Virtual reality and behaviour management in paediatric dentistry: a systematic review.

BACKGROUND: Virtual reality (VR) has emerged as an innovative tool in medicine and dentistry, improving anxiety and pain management in children. The immersive and interactive environments of VR technology facilitate positive engagement of young patients during dental procedures via distraction, potentially reducing anxiety levels and improving treatment experience. The aim of this review was to provide current evidence-based guidance on the usage of VR in the clinical practice of paediatric dentistry. METHODS: A systematic review was conducted according to the PRISMA guidelines with the following research question using the PICO format: Does VR (I) effectively manage anxiety and pain (O) during a paediatric dental consultation (P) compared to alternative behavioural control techniques (C)? PubMed/Medline®, SCOPUS and Web of Science databases were searched and analysed. RESULTS: A total of 22 randomised control trials were included in this review. These studies have shown that VR is a highly effective method of behaviour management, successfully alleviating pain and anxiety in children during dental treatment, surpassing traditional tools. Selected studies included participants with a large age range and dental procedures varied greatly, from first consultations to infiltration of local anaesthetic and other invasive procedures. VR was mostly used during treatment delivery and different immersive VR techniques were considered. Behaviour, anxiety and pain scales were used to determine efficacy and patient satisfaction. CONCLUSIONS: VR offers an engaging and immersive experience, effectively diverting patients' attention away from the clinical environment, fostering a positive and enjoyable treatment experience. However, it is important to acknowledge the limitations of existing studies and the need for further research to enhance the understanding of VR's full potential in paediatric dentistry.

Validity and reliability of the Portuguese version of the rapid estimate of adult literacy in dentistry: REALD-29 PT.

BACKGROUND: Health literacy is a main factor in health for its improvement, allowing the individuals to have a greater capacity to engage and participate in collective health promotion actions. The evaluation of functional health literacy is essential to determine the ability that each individual has to understand basic health information. The present study aimed to perform the translation and cross-cultural adaptation of the Rapid Estimate of Adult Literacy in Dentistry-30 to the Portuguese language and test the reliability and validity of this version. METHODS: After translation and cultural adaptation, the instrument was applied to a group of individuals that participate in the program Atividade Senior, developed by the municipality of Viseu, Portugal. The final sample was composed by 206 participants that accepted responding to the translated version of the instrument. Statistical validation was accomplished to complete the process and obtain the final instrument. One question was removed for the creation of the final instrument with 29 questions, therefore being named Rapid Estimate of Adult Literacy in Dentistry-29 PT. RESULTS: The Rapid Estimate of Adult Literacy in Dentistry-29 PT presented good internal reliability. Cronbach's alpha ranged from 0.89 to 0.90 when words were deleted individually. The analysis of test-retest reliability revealed excellent reproducibility. We can verify that the Rapid Estimate of Adult Literacy in Dentistry-29 PT scale for assessment of oral health literacy among older adults presents an acceptable internal consistency, with a global Cronbach´s alpha of 0.894. CONCLUSIONS: The new scale can be applied to assess oral health literacy among older Portuguese adults, presenting an acceptable internal consistency and is validated to assess oral health literacy and is crucial in epidemiological studies.

Oral Health Strategies: Surveying the Present to Plan the Future of Community-Based Learning.

Introduction: Oral health literacy relates to the capacity of individuals to acquire, understand and to act upon oral health information to make appropriate health decisions. This scientific review's main goal is to analyze the strategies that improve oral health literacy within the community, specifically oriented to a community-based learning model focused on the most vulnerable risk groups in society. Materials and Methods: The current review is based on the literature on oral health literacy within community-based learning strategies. The present review selected scientific studies by searching MEDLINE and related databases, such as Web of Science and PUBMED, and by consulting existing bibliographies. Results: Based on the application of the inclusion criteria to the abstracts, 45 publications were retrieved which explicitly dealt with the definitions of oral health literacy, community-based learning, and service learning. Several studies have demonstrated that health consumers with low health literacy fail to understand the available health information. Therefore, innovative oral health literacy strategies should be undertaken. Service learning is an example of an educational approach where the student learns specific soft skills in the classroom and collaborates directly with an agency or institution and engages in reflection activities to deepen their understanding of what is being taught. Conclusions: One of the main strategies used to incorporate the oral health professional in social responsibility and direct contact in the community is through experiencing community-based learning projects. The future graduate must be an educator capable of educating patients in order to themselves acquire high-level skills in oral health literacy.

Blood and Salivary Inflammatory Biomarkers Profile in Patients with Chronic Kidney Disease and Periodontal Disease: A Systematic Review.

