológico (p < 0,001), incapacidade física (p < 0,001), psicológica (p < 0,001) e social (p < 0,001). Ansiedade influenciou na pior qualidade de vida, com impacto nos domínios desconforto psicológico (p = 0,009), incapacidade fisica (p = 0,016), psicológica (p = 0,011) e desvantagem social (p = 0,028). Esse estudo é relevante para o planejamento de ações voltadas para a saúde bucal dos pacientes atendidos nos serviços de urgência odontológica, priorizando aqueles com maiores impactos psicossociais decorrentes dos problemas bucais.

Abstract The scope of this study was to assess the association between preoperative pain, anxiety and the impact of the oral condition on the quality of life of patients treated at the Dental Emergency Service at the Federal University of the Jequitinhonha and Mucuri Valleys. A retrospective cross-sectional study was conducted evaluating data from 240 patient charts aged from 18 to 65 years. Pain was measured by the Heft-Parker Visual Analog Scale; dental anxiety by Corah's Dental Anxiety Scale; and oral health-related quality of life by the Oral Health Impact Profile (OHIP-14). Associations were analyzed using Pearson's Chi-square test (p < 0.05). A statistically significant association was observed between pain and poorer quality of life, with impacts on psychological discomfort (p < 0.001), physical incapacity (p < 0.001) and the psychological (p < 0.001) and social (p < 0.001) domains. Anxiety influenced poorer quality of life, with impacts on the psychological discomfort (p = 0.009), physical disability (p = 0.016), psychological disability (p = 0.011) and social disadvantage (p = 0.028) domains. This study is relevant for the planning of programs and actions aimed at the oral health of patients treated in dental emergency services, prioritizing those with the greatest psychosocial impact arising from oral problems.

Gênero e Odontologia: Um relato de experiência / Gender and Dentistry: a clinical case report

Objetivo: a literatura tem apontado para uma pequena sensibilização e capacitação dos profissionais de saúde ao acolher e atender a população LGBT. O presente estudo objetivou relatar um caso clínico de uma usuária trans e discutir aspectos importantes sobre o atendimento e o acolhimento de transexuais e travestis. Relato de caso: a usuária, nome social de "A", 25 anos de idade, sexo biológico masculino e gênero feminino foi encaminhada da Unidade Básica de Saúde com queixas estéticas e cálculo supra/subgengival. A usuária chegou ao atendimento já apresentando sinais claros de desconforto e reclusão. Ao observar tal estado foi indagado à usuária, no início da entrevista dialogada, se ela teria outro nome em que gostaria de ser identificada. Então, prontamente a paciente identificou seu nome social. A partir daquele momento, J.F.C.P., passou a ser "A" durante todo o atendimento, bem como seu direito lhe assegura. Em seguida, a usuária já demonstrou estar mais confortável e receptiva a conversa da entrevista dialogada, fortalecendo o vínculo com a estudante. Ainda durante a entrevista, a usuária demonstrou ter dúvidas em relação a alguns de seus direitos enquanto mulher trans, como por exemplo, o uso do nome social no cartão do SUS. Considerações Finais: o profissional de saúde tem como principal papel no acolhimento de transexuais e travestis a criação de um vínculo isento de preconceitos. Assim, é dever do profissional atualizar-se em relação a questões de gênero e sexualidade a fim de prevenir situações e propagações de preconceito, discriminação e violência.(AU)

Objective: The literature has indicated a low level of awareness and training of health professionals in welcoming and serving the LGBT population. The present study aimed to report a clinical case of a trans user and discuss important aspects about the care and reception of transsexuals and transvestites. Case report: The user, with a social name of "A", 25 years old, male biological sex and female gender, was referred from the Basic Health Unit with aesthetic complaints and supra/subgingival calculus. The user arrived at the service already presenting clear signs of discomfort and seclusion. Considering such a state, the user was asked at the beginning of the dialog interview whether she had another name in which she would like to be identified. Then, the patient promptly identified her social name. From that moment, J.F.C.P. became "A" throughout the service, as assured by her rights. After this, the user was already more comfortable and receptive to the conversation in the interview, strengthening the bond with the student. During the interview, the user also expressed doubts about some of her rights as a trans woman, such as the use of the social name on her public health system card. Final considerations: The main role of health professionals in the reception of transsexuals and transvestites is to create a bond free of prejudices. Thus, professionals have a duty to be updated on issues of gender and sexuality to prevent situations and propagations of prejudice, discrimination, and violence.(AU)

