Traumatic dental injuries among children attending the public after-hours emergency dental clinic in Bergen, Norway.

OBJECTIVES: To investigate traumatic dental injuries (TDIs) among children who for 1 year attended a Norwegian public after-hours emergency public dental (EPD) clinic. MATERIALS AND METHODS: The study included 7-18-year-olds (n = 312) who presented at the EPD clinic, underwent a clinical dental examination, and consented to the disclosure of clinical information. Recording of TDIs was restricted to anterior permanent teeth. Potential TDI predictors were also analysed. RESULTS: Almost half (n = 148) of the children were assessed with TDIs in permanent teeth, showing a mean age of 11.0 (standard deviation [SD]: 3.5) years. Males constituted 54.7%. The children experienced TDIs often outside school hours (43.9%), and the majority (58.1%) were caused by falls/accidents. Sixty of them experienced only one TDI. The most common location was the maxillary central incisors. Assessment of TDIs according to severity, could only be done in 131 individuals, involving 253 TDIs. Of these, 81.8% were mild. The odds of visiting the emergency clinic for a TDI were higher (odds ratio [OR] = 2.64, confidence interval [CI]: 1.61-4.31) among children with previous TDIs and lower (OR = 0.28, CI: 0.12-0.68) among those with poor dental attendance. CONCLUSIONS: Traumatic dental injuries were a common reason for seeking emergency care. Milder injuries dominated and involved mostly one maxillary central incisor. Previous episodes of TDIs and attendance patterns seemed to be associated with seeking care for TDIs.

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)

Management of odonto-stomatological emergencies during the COVID-19 alarm state in dental clinics in the Autonomous Community of Madrid (CAM), Spain: An observational study

BACKGROUND: Odontology practice has been severely compromised by the pandemic caused by COVID-19 and Spain is one of the countries with higher incidence. Our aim with this study is to find out the number of cases and type of odonto-stomatological emergencies (OSE) treated in four dental clinics of the Madrid capital area and region (CAM) in the period covered between March 17th and 4th of May. MATERIAL AND METHODS: We search the cases in the demographic/epidemiological databases of the CAM regional government and the Illustrious Official College of Dentists and Stomatologists of the First Region (Madrid). RESULTS: We found that the most prevalent pathology was acute apical periodontitis whereas odontogenic abscess showed the lowest frequency. Prosthetic-orthodontic OSE represented 14% of cases. CONCLUSIONS: In this period of time, the most prevalent pathology acute apical periodontitis, odontogenic abscess reported the lowest frequency and prosthetic-orthodontic treatments were the third in number of cases. Most of OSE were resolved, without referring the patient to a hospital emergency department

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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)

Factors associated with conducting planning for secondary oral health care services in Brazil.

BACKGROUND: Planning in health services specifically aims to improve the health status of a given population, guaranteeing access with equity and justice, as well as streamlining the response of the health system to the needs perceived by the community. This research aims to identify the factors associated with planning Specialized Dental Clinics (SDCs). METHODS: Secondary data were used from the external evaluation of the database of the first National Program for Access and Quality Improvement of SDCs (NPAQI-SDCs) and the informed Outpatient Information System of the Unified Health System (OIS/UHS), which contains data on the specialized dental procedures performed at SDCs. It consisted of a quantitative study in which Pearson chi-square statistical tests (p < 0.05) and a multivariate logistic regression were applied with odds ratio (OR) estimate. RESULTS: The results indicated that the realization of planning in SDCs was associated with lower coverage of the Oral Health Team of the Familiy Health Strategy in a municipality (OR = 1.4; 95% CI: 1.0-1.9, p = 0.049), additional training for managers (p = 0.038), the practice of self-assessment (OR = 8.2; 95% CI: 5.8-11.6; p = 0.000) and meeting service production targets (OR = 1.9; 95% CI: 1.2-3.2; p = 0.011). CONCLUSION: The results indicate that the work processes of the SDCs, especially with regard to service management, are essential to the proper functioning of the service and the practice of planning is linked to the technical capacity and commitment of service managers.

Prevalence of Impacted Teeth in Saudi Patients Attending Dental Clinics in the Eastern Province of Saudi Arabia: A Radiographic Retrospective Study.

AIM: To evaluate the prevalence of impacted teeth in Saudi patients and compare between male and female subjects. METHOD: This cross-sectional study comprised of Saudi patients who attended dental clinics in major hospitals in the Eastern Province of Saudi Arabia. Patients' dental records and panoramic radiographs were reviewed retrospectively. Impacted teeth excluding third molars and spaces occupied by primary, permanent, and transmigrated teeth were recorded from panoramic radiographs. The Pearson chi-squared test was performed to determine gender differences regarding impacted teeth and spaces occupied by other teeth. RESULTS: The study included radiographs of 539 patients with a mean age of 23.3 ± 10.8 years. Seventy-one patients (13.2%) had at least one impacted tooth. The total number of impacted teeth was 115 in the sample, out of which 91 (79.1%) were in the upper arch and 24 (20.8%) in the lower arch. Fifty-eight maxillary canines (50.4%) were impacted making them the most commonly impacted teeth, followed by 21 upper second premolars (18.2%) and 14 lower second premolars (12.2%). More females (70.7%) than males (29.3%) had impacted teeth (P=0.82). Of 61 spaces occupied, 35 (57.4%) were occupied by permanent teeth, 24 (39.3%) by primary teeth, and 2 (3.3%) by transmigrated teeth. Greater proportions of spaces were occupied in female than male participants (P > 0.05). CONCLUSION: There was a high prevalence of impacted teeth in Saudi patients. The canines were the most commonly impacted teeth followed by the second premolars. Females demonstrated a higher occurrence of impacted teeth than males. Early detection of impacted teeth can help prevent malocclusion and maintain a healthy dentition.