Introduction: Periodontitis is the most prevalent inflammatory disease worldwide. Its inflammatory levels spread systemically, which can be associated with chronic kidney disease. Biomarkers have the potential to diagnose and correlate periodontitis and chronic kidney disease, helping to monitor systemic inflammation. Thereby, this study aimed to analyze the association between chronic kidney disease and periodontitis by conducting a biomarker analysis on blood and saliva. Material and methods: An electronic search through PubMed/MEDLINE, EMBASE, and Web of Science databases was conducted to identify clinical studies published in the last ten years, with no language restrictions. Twelve articles met all the inclusion criteria, two randomized controlled trials, one cohort study, and nine observational studies. Results: The studies included a total of 117 patients for saliva biomarkers, with a mean age of approximately 57 years old, and 56.68% of the subjects were female. After analyzing all the included studies, it was possible to verify the following biomarkers assessed: CRP, WBC, fibrinogen, IL-4 and -6, cardiac troponin T, NOx, ADMA, albumin, osteocalcin, cystatin C, PGLYRP1, cholesterol, HDL, LDL, triglycerides, and hemoglobin. Conclusion: A direct cause-effect association between periodontitis and CKD could not be established. However, it was possible to conclude that there was a correlating effect present, through the analyzed biomarkers.

Oral health behaviour perception scale applied among a sample of portuguese adolescents / Escala de percepción del comportamiento de salud bucal aplicada en una muestra de adolescentes portugueses

Introduction: The application of a scale can be particularly useful for the epidemiological studies comparing different populations and for analysis of the influence of distinct aspects of oral health on the development of certain health conditions. The aim of this study consists in the creation of a scale to classify the level of perception of the oral health behaviors applicable to a sample of Portuguese adolescents. Material and Methods: An observational cross-sectional study was designed with a total of 649 adolescents between the ages of 12 and 18 years old from five public schools in the Viseu and Guarda districts, in Portugal. Data was collected by the application of a self-administered questionnaire and, after analysis of data collection, the newly Universidade Católica Portuguesa (UCP) oral health perception scale was created. Statistical analysis was performed using SPSS-IBM software version 24.0 (IBM SPSS, Chicago, Il., USA). In the descriptive statistical analysis, absolute and descriptive frequencies were used for variables with nominal measurement level, mean as a measure of central tendency and standard deviation as a measure of dispersion for interval variables. Results: Oral health behaviors perception respecting the assumptions defined by the present scale has been elaborated. The result showed that 67% of the sample presented a poor perception of their oral health behaviors, 23.9% intermediate/sufficient, while 8.2% refer having good perception, respecting the assumptions defined for the elaboration of the present scale. Conclusion: For this purpose, through the scale to classify the level of oral health behaviors applicable to the sample of portuguese adolescents, it is possible to compare the data of several samples and understand what are the most frequent oral or eating habits among adolescents

Introducción: La aplicación de una escala puede ser particularmente útil para los estudios epidemiológicos que comparan diferentes poblaciones y para el análisis de la influencia de distintos aspectos de la salud bucal en el desarrollo de determinadas condiciones de salud. El objetivo de este estudio consiste en la creación de una escala para clasificar el nivel de percepción de las conductas de salud bucal aplicable a una muestra de adolescentes portugueses. Material y Métodos: Se diseñó un estudio observacional transversal con un total de 649 adolescentes de entre 12 y 18 años de cinco escuelas públicas de los distritos de Viseu y Guarda, en Portugal. La recolección de datos se realizó mediante la aplicación de un cuestionario autoadministrado y, tras el análisis de la recolección de datos, se creó la nueva escala de percepción de salud bucal de la Universidad Católica Portuguesa (UCP). El análisis estadístico se realizó utilizando el software SPSS-IBM versión 24.0 (IBM SPSS, Chicago, Il., EE. UU.). En el análisis estadístico descriptivo se utilizaron frecuencias absolutas y descriptivas para variables con nivel de medida nominal, media como medida de tendencia central y desviación estándar como medida de dispersión para variables de intervalo. Resultados: ha elaborado la percepción de conductas de salud bucal respetando los supuestos definidos por la presente escala. El resultado mostró que el 67% de la muestra presentó mala percepción de sus conductas de salud bucal, el 23,9% intermedia / suficiente, mientras que el 8,2% refiere tener buena percepción, respetando los supuestos definidos para la elaboración de la presente escala. Conclusión: Para ello, a través de la escala para clasificar el nivel de conductas de salud bucal aplicable a la muestra de adolescentes portugueses, es posible comparar los datos de varias muestras y comprender cuáles son los hábitos orales o alimentarios más frecuentes entre los adolescentes.

