Generalized anxiety disorder in Brazilian undergraduate dental students during the COVID-19 pandemic: A cross-sectional study.

OBJECTIVE: Explore the prevalence of generalized anxiety disorder (GAD) and associated factors in undergraduate dental students during the first wave of the COVID-19 pandemic in Brazil. MATERIALS AND METHODS: Cross-sectional study. A semi-structured questionnaire addressing the variables of interest was shared with dental students between July 8 and 27 2020. The outcome was determined using the seven-item generalized anxiety disorder (GAD-7) scale. A 'positive' diagnosis was defined as a total of ≥10 points on the scale. Statistical analysis involved descriptive, bivariate and multivariate analyses, with the significance level set at 5%. RESULTS: Among the 1050 students evaluated, 53.8% had a positive diagnosis for GAD. The multivariate analysis revealed that the prevalence of symptoms was higher among individuals who resided with more than three people, those enrolled at teaching institutions that suspended all clinical and laboratory activities, those who did not have an adequate home situation to maintain distance learning, those who had been diagnosed with COVID-19, those who felt anxious about having to see patients with a suspicion or diagnosis of COVID-19 and those who preferred to interrupt in-person academic activities until the population is vaccinated for the COVID-19 virus. CONCLUSION: The prevalence of GAD was high. Aspects related to the composition and organization of the home, the suspension of academic activities, a history of COVID-19 contamination, feelings of anxiety in providing dental care to patients with symptoms/suspected of COVID-19 infection and the preference to interrupt in-person academic activities until the population is vaccinated for COVID-19 were factors predisposing the students to anxiety during the first wave of the pandemic.

Association between dental environment stress and sense of coherence in dental students: a cross-sectional study.

The aim of this study was to explore associated variables with sense of coherence (SOC), and dental environment stress (DES) in a sample of dental students. All undergraduate (n = 474) and graduate (n = 105) dental students enrolled in the first semester of 2020 at a public university in southern Brazil were invited to participate. Data collection was performed by an online questionnaire, which included information related to sociodemographic and educational characteristics, biopsychosocial factors, aspects related to feelings experienced in the COVID-19 pandemic, and the SOC scale. The study outcome (DES) was measured by a validated tool. Linear regression analyses were performed to identify the associations between the outcome and all independent variables. A total of 408 students were included (response rate: 70.5%). The overall mean score of the DES scale was 73.95 (SD: 24.13). Students with higher SOC scores were observed to have significantly lower DES scores (ßGRADUATE: -0.376; 95%: -0.482 to -0.271; ßUNDERGRADUATE: -0.478; 95%:-0.658 to -0.297). Female undergraduate students (ß: 11.788; 95%CI: 7.161-16.415) had higher DES scores compared with undergraduate male students. In addition, the presence of anxiety symptoms when providing dental care to patients with symptoms or suspected COVID-19 infection was associated with higher DES scores (ß: 10.460; 95%CI: 5.644-15.277) among undergraduate dental students. The level of stress was higher in non-white undergraduate students than white (ß: 8.912; 95%CI: 3.581-14.244). Among both undergraduate and graduate dental students, higher SOC scores were associated with lower DES.

Mediating effect of eating pattern on the relationship between television exposure and caries in children.

Behavioral characteristics may also take part in the etiology of dental caries. Sedentary behavior, especially watching television, is associated with increased intake of foods high in fat or free sugar, which could influence the occurrence of dental caries. The aim of this study was to assess the mediating effect of eating pattern on the relationship between television exposure time and the presence of dental caries in children. A cross-sectional study was conducted with a representative sample of 580 parent-child dyads with children aged 7 to 8 years in 20 public schools in Pelotas, Brazil. Parents or legal guardians were interviewed and provided information on demographic/socioeconomic data, children's daily television exposure time, and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN-K-eating pattern domain). Caries was evaluated through clinical examination. The mediating effect of eating pattern on the relationship between television exposure and presence of dental caries was estimated using the parametric g-formula. Prevalence of dental caries was 63%, and 22% of children watched TV 4 or more hours per day. Television exposure had no direct effect on the dental caries experience [odds ratio (OR): 1.05 (95% confidence interval (95%CI): 0.92-1.19)]. Nevertheless, difficulty maintaining regular eating pattern mediated the natural indirect effect of television exposure time (≥ 4 hours/day) on dental caries experience [OR: 1.07 (95%CI): 1.01-1.14)]. The results of this study confirm the indirect pathway between television viewing and dental caries and the role of disordered eating patterns in this association.