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.

Factors related to the dissatisfaction of users of specialized dental care centers in Brazil in 2014: a cross-sectional study. / Fatores associados à insatisfação dos usuários dos centros de especialidades odontológicas do Brasil em 2014: estudo transversal.

OBJECTIVE: to evaluate factors related to the dissatisfaction of users of the specialized dental care centers (CEO) in Brazil. METHODS: this was a cross-sectional study with data from the Dental Specialty Center Access and Quality Improvement Program; the study was conducted in 2014 and included a non-probabilistic sample of users; those who answered that the service received was regular, poor or very poor were classified as dissatisfied. RESULTS: a total of 8,730 users were included, 4.8% reported dissatisfaction; longer time taken to get to the service (OR=1.38 - 95%CI1.10;1.74), and longer waiting time until treatment (OR=1.37 - 95%CI1.07;1.75), were positively associated with dissatisfaction, whereas negative association was found with attention received (OR=0.12 - 95%CI0.09;0.16), the possibility of asking questions about treatment (OR=0.37 - 95%CI0.24;0.58), and receiving advice during treatment (OR=0.33 - 95%CI0.25;0.44). CONCLUSION: prevalence of user dissatisfaction was low and was associated with factors related to service organization and receipt of information and support.

Universal access to oral health care for Australian children: comparison of travel times to public dental services at consecutive census dates as an indicator of progressive realisation.

Progressive realisation of equitable access to health services is a fundamental measure of a state's resolve to achieve universal health coverage. The World Health Organization has reprioritised the importance of oral health services as an integral element of the roadmap towards health equity. This study sought to determine whether there is an indication of progressive realisation of equitable spatial access to public dental services for Australians <18 years of age through a comparison of travel times to the nearest public dental clinic at successive census dates. The distribution of children classified by rural remoteness and level of socioeconomic disadvantage, as well as the location of public dental clinics at the 2011 and 2016 Australian Bureau of Statistics censuses, was mapped using geographic imaging software. OpenRouteService software was used to calculate the travel time by car between each statistical census district and the nearest public dental clinic. There has been an improvement in the percentage of the population <18 years of age living within a reasonable travel time of a public dental clinic. The most socioeconomically disadvantaged groups in more densely populated areas have better spatial access to publicly funded dental services than less disadvantaged groups. Children living in very remote areas continue to experience lengthy travel times to access fixed oral health services.

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)

Molecular Characterization of Staphylococcus aureus Isolates Associated with Nasal Colonization and Environmental Contamination in Academic Dental Clinics.

Aim: To determine the genetic makeup of methicillin-sensitive/methicillin-resistant Staphylococcus aureus (MSSA/MRSA) from nasal colonization and environmental contamination in dental clinics. Materials and Methods: Nasal swabs from students and health care workers and environmental swabs were obtained at two academic dental clinics in the United Arab Emirates. The StaphyType DNA microarray-based assay was used for molecular characterization. Results: Forty-eight S. aureus isolates were identified phenotypically (nasal: n = 43; environmental: n = 5), but 6 of these were assigned to S. argenteus by genotyping. These were CC(argenteus)2596, CC(arg)2250-MSSA, CC(arg)2250-MSSA-(Panton Valentine leukocidin [PVL]+) (n = 2), and CC(arg)2198-MSSA (n = 2). MRSA nasal colonization rate was 5.4% (n/N = 8/146) with the following strain affiliations: CC5-MRSA-[IV+fus+ccrAB], "Maltese Clone"; CC6-MRSA-IV, "WA MRSA-51"; CC22-MRSA-IV (PVL+/tst+); CC22-MRSA-[IV+fus+ccrAA/(C)]; and two each of CC5-MRSA-[VI+fus] and CC97-MRSA-[V/VT+fus]. The SCC-borne fusidic acid resistance (fusC) gene was detected in MRSA (n = 5) and MSSA (n = 1). Some MSSA strains, CC1-MSSA-[fus+ccrAB1] and ST1278-MSSA-[ccrA1], harbored recombinase genes. A CC30-MSSA harbored ACME locus/arc-genes, while ST1278-MSSA-[ccrA1] had an ACME-III element. Enterotoxin genes were commonly carried, but tst-1 gene was found in only CC22, CC30, and CC34 strains, while pvl genes were identified in CC(arg)2250 and CC22-MRSA-IV. Of the 51 noncoagulase staphylococci (CoNS) identified, 18 were mecA positive. Conclusion: The findings demonstrate the first report of rare strains (ST1278 MSSA, CC(arg)2198, CC(arg)2596, and PVL+CC(arg)2250) in our region. Detection of MSSA with recombinase genes and ACME loci alongside mecA-positive CoNS is of clinical significance as this could provide a milieu for acquisition and transfer of SCC-elements, either with different ACME types, with fusC or the mecA gene resulting in conversion of MSSA into MRSA.