Dental caries and oral health behavior assessments among portuguese adolescents / Caries dental y evaluaciones del comportamiento de salud bucal en adolescentes portugueses

Introduction: Adolescents have a high risk of developing caries in Portugal. The present study is designed to assess dental caries experience among the adolescents by the application of DMFT index, characterize the oral health risk factors and to determine the association between caries experience and socio-demographic variables. The characterization of the oral health behaviors of adolescents of the central region of Portugal will help in the development of specific oral health education strategies to improve oral health among the local communities. Material and methods: A cross-sectional study was conducted among a convenient sample of 694 adolescents aged 12 to 18 years attending public schools in two Portuguese districts using a structured questionnaire designed to investigate oral health and behavior of participants. In addition, a clinical examination was carried out noting the decayed, missing and filled teeth. A descriptive analysis of the variables was performed using the Chi-square, Mann-Whitney and Kruskal-Wallis tests (p<0.05). A multivariate analysis was applied for analysis of the association between variables. Results: The mean DMFT index score of 2.91±2.9 was obtained. Of the total sample, 73% consumed sugary food daily, 50.1% considered having good oral health and 70.8% did not report pain in the last 12 months. Most adolescents (79.4%) brushed their teeth daily and 60% did not use dental floss. Of the total sample, 96.4% had a dental appointment in the last 12 months, 46.4% of which was for preventive purposes. Applying the Chi-square statistical test, we verified that the adolescents who brush their teeth daily presented a good perception about their oral health (p<0.001), the DMFT index scores were associated with the residence area (p=0.01) and the presence of dental caries was associated with the perception of oral health (p=0.049) and sugary food intake (p=0.029).Conclusion: Portuguese adolescents presented a low DMFT index. The DMFT index was associated with residence area, perception of oral health and sugary food intake. Daily toothbrushing was associated with self-perception of oral health. It is suggested that oral health promotion and prevention programs should aim to reduce the risks of oral disease development.

Introducción: Los adolescentes tienen un alto riesgo de desarrollar caries en Portugal. El presente estudio está diseñado para evaluar la experiencia de caries dental entre los adolescentes mediante la aplicación del índice CPOD, caracterizar los factores de riesgo para la salud bucal y determinar la asociación entre la experiencia de caries y las variables sociodemográficas. La caracterización de los comportamientos de salud bucal de los adolescentes de la región central de Portugal ayudará en el desarrollo de estrategias específicas de educación en salud bucal para mejorar la salud bucal entre las comunidades locales. Material y Métodos: Se realizó un estudio transversal en una muestra por conveniencia de 694 adolescentes de 12 a 18 años que asisten a escuelas públicas en dos distritos portugueses utilizando un cuestionario estructurado diseñado para investigar la salud bucal y el comportamiento de los participantes. Además, se llevó a cabo un examen clínico observando los dientes cariados, faltantes y obturados. Se realizó un análisis descriptivo de las variables mediante las pruebas de Chi-cuadrado, Mann-Whitney y Kruskal-Wallis (p <0,05). Se aplicó un análisis multivariado para el análisis de la asociación entre variables. Resultados: Se obtuvo la puntuación media del índice CPOD de 2,91 ± 2,9. Del total de la muestra, el 73% consumía alimentos azucarados diariamente, el 50,1% consideró tener buena salud bucal y el 70,8% no refirió dolor en los últimos 12 meses. La mayoría de los adolescentes (79,4%) se cepillaban los dientes a diario y el 60% no usaba hilo dental. Del total de la muestra, el 96,4% tuvo cita con el dentista en los últimos 12 meses, de la cual el 46,4% fue con fines preventivos. Aplicando la prueba estadística de Chi-cuadrado, verificamos que los adolescentes que se cepillan los dientes diariamente presentaban una buena percepción sobre su salud bucal (p <0.001), las puntuaciones del índice CPOD se asociaron al área de residencia (p = 0.01) y la caries dental se asoció con la percepción de salud bucal (p = 0,049) y con la ingesta de alimentos azucarados (p = 0,029). Conclusión: Los adolescentes portugueses presentaron un índice CPOD bajo. El índice CPOD se asoció con el área de residencia, la percepción de salud bucal y la ingesta de alimentos azucarados. El cepillado diario de los dientes se asoció con la autopercepción de la salud bucal. Se sugiere que los programas de promoción y prevención de la salud bucal deben ser enfocados en reducir los riesgos de desarrollo de enfermedades bucodentales.