Factors associated with poor academic performance among undergraduate dental students: A cross-sectional study.

OBJECTIVE: To evaluate the factors associated with poor academic performance among undergraduate dental students enrolled at a public university in Brazil. METHODS: A semi-structured questionnaire addressing the exploratory variables of interest (sociodemographic and economic characteristics, use of medications and drugs, dentistry as the first choice of undergraduate course, and the Pittsburgh Sleep Quality Index) was hosted on Google Forms and shared with all dental students at the Federal University of Pelotas. Academic performance was evaluated based on institutional records, access to which the participants had previously authorized; students with good (average ≥7.0 points) or poor academic performance (average <7.0 points) were considered. Adjusted logistic regressions were performed to verify the association between academic performance and the exploratory variables (p < 0.05). RESULTS: In total, 244 students were included, of whom 18.8% had poor academic performance. Increased age (OR: 1.34; 95%CI: 1.18-1.52), non-white skin color (OR: 1.34; 95%CI: 1.18-1.52), the use of medications for anxiety and depression (OR: 1.34; 95%CI: 1.18-1.52), and poor sleep quality (OR: 1.34; 95%CI: 1.18-1.52) were factors associated with poor academic performance. CONCLUSION: A low prevalence of poor academic performance was observed. Non-white skin color, increased age, use of anxiolytics or antidepressants, and poor or disturbed sleep may reduce dental students' academic performance.

Use of dental implants among older adults of two southern Brazilian cities: A population-based cross-sectional study.

AIM: To assess the prevalence and associated factors with use of dental implants among older adults. METHODS: This cross-sectional study was performed with home dwelling older adults from the cities Cruz Alta and Veranópolis, Brazil. The main outcome was obtained by a clinical oral examination, considering those with at least one dental implant. Independent variables were collected by a structured questionnaire. Crude and adjusted analysis was performed by Poisson regression with robust variance estimation; results are presented in prevalence ratio (PR) and 95% confidence interval. RESULTS: It was included 569 participants. The overall prevalence of using at least one dental implant was 16.7%. Higher PR for the use of dental implants was observed in white individuals (PR:5.147; 95% CI:2.033-3.034), in those with at least medium income (PR:3.202; 95% CI:1.196-5.572) and in those with access to dental care in the last 12 months (RP:1.595; 95% CI:1.087-2.340). Older adults with a medium level of education (RP:0.484; 95% CI:0.240-0.978) and those that did not use dental floss (RP:0.627; 95% CI:0.240-0.978) demonstrated a significantly lower PR for use of dental implants. CONCLUSION: A substantial prevalence of use of dental implants was observed among older adults. In addition, white ones, those with a better financial situation and users of dental floss presented higher use of dental implants.

Daily screen time, sleep pattern, and probable sleep bruxism in children: A cross-sectional study.