Avaliação da satisfação com a assistência odontológica na perspectiva de usuários brasileiros adultos: análise multinível / Evaluation of satisfaction with dental care from the standpoint of adult Brazilian users: a multilevel analysis

Resumo Objetivou-se avaliar a satisfação quanto aos serviços de assistência odontológica e identificar associação entre a insatisfação e as variáveis contextuais/individuais. Estudo transversal multinível de dados secundários de uma amostra representativa de 8.943 adultos de 177 municípios. Encontravam-se insatisfeitos 14,9% dos adultos. Registrou-se maior chance de insatisfação com os serviços odontológicos entre adultos que residiam em municípios com maior desigualdade social (OR:1,53;IC95%:1,31-1,81) e com menor proporção de dentistas por habitante (OR:1,17;IC95%: 1,00-1,37); amarelos/negros/pardos/indígenas (OR:1,12; IC95%: 0,99-1,27); menor escolaridade (OR:1,14; IC95%: 0,98-1,33); consulta por motivo de problemas bucais (OR:1,23; IC95%: 1,04-1,44); insatisfeitos com os dentes e boca (OR:2,60;IC95%:2,53-3,02) e com impacto das desordens bucais no desempenho diário (OR:1,48;IC95%:1,30-1,69). A implementação ou adequação de políticas públicas com o intuito de melhorar a satisfação com os serviços odontológicos deve priorizar os municípios com maior desigualdade social e com menos dentistas e usuários socialmente desfavorecidos, que autopercebem problemas bucais, insatisfeitos com sua saúde bucal e com impactos decorrentes dos problemas bucais.

Abstract The scope of this paper was to evaluate the satisfaction regarding dental care services and to identify the association between dissatisfaction and contextual/individual variables. It involved a cross-sectional study of a representative sample of 8,943 adults from 177 municipalities, in which 14.9% of adults were dissatisfied. In the multiple analysis there was a greater chance of dissatisfaction with dental services among adults residing in cities with greater social inequality (OR: 1.53, 95% CI: 1.31-1.81) and with a lower proportion of dentists per inhabitant (OR: 1.17; 95% CI: 1.00-1.37); yellow/black/brown/indigenous (OR: 1.12; 95% CI: 0.99-1.27); lower schooling (OR: 1.14; 95% CI: 0.98-1.33); consultation due to oral problems (OR: 1.23; 95% CI: 1.04-1.44); (OR: 2.60; 95% CI: 2.53-3.02) and impact of oral disorders on daily performance (OR: 1.48; 95% CI: 1.30-1.69). The implementation or adequacy of public policies with the aim of improving satisfaction with dental services should prioritize those municipalities with greater social inequality and with fewer dentists and socially disadvantaged users, who self-perceive oral problems, are dissatisfied with their oral health and suffer impacts resulting from oral problems.

Instrumento para medir satisfacción de pacientes sobre atención clínica odontológica / Instrument to measure patient satisfaction about dental care clinic

El objetivo fue dar a conocer la importancia de creación de un instrumento de medición de satisfacción de atención para los pacientes que concurren a las clínicas odontológicas de la Universidad de La Frontera. Los criterios utilizados tanto para la justificación de la creación como los elementos que deben conformar el instrumento de medición, fueron obtenidos de una amplia revisión bibliográfica de distintas índoles sociales, obteniendo datos sobre la importancia de registrar y procesar la satisfacción del usuario como instrumento de mejoramiento en el mundo moderno de la calidad del servicio entregado por las instituciones. Además, entrega componentes que debieran ser incorporados en una encuesta de satisfacción para el grupo objetivo seleccionado.

This paper discloses the importance of creating an instrument for measuring the satisfaction of attention of the patients attending at the dental clinics of La Frontera University. The criteria used to justify both the creation and the elements that should include the measuring instrument were obtained from a review of several authors, references covering items of various kinds of social, getting data from the current importance of recording and processing user satisfaction as a means of improvement in the modern world the quality of service provided by the institutions. Moreover, delivery components that should be incorporated in a satisfaction survey for the selected target group.