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.

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

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.

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.

The transition from amalgam to other restorative materials in the U.S. predoctoral pediatric dentistry clinics.

Increased concerns about the safety of amalgam restorations in children have resulted in many dental schools emphasizing the teaching of alternative dental materials. This study investigated the current teaching of different dental materials for use in posterior teeth in the United States predoctoral pediatric dentistry programs. In 2011, the authors invited the chairs of the predoctoral pediatric dentistry departments in all accredited dental schools at that time (N = 57) to participate in an internet-based survey. Descriptive statistics were calculated to describe the frequency of using different restorative materials. Regression models were developed to explore the factors related to the use of dental restorations in predoctoral pediatric clinics. Among the 44 dental schools that responded (77% response rate), 74% used amalgam, and 93% used composite in primary posterior teeth. Glass ionomer was used by 61% of the schools in primary posterior teeth. Placing amalgam in primary posterior teeth was associated with programs that treated more 3-5-year-old patients (ß = .302, p < .043), whereas the use of glass ionomer was associated with having students serving at off-site satellite dental clinics (ß = .015, p < .012). In general, having departments with chairs who had positive attitudes towards Minimal Invasive Dentistry (MID) used composite (ß = .091, p < .0001) and glass ionomer (ß = 103, p < .0001) more frequently and were less likely to use amalgam (ß = -.077, p < .005) in primary posterior teeth. Although teaching MID concepts in predoctoral pediatric clinics in dental schools is increasing, the use of amalgam in posterior primary and permanent teeth is still widely practiced.

Age and reasons for first dental visit among children in Lagos, Nigeria.

BACKGROUND: An early first dental clinic appointment offers the prospect of prompt preventative care and parental education regarding the oral health of the child. The evidence-based recommendation by dental professionals all over the world is that a child should visit a dentist before or by 1 year of age. AIM: This study aimed to determine the chronological age at and the purpose for a first dental clinic visit amongst children aged 16 years and below attending the Paediatric Dental Clinic at the Lagos University Teaching Hospital (LUTH). MATERIALS AND METHODS: This was a retrospective study conducted amongst children who attended the Paediatric Dental Clinic at the LUTH between January 2017 and December 2018. Data on age at first dental visit, reasons for attending and other information relevant to the study were collected. Descriptive statistics and Chi-square analysis were conducted, and the level of significance was set at P < 0.05. RESULTS: A total of 1157 children were studied, comprising 580 (50.5%) males and 577 (49.9%) females. Their mean age on their first dental visit was 7.9 ± 3.7 years. Most of the children (31.4%) had their first dental visits at 7 and 9 years, and 0.8% of the children had their first dental visit below the age of 1 year. The most common reason for visiting the dental clinic was dental pain (33.1%). A higher proportion of the children (911 [79.0%]) had their first dental visit for therapeutic purposes, whereas 246 (21.0%) children visited the dental clinic for preventive care. Sex and age at first dental visit were statistically significantly associated with the reason for attendance (P < 0.001). CONCLUSION: Most children had their first dental visit between the ages of 7 and 9 years, mainly because of pain. It is necessary to create more awareness among parents/caregivers and to establish the concept of dental home.

Indications for root canal treatment in a Swedish county dental service: patient- and tooth-specific characteristics.

AIM: To study patient- and tooth-specific characteristics of teeth indicated for root canal treatment, in the public dental service of the county of Västra Götaland, Sweden. METHODOLOGY: During a designated 8-week period, general dental practitioners working at 20 different public dental clinics consecutively registered indications for undertaking root canal treatment. The patients' subjective level of pain was also registered (visual analogue scale) at the very first appointment. The following information was retrieved from computerized dental records and radiographs: gender, age, number of remaining teeth, tooth group, previous restoration, number of restored surfaces, dental caries and tooth substance loss. Gender and age were compared using both descriptive and analytical statistics. RESULTS: The material comprised 243 teeth in 243 patients: 128 (52.7%) women and 115 (47.3%) men, mean age 48.3 years. Molar teeth predominated (47.7%). Most of the teeth (83.5%) had previously been restored and exhibited significant loss of tooth substance, more than a third of the crown (71.3%). Dental caries was present in 127 teeth (62.9%). Dental trauma was implicated in only seven cases (2.9%). Initial treatment was frequently undertaken at an emergency visit, for relief of symptoms (64.9%). The most commonly registered indication was pulpal necrosis with apical periodontitis (38.1%), followed by pulpitis (37.7%). Retreatment of a root filled tooth was reported in 18 teeth (7.4%). CONCLUSIONS: In the general Public Dental Service of Sweden, root canal treatment is most frequently undertaken in molars. The primary indication is relief of symptoms. Retreatment of root filled teeth is uncommon.

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)