OBJECTIVE: This study aimed to evaluate the prevalence of probable sleep bruxism (SB) in children aged 7-8 years and its association with sleep pattern and the time spent using devices with a screen. MATERIAL AND METHODS: A cross-sectional study was conducted with children from Pelotas, Brazil (n = 556). Parents/caregivers were interviewed and provided demographic/socioeconomic information, children's daily screen time, nighttime tooth grinding or clenching, sleep duration and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN-K-sleep domain). Probable SB was determined based on a positive clinical inspection with/without a positive parental/caregiver's reports of tooth clenching or grinding. Hierarchical Poisson regression was performed. RESULTS: The prevalence of probable SB was 15.83% (n = 88). There was no difference in the probable SB prevalence according to the daily screen time (p = 0.744), and low family socioeconomic status was associated with higher SB prevalence (Prevalence Ratio [PR] = 1.95; 95% Confidence Interval [95% CI]: 1.21-3.17; p = 0.006). Higher scores in the sleep domain of the BRIAN-K scale were associated with probable SB [PR = 1.07; 95% CI: 1.01-1.30; p = 0.013]. CONCLUSIONS: Difficulties in maintaining sleep and low family socioeconomic status were associated with probable SB in schoolchildren, while screen time spent using devices with a screen was not associated.

Mediating effect of eating pattern on the relationship between television exposure and caries in children

Abstract Behavioral characteristics may also take part in the etiology of dental caries. Sedentary behavior, especially watching television, is associated with increased intake of foods high in fat or free sugar, which could influence the occurrence of dental caries. The aim of this study was to assess the mediating effect of eating pattern on the relationship between television exposure time and the presence of dental caries in children. A cross-sectional study was conducted with a representative sample of 580 parent-child dyads with children aged 7 to 8 years in 20 public schools in Pelotas, Brazil. Parents or legal guardians were interviewed and provided information on demographic/socioeconomic data, children's daily television exposure time, and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN-K-eating pattern domain). Caries was evaluated through clinical examination. The mediating effect of eating pattern on the relationship between television exposure and presence of dental caries was estimated using the parametric g-formula. Prevalence of dental caries was 63%, and 22% of children watched TV 4 or more hours per day. Television exposure had no direct effect on the dental caries experience [odds ratio (OR): 1.05 (95% confidence interval (95%CI): 0.92-1.19)]. Nevertheless, difficulty maintaining regular eating pattern mediated the natural indirect effect of television exposure time (≥ 4 hours/day) on dental caries experience [OR: 1.07 (95%CI): 1.01-1.14)]. The results of this study confirm the indirect pathway between television viewing and dental caries and the role of disordered eating patterns in this association.

COVID-19 pandemic and impact on dental education: perception of Brazilian dental students

Aim: The aim of the present study is to assess the perception of undergraduate students on the impact of the COVID-19 pandemic on Brazilian dental education. Methods: This crosssectional study was conducted using an online questionnaire hosted in Google Forms platform and publicized on Instagram® and Facebook®. The questionnaire was available between July 8-27, 2020. Absolute and relative frequencies were obtained for variables of interest using Pearson's chi-squared and considering 95% confidence intervals. Prevalence of learning resource variables according to self-reported skin color, educational institution, and Brazilian region were presented using equiplots. Results: A total of 1,050 undergraduate dental students answered the questionnaire. Most students reported being in full-distance learning mode. Among the undergraduate students, 65.4% reported perceiving a very high impact in dental education, and 16.6% of students reported not being able to follow distance learning. In addition, 14% reported not having a personal laptop or desktop to study with, with this condition being more prevalent among non-white than white individuals. Conclusion: We conclude that Brazilian dental students perceived a high impact of COVID-19 on dental education, as well as one-sixth of the students reported not having adequate resources to continue with distance learning. It is important that different policies are developed at the institutional and governmental levels to reduce the impact of the pandemic on dental education

Association between dental environment stress and sense of coherence in dental students: a cross-sectional study