Desgaste profesional: síndrome de burnout / Professional burnout syndrome

La actividad profesional odontológica contiene ciertas ventajas en su ejercicio (en general, es independiente, de primera necesidad en la sociedad, etc.), pero otras pueden llevar al profesional a padecerlas. Dentro de éstas, veremos el agotamiento psico-físico, la pérdida de una óptima calidad de vida, una serie de síntomas que van desarrollando un proceso de deterioro que se denomina síndrome de burnout (del quemado o fundido). La dificultad principal radica en que se va instalando en forma larvada, es decir, sin conciencia del sujeto, que generalmente se da cuenta cuando ya es demasiado tarde. El planteo que nos indica que el incipiente profesional, sostenido por el ideal que representa la carrera que eligió puede ir, en el transcurso de su clínica, desilusionándose a través de diversas complicaciones que se le van presentando. Dicha problemática no es excluyente de los odontólogos, sino que involucra a todos los profesionales que atienden la salud de las personas, tanto orgánica como psíquica. Por lo expuesto, diremos que ésta no es una situación exclusivamente individual, sino que afecta a las instituciones, a los equipos de trabajo, a los pacientes y a la comunidad en general. Contrapuesta a la creencia de la profesión de salud como apostolado, advertiremos que debe tenerse en cuenta la prevención del síndrome y su desnaturalización, para poder evitar sus efectos deletéreos. Ocuparse de la salud de los que curan debería ser prioritario en toda sociedad.

Validade e utilidade da autopercepção de necessidade de tratamento odontológico por adultos e idosos / Validity and utility of self-perceived need for dental treatment by adults and elderly / Validez y utilidad de la auto-percepción respecto a la necesidad del tratamiento dental en adultos y ancianos

O objetivo deste trabalho foi determinar a validade das medidas de autopercepção como indicador de necessidades de tratamentos odontológicos em adultos e idosos. A amostra foi composta por indivíduos que participaram da Pesquisa Nacional de Saúde Bucal e da Pesquisa sobre as Condições de Saúde Bucal da População Mineira. A autopercepção da necessidade de tratamento dentário e de prótese total foi comparada com a necessidade determinada a partir do exame odontológico, considerado padrão-ouro. A qualidade das medidas foi avaliada por meio da sensibilidade, da especificidade e de valores preditivos. A sensibilidade variou de 51% a 90%, enquanto a especificidade ficou entre 56% e 90%. Os valores preditivos positivos foram de 11% a 95%, e os negativos, de 23% a 99%. A autopercepção de necessidade de tratamento dentário em adultos e de necessidade de próteses totais em idosos apresentou valores aceitáveis de validade. Por outro lado, a autopercepção da necessidade de tratamento por idosos e da necessidade de próteses totais por adultos não foi considerada útil devido a seu baixo desempenho.

This study aimed to determine the validity of self-rated measures as an indicator of dental treatment needs in adults and the elderly. The sample consisted of individuals that participated in the National Oral Health Survey and the Survey on Oral Health Conditions in Minas Gerais State. Self-rated needs for dental treatment and total prostheses were compared to need based on dental examination, defined as the gold standard. The quality of measures was assessed by sensitivity, specificity, and predictive values. Sensitivity varied from 51% to 90%, and specificity from 56% to 90%. Positive predictive values were 11% to 95% and negative predictive values were 23% to 99%. Self-rated need for dental treatment in adults and for total prostheses in the elderly showed acceptable validity. Meanwhile, self-rated need for dental treatment in the elderly and for total prostheses in adults were not considered useful, due to their low performance.

El objetivo de este estudio fue determinar la validez de las medidas de autopercepción como un indicador de necesidades de tratamiento dental en adultos y ancianos. La muestra se compone de personas que participaron en la Encuesta Nacional de Salud Oral y la investigación sobre el estado de salud oral de la población de Minas Gerais. Se evaluó la necesidad autopercibida para tratamiento dental y dentaduras. Estos fueron comparados con la necesidad evaluada en un examen dental, considerado el estándar de oro. La calidad de las medidas se evaluó por la sensibilidad, especificidad y valores predictivos. La sensibilidad varió de un 51% a un 90% y la especificidad de un 56% a un 90%. Los valores predictivos positivos fueron de un 11% a un 95% y los negativos de un 23% a un 99%. La autopercepción de necesidad de tratamiento dental en adultos y necesidad de dentaduras en ancianos mostraron niveles aceptables de validez. Por otro lado, la autopercepción de la necesidad de tratamiento dental de los ancianos y la necesidad de prótesis dentales para adultos no se consideraron útiles, debido a su bajo rendimiento.

