Exploring the relationship between anxiety, patient characteristics and pain outcomes in oral surgery under local anesthesia: The measurement problem.

BACKGROUND: Anxiety during oral surgery can impact patient homeostasis, increase the difficulty of the procedure and create additional stress for the surgeon. Furthermore, it has been associated with more intense and prolonged pain during and after dental treatment. OBJECTIVES: The aim of the study is to evaluate the relationship between anxiety, patient characteristics and pain outcomes in oral surgery, as well as to verify the impact of anxiety on patient's perception of pain during and after oral surgery. MATERIAL AND METHODS: This is a prospective observational study. Several variables were evaluated during the course of the oral surgery. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), the Interval Scale of Anxiety Response (ISAR), and Patient SelfRated Anxiety (PAnx) during the procedure. RESULTS: General anxiety measures (STAI) were not associated with specific dental anxiety or external observations of anxiety. Anxiety levels varied according to gender and body mass index (BMI), and were correlated with increased heart rate (HR) (with variability among assessment tools). Odontectomy, ostectomy and an increased volume of anesthesia were associated with higher anxiety levels (with variability among the assessment tools). There was a correlation between pain and anxiety, with anxiety contributing to approx. 12% of the variability in postoperative pain. CONCLUSIONS: Dental anxiety is a complex, multidimensional mental phenomenon characterized by high variability due to the influence of several dynamic factors.

Adequação dos serviços odontológicos do Paraná no enfrentamento da Covid-19: um estudo transversal / Adequacy of dental services in Paraná during the COVID-19 pandemic: a cross-sectional study

RESUMO O objetivo deste estudo transversal foi identificar adequações quanto à utilização de Equipamentos de Proteção Individual e organização do processo de trabalho no atendimento odontológico ambulatorial no Paraná durante o primeiro ano da pandemia da Covid-19. A amostra de conveniência incluiu 1.105 profissionais de saúde bucal (cirurgiões-dentistas, técnicos e auxiliares em saúde bucal) durante o primeiro ano da pandemia (agosto a outubro de 2020). Formulário on-line (Google Formulários®) foi enviado por e-mail pelo Conselho Regional de Odontologia. As medidas de enfrentamento da Covid-19 foram comparadas entre os tipos de serviços odontológicos: ambulatorial do Sistema Único de Saúde - SUS (Atenção Primária, Centro de Especialidades Odontológicos e Pronto Atendimento), clínica privada, e outros (Sistema S, forças de segurança, sindicatos, hospitais públicos e privados e clínicas de ensino). Os profissionais dos serviços ambulatoriais do SUS relataram com maior frequência que: suspenderam atendimentos eletivos, evitavam gerar aerossóis e trabalhavam a quatro mãos. Nas clínicas privadas, utilizavam frequentemente teleorientação e telemonitoramento. Nos 'outros serviços', houve maior proporção de redução das horas de trabalho e autoclavagem de peças de mão após cada atendimento. Conclui-se que, apesar da alta adequação às medidas de enfrentamento da Covid-19, houve diferença na prática profissional nos diferentes tipos de serviços odontológicos.

ABSTRACT This cross-sectional study aimed to identify adjustments regarding the use of Personal Protective Equipment and the organization of the work process in outpatient dental care in Paraná during the first year of the COVID-19 pandemic. The convenience sample included 1,105 oral health professionals (dental surgeons, oral health assistants, and dental hygienists) during the first year of the pandemic (August to October, 2020). An online form (Google Forms®) was sent by email by the Regional Council of Dentistry. COVID-19's measures were compared between the types of dental services: 'outpatient clinic of the Unified Health System - SUS' (Primary Care, Dental Specialty Center, and Emergency Care), 'private clinic' and 'other services' (Sistema S, security forces, trade union, public and private hospitals, and teaching clinics). Professionals from SUS outpatient services reported more frequently: that they suspended elective care, avoided generating aerosols, and worked four-handed. Professionals from 'private clinics' used teleorientation and telemonitoring more regularly. In the 'other services', there was a more significant proportion reduction in work hours and handpieces autoclaving after each service. It is concluded that, despite the high adequacy of the measures to combat COVID-19, there was a difference in professional practice among the different types of dental services.