Abstract The aim of this study was to explore associated variables with sense of coherence (SOC), and dental environment stress (DES) in a sample of dental students. All undergraduate (n = 474) and graduate (n = 105) dental students enrolled in the first semester of 2020 at a public university in southern Brazil were invited to participate. Data collection was performed by an online questionnaire, which included information related to sociodemographic and educational characteristics, biopsychosocial factors, aspects related to feelings experienced in the COVID-19 pandemic, and the SOC scale. The study outcome (DES) was measured by a validated tool. Linear regression analyses were performed to identify the associations between the outcome and all independent variables. A total of 408 students were included (response rate: 70.5%). The overall mean score of the DES scale was 73.95 (SD: 24.13). Students with higher SOC scores were observed to have significantly lower DES scores (βGRADUATE: -0.376; 95%: -0.482 to -0.271; βUNDERGRADUATE: -0.478; 95%:-0.658 to -0.297). Female undergraduate students (β: 11.788; 95%CI: 7.161-16.415) had higher DES scores compared with undergraduate male students. In addition, the presence of anxiety symptoms when providing dental care to patients with symptoms or suspected COVID-19 infection was associated with higher DES scores (β: 10.460; 95%CI: 5.644-15.277) among undergraduate dental students. The level of stress was higher in non-white undergraduate students than white (β: 8.912; 95%CI: 3.581-14.244). Among both undergraduate and graduate dental students, higher SOC scores were associated with lower DES.

Association Involving Possible Sleep Bruxism, Stress, and Depressive Symptoms in Brazilian University Students: A Cross-sectional Study.

The aim of the present study was to examine the association regarding sleep bruxism (SB), depression, and stress in Brazilian university students. We conducted a cross-sectional study with a large-sample of university students ( n = 2,089) in the city of Pelotas, Rio Grande do Sul, Southern Brazil. A self-administered questionnaire was sent to classrooms to evaluate socioeconomic and demographic characteristics. Possible SB was detected by self-report according to the International Consensus on The Assessment of Bruxism Criteria (2018). The Patient Health Questionnaire-9 and the Perceived Stress Scale were used to assess depression and stress symptoms respectively. Crude and adjusted Poisson regression analyses were performed. The prevalence of possible SB, high level of stress, and depressive symptoms in the sample were of 20.4%, 16.6%, and 16.6% respectively. Stress in female students was significantly associated with an increased prevalence of possible SB, but not in male students. Regarding depression, the prevalence of SB was 28% higher in students with depressive symptoms. Students with stress or depression had a 35% higher prevalence of SB than those without any symptoms. Conclusion The findings have shown that university students with stress and depressive symptoms were more likely to be detected with possible SB.

Ultra-processed food consumption and dental caries in children and adolescents: a systematic review and meta-analysis.

This study summarised the association between ultra-processed food (UPF) consumption and dental caries in children and adolescents through a systematic review and meta-analysis. The search of PubMed, Cochrane, Web of Science and Scopus databases using the 'PECOS' strategy retrieved 1462 eligible articles. Only studies with humans aged ≤ 19 years; that assessed groups of any UPF or specific UPF items; that measured dental caries as the decayed, filled and missing surfaces or teeth indexes, based on the WHO criteria; cross-sectional, case-control, cohort and all types of interventions that examined the adjusted association between UPF consumption and dental caries were included. All studies received qualitative evaluation. Meta-analysis using random-effects models combined multivariable-adjusted OR for case-control and cross-sectional studies and risk ratio (RR) for longitudinal studies of the highest v. lowest category of UPF consumption. Forty-two studies were included in the qualitative synthesis and twenty-seven in the meta-analysis. The pooled RR was 1·71 (95 % CI 1·31, 2·24), and the pooled OR was 1·55 (95 % CI 1·37, 1·75). The highest OR was found among participants who had dental caries prevalence >70 % (OR = 3·67, 95 % CI 2·16, 6·23). Better evidence quality was found among cohort studies that evaluated children <6 years old. The findings suggest that higher UPF consumption is associated with greater dental caries in children and adolescents. Public health efforts to reduce UPF consumption are needed to improve the oral health of children and adolescents.