Dentistry and HIV/AIDS related stigma / La odontología y el estigma asociado al VIH

OBJECTIVE To analyze HIV/AIDS positive individual's perception and attitudes regarding dental services.METHODS One hundred and thirty-four subjects (30.0% of women and 70.0% of men) from Nuevo León, Mexico, took part in the study (2014). They filled out structured, analytical, self-administered, anonymous questionnaires. Besides the sociodemographic variables, the perception regarding public and private dental services and related professionals was evaluated, as well as the perceived stigma associated with HIV/AIDS, through a Likert-type scale. The statistical evaluation included a factorial and a non-hierarchical cluster analysis.RESULTS Social inequalities were found regarding the search for public and private dental professionals and services. Most subjects reported omitting their HIV serodiagnosis and agreed that dentists must be trained and qualified to treat patients with HIV/AIDS. The factorial analysis revealed two elements: experiences of stigma and discrimination in dental appointments and feelings of concern regarding the attitudes of professionals or their teams concerning patients' HIV serodiagnosis. The cluster analysis identified three groups: users who have not experienced stigma or discrimination (85.0%); the ones who have not had those experiences, but feel somewhat concerned (12.7%); and the ones who underwent stigma and discrimination and feel concerned (2.3%).CONCLUSIONS We observed a low percentage of stigma and discrimination in dental appointments; however, most HIV/AIDS patients do not reveal their serodiagnosis to dentists out of fear of being rejected. Such fact implies a workplace hazard to dental professionals, but especially to the very own health of HIV/AIDS patients, as dentists will not be able to provide them a proper clinical and pharmaceutical treatment.

OBJETIVO Analizar la percepción y las actitudes de las personas que viven con VIH/sida hacia los servicios odontológicos.MÉTODOS Participaron 134 voluntarios (30.0% mujeres y 70.0% hombres) de Nuevo León, México (2014), que contestaron un cuestionario estructurado de tipo analítico, auto-administrado y anónimo. Además de las variables sociodemográficas, fueron analizadas la percepción sobre los servicios y los prestadores de servicios odontológicos públicos y privados; igualmente se exploró mediante escala tipo Likert la percepción del estigma asociado al VIH/sida. El análisis estadístico incluyó análisis factorial y declustersno jerárquico.RESULTADOS Se presentaron desigualdades sociales en la búsqueda de atención de prestadores y servicios odontológicos públicos y privados. La mayoría ocultó su serodiagnóstico y concordó en que el odontólogo debe capacitarse en la atención del VIH. El análisis factorial reveló dos factores: experiencias de estigma y discriminación en la consulta odontológica y sentimientos de preocupación por la actitud del odontólogo o su personal hacia el serodiagnóstico del paciente. El análisis de clustersidentificó tres grupos: usuarios que no han experimentado estigma ni discriminación (85.0%); los que no han experimentado estigma ni discriminación, pero sienten una ligera preocupación (12.7%); y finalmente, los que han experimentado estigma y discriminación, y sienten preocupación (2.3%).CONCLUSIONES Se presentó un bajo porcentaje de estigma y discriminación en la consulta odontológica; sin embargo, la mayoría de las personas que viven con VIH/sida no revelan al odontólogo su serodiagnóstico por temor al rechazo. Estos hechos plantean un riesgo laboral para el odontólogo, pero especialmente para la propia salud de las personas que viven con VIH/sida, dado que el odontólogo no podrá proporcionar un tratamiento clínico y farmacológico adecuado.