Factors associated with the reduction of dental care in Primary Health Care in Brazil after the emergence of COVID-19: a cross-sectional study, 2020. / Fatores associados à redução de atendimentos odontológicos na Atenção Primária à Saúde no Brasil, com o surgimento da COVID-19: estudo transversal, 2020.

OBJECTIVE: To analyze factors associated with the reduction of dental care in Primary Health Care, during the COVID-19 pandemic in Brazil. METHODS: This was a cross-sectional study conducted with dentists in primary healthcare centers (PHCCs). The reduction of dental care was the outcome, and the exposure variables were sociodemographic data, availability of personal protective equipment (PPE) and measures adopted by PHCCs during the pandemic. Poisson regression was performed to determine the prevalence ratio and 95% confidence interval (95%CI). RESULTS: Of the total of 958 participants, 62.6% reported a reduction of over 50% in dental visits after the beginning of the pandemic. Adoption of biosafety protocols (PR = 1.04; 95%CI 1.01;1.07), availability of PPE recommended by new protocols (PR = 0.94; 95%CI 0.89;0.99) and adoption of tele-screening (PR = 0.90; 95%CI 0.85;0.96) were associated with the reduction. CONCLUSION: The availability of new types of PPE and implementation of tele-screening in PHCCs seem to have minimized the reduction of dental care after the beginning of the pandemic.

Factors associated with the reduction of dental care appointments in Primary Health Care in Brazil with the emergence of COVID-19: cross-sectional study, 2020 / Factores asociados a la reducción de la atención odontológica en Atención Primaria de Salud en Brasil con la aparición de COVID-19: estudio transversal, 2020 / Fatores associados à redução de atendimentos odontológicos na Atenção Primária à Saúde no Brasil, com o surgimento da COVID-19: estudo transversal, 2020

Objective: To analyze the associated factors of reductions for dental visits performed in Primary Health Care (PHC) in Brazil during COVID-19 pandemic. Methods: Crosssectional study with PHC dentists. The outcome was a reduction in dental care appointments and that the exposure variables included sociodemographic factors, aspects about personal protective clothing and equipment (PPE) and measures adopted by the Basic Health Unit (UBS) in Brazil after the appearance of COVID. Poisson regression was performed, used to determine the prevalence ratio and 95% confidence interval. Results: Reduction in visits above 50% after the onset of the pandemic was reported by 62.6% of 958 participating. Biosafety protocols (PR=1.04 ­ 95%CI 1.01;1.07), PPE suggested by the protocols (PR=0.94 ­ 95%CI 0.89;0.99), and telescreening (PR=0.90 ­ 95%CI 0.85;0.96) were factors associated with this reduction. Conclusion: The availability of the new PPE and the implementation of telescreening at UBS seem to have minimized the reduction in dental care after the onset of the pandemic

Objetivo: Analizar factores asociados a la reducción de consultas odontológicas en Atención Primaria de Salud (APS) en Brasil durante COVID-19. Métodos: Estudio transversal con dentistas de APS. El hecho investigado fue reducción de consultas odontológicas y las variables de exposición incluyeron factores sociodemográficos, aspectos de los equipos de protección personal (EPI) y las medidas adoptadas por la Unidad Básica de Salud (UBS) tras la aparición del COVID. Regresión de Poisson utilizada para determinar la razón de prevalencia y el intervalo de confianza del 95%. Resultados: El 62,6% de los 958 participantes informó una reducción en la asistencia superior al 50% después del inicio de la pandemia. La adopción de protocolos (RP=1,04 ­ IC95% 1,01;1,07), disponibilidad de EPI recomendado por los nuevos protocolos (RP=0,94 ­ IC95% 0,89;0,99) y la adopción de televaluación (RP=0,90 ­ IC95% 0,85;0,96) fueron factores que se asoció con esta reducción. Conclusión: La disponibilidad del nuevo EPP y la implementación de la teleprotección en UBS parecen haber minimizado la reducción en la atención dental después del inicio de la pandemia.