Humanização no atendimento odontológico: acolhimento da subjetividade dos pacientes atendidos por alunos de graduação em Odontologia / Humanization in dental care: reception of the subjectivity of patients treated by undergraduate students in dentistry

Objetivo: O objetivo do presente estudo foi avaliar a subjetividade dos pacientes, quanto ao seu atendimento por alunos de graduação; à existência de ansiedade odontológica; e ao perfil de um dentista ideal. Materiais e Métodos: A pesquisa, descritiva e exploratória, utilizou o método quanti-qualitativo, com análise de conteúdo. O instrumento de coleta de dados foi uma entrevista estruturada com perguntas objetivas e subjetivas e a amostra foi constituída por 48 usuários da demanda espontânea das clinicas odontológicas da Universidade Federal da Paraíba, selecionada por conveniência. Foram incluídos na amostra os pacientes a partir de 12 anos de idade, de ambos os gêneros, sem distinção de raça, que procuraram os serviços odontológicos no período de novembro de 2009 a maio de 2010. Foram excluídos da pesquisa os pacientes portadores de necessidadesespeciais, que não tinham condições de interagir com o pesquisador. Foi identificado, em cada questão, o(s)núcleo(s) de sentido existente(s), de onde foram extraídos os indicadores visando a classificação nas categoriase a sua contagem, cujos resultados foram expressos através de freqüência e números absolutos. Resultados:A maioria dos entrevistados (56,3%) se sentia seguro ao serem atendidos por alunos de graduação; 41,7% dospacientes consideraram que um dentista ideal deveria ter capacidade técnica e ser atencioso; e 35% possuíamansiedade odontológica. Conclusões: Os pacientes se sentem seguros e confiantes ao serem atendidos poralunos do curso de Graduação nas escolas de Odontologia e almejam que um dentista ideal seja um profissionalcom habilidades técnicas, mas, sobretudo, que tenham um contato humanizado e acolhedor com o paciente.A ansiedade odontológica ainda é um temor freqüente entre os pacientes, mas, acredita-se que num futuropróximo esse sentimento seja minimizado em virtudes das novas políticas de humanização nos serviços desaúde.

Oral health-related knowledge, attitude, and practices among 12-year-old schoolchildren studying in rural areas of Panchkula, India.

Oral health is fundamental to general health and well being. Schools can provide a supportive environment for promoting oral health. School policies and education on health-related matters are imperative for the attainment of good oral health and control of related risk behaviors. Aim: This study was conducted to assess oral health-related knowledge, attitude, and practices among 12-year-old schoolchildren studying in rural areas of Panchkula, India. The ultimate goal was to implement an oral health-promotion program in this area. Materials and Methods: A total of 440 children (216 males and 224 females) from 12 schools were included in this study. All the participants were requested to complete a 13-question closed-ended questionnaire. The statistical significance of any difference between the two genders was determined using the Chi-square test. Results: Only 25% of the participants said that they cleaned their teeth more than once in a day. Thirty-two percent did not clean their teeth daily. Over the preceding 1 year, 45.5% of the childern had had some problem with their teeth and/or gums, but only 35.9% visited the dentist. Among these children, 8.2% used tobacco in some form. Oral health-related knowledge of girls was significantly better than that of boys. Conclusion: Based upon the findings of the present study, the knowledge, attitude, and practices of the surveyed children with regard to oral health is poor. Hence, there is a need for regular oral health education of the children, as well as their parents and school teachers.

Dental pain as a determinant of expressed need for dental care among 12-year-old school children in India.

Objective: We have undertaken a cross-sectional study to assess factors associated with dental pain that determine the expressed needs for dental care among 12-year-old school children in India. Materials and Methods: A total of 2 250 school children were surveyed after being drawn through stratified cluster random sampling. The simultaneous effects of sociodemographic characteristics, pain characteristics, and the impact of pain on the quality of life were studied in association with the expressed needs for dental treatment. Results: Among the studied school children, 71.4% suffered from dental pain, only 27.7% expressed need for dental healthcare. Socioeconomic status (SES) was a statistically significant determinant. Pain characteristics like the severity of pain and pain on eating hot and cold foods were significantly associated with expressed needs. Impact characteristics associated with expressed needs were embarrassment in showing teeth, brushing teeth, and difficulty in eating and drinking. Logistic regression analysis yielded a Nagelkerke R 2 value of 0.106. Conclusion: Important determinants of expressed needs for dental care among the studied population were SES, pain intensity, pain on thermal stimuli, impact characteristics like eating/drinking and embarrassment in showing teeth.

Prevalence and socio-demographic correlates of dental anxiety among a group of adult patients attending a dental institution in Vadodara city, Gujarat, India.

Context: Anxiety is a subjective state of feelings. Dental anxiety is often reported as a cause of irregular dental attendance, delay in seeking dental care or even avoidance of dental care, resulting in poor oral health related quality of life. Aim: To assess the prevalence and socio-demographic correlates of dental anxiety among a group of adult patients attending a dental institution in Vadodara, Gujarat. Patients and Methods: A total of 150 adult patients waiting in the out-patient Department of Oral Diagnosis of K.M. Shah Dental College and Hospital were included in the study. Subjects were selected by convenience sampling. Dental anxiety was assessed by using Modified Dental Anxiety Scale (MDAS) and self-designed, semi-structured questionnaire incorporating various demographic variables, type and nature of dental treatment. Statistical analysis was done using SPSS version 16. Descriptive analysis, unpaired t-test, one-way analysis of variance (ANOVA) test and multiple logistic regression were applied for statistical analysis. Results: 46% of the participants were dentally anxious. Females were found to be significantly more anxious than males. Subjects residing in villages had significantly more score than those residing in city. Relative influence of age, education, type of dental treatment, and previous dental visit were not significantly associated with dental anxiety. However, those subjects who had past negative dental experience were found to be significantly more anxious. Conclusions: The study shows that dental anxiety was high among study subjects. It is recommended that this issue should be given due importance and addressed in a practical and meaningful manner.

Over dental anxiety problems among university students: perspective from Pakistan

Oral health seeking behavior is compromised by dental anxiety, and affects quality of life. This preliminary study using convenience sampling was conducted among university students in the cities of Islamabad, Rawalpindi, and Multan, Pakistan, using standardized, valid and reliable scales to determine the prevalence and correlates of dental anxiety. Cumulatively 503 students including 278 males and 225 females completed the questionnaire. High to severe anxiety on Dental Anxiety Scale-Revised was reported by 60 [21.6%] males and 54 [24%] females. Seventy-five [27%] males and 62 [27.6%] females reported being quite afraid to very afraid on Dental Anxiety Question. Results underline the need for population-based representative studies to determine the prevalence and correlates of dental anxiety for better dental health in Pakistan

Dental anxiety scale in exodontia patients

The objectives of the study were to determine the frequency of dental anxiety, its age, gender distribution and to find out the fear of local anesthesia amongst patients reporting for extraction to the Department of Oral and Maxillofacial Surgery Khyber College of Dentistry Peshawar. Questionnaires were constructed with questions directed at covering the necessary variables and using the International Dental Anxiety Scale to determine the anxiety level of the patients. The study was carried out in the Department of Oral and Maxillofacial Surgery Khyber College of Dentistry over a period of 4 months. A total of 200 patients were questioned in this study and out of these 27% were phobic. Severe anxiety was noted in 14.5% of patients, 19.5% were moderately anxious, 28% mildly anxious and 11% were not anxious at all. The ratio of phobic female patients was greater than males, 5.75:1. Our study showed high frequency of phobia. This highlights the need or implementation of integrated dental care to patients treatment. This will ensure patients comfort and will bring a positive increase in dental attendance of patients

Prevalence of dental anxiety among university students in Islamabad, Pakistan

The aims of the current study were to find the prevalence of Dental Anxiety amongst Pakistani University Students and to determine the differences in relation to gender, education and level of dental anxiety. A questionnaire consisting Dental Anxiety Scale and Dental Fear Scale describing anxiety-provoking stimuli was constructed and presented to 385 university students. A convenient sample of 11 Universities students [n=385] of Islamabad, the capital of Pakistan was selected for the survey. The survey comprised different questions concerning demographic variables, first denial visit; last dental visit and reasons for avoidance of dental appointment and the level of dental anxiety. The methods of measurement of dental anxiety were 20 questions of Dental Fear Scale and 4 questions of the Corah Dental Anxiety Scale. The results indicated that waiting for the drill in Dental Anxiety Scale was highly prevalent while in Dental Fear Scale the most fear provoking stimuli for university students were items dealing with injection feeling and sighs of the needle males were significant more likely to report a high dental anxiety compared to males [p<0.05,]. The prevalence of high dental anxiety [Phobia] in the sample as measured by the Dental Fear Scale and Dental Anxiety Scale was 21.8% and 21.4% respectively. This study found a relativity high prevalence of dental anxiety and fear which confirm the scope of this problem facing dentists as well as patients. This problem should be addressed by the polify makers to improve the oral health of the population. The present findings support the need for assessment procedures using a broad spectrum of potentially anxiety-provoking stimuli in general population as well