Objetivo: Analisar fatores associados à redução de atendimentos odontológicos na Atenção Primária à Saúde, durante pandemia de COVID-19 no Brasil. Métodos: Estudo transversal, com cirurgiões-dentistas das unidades básicas de saúde (UBS). O desfecho foi a redução dos atendimentos odontológicos, e as variáveis de exposição, dados sociodemográficos, disponibilidade de equipamentos de proteção individual (EPIs) e medidas adotadas pela UBS na pandemia. Realizou-se regressão de Poisson para determinar razão de prevalências e intervalo de confiança de 95%. Resultados: A redução de atendimentos acima de 50% após o início da pandemia foi relatada por 62,6% dos 958 participantes. Adoção de protocolos de biossegurança (RP=1,04 ­ IC95% 1,01;1,07), disponibilidade de EPI preconizados por novos protocolos (RP=0,94 ­ IC95% 0,89;0,99) e adoção da teletriagem (RP=0,90 ­ IC95% 0,85;0,96) estiveram associados à redução. Conclusão: A disponibilização dos novos EPIs e a implementação da teletriagem nas UBS parecem ter minimizado a redução dos atendimentos odontológicos após o início da pandemia.

Knowledge About Biosafety Measures in Clinical Setting During the COVID-19 Pandemic: A Cross-Sectional Study With Brazilian Dental Students.

OBJECTIVE: The aim of this study is to evaluate the knowledge of Brazilian dental students about biosafety measures that should be adopted in the clinical setting during the coronavirus disease (COVID-19) pandemic. METHODS: A cross-sectional study with 1050 dental students was conducted. A semi-structured questionnaire was shared with students. Mean knowledge score on biosafety guidelines during the COVID-19 pandemic was the outcome, with a maximum of 8 scores. Explanatory variables included sociodemographic and educational characteristics, aspects related to biosafety education, actions adopted by the dental schools during the pandemic, and sources of biosafety information. Multivariate linear regression analyses were performed. RESULTS: Mean knowledge score was 5.19 (1.28). Female students (ß = 0.346; 95% CI: 0.154-0.539), those enrolled in the intermediate (ß = 0.525; 95% CI: 0.167-0.883) or final (ß = 0.569; 95% CI: 0.200-0.937) stage of course, and those who had already received theoretical-practical training in biosafety (ß = 0.464; 95% CI: 0.063-0.866) presented higher mean knowledge scores. Students who did not receive guidance on aerosol control measures before the pandemic (ß = -0.324; 95% CI: -0.519 to -0.130) had the lowest score. CONCLUSION: Students presented a medium level of knowledge about dental biosafety measures concerning the COVID-19 pandemic. Sociodemographic characteristics and those related to the institutional profile of the participants, and access to orientation and training in biosafety, may influence their knowledge.

Virucidal efficacy of chlorhexidine: a systematic review.

This study aimed to systematically review the literature about the virucidal efficacy of CHX in comparison to other substances used in the oral cavity. Electronic searches were performed in four databases (PubMed, Scopus, Embase, and Web of Science). Only studies that presented the following characteristics were included: (1) verified virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1), any Influenza, or any human coronavirus (HcoV); and (2) compared the virucidal efficacy of CHX with essential oils (Listerine®), quaternary ammonium compounds, povidone-iodine, hydrogen peroxide, negative control substance, and absence of therapy. Two researchers independently selected the studies, extracted data and evaluated the risk of bias. A narrative data synthesis was used. Twenty-five studies were included, of which 21 were in vitro and four were randomized clinical trials (RCT). Studies assessed the virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1) (10 studies), Influenza A (InfluA) (4 studies), human coronavirus (HCoV) (4 studies) and Severe Acute Respiratory Syndrome-Related Coronavirus (SARS-CoV-2) (11 studies). Most studies demonstrated that CHX has a positive virucidal efficacy against HSV-1 and InfluA strains. However, lower efficacy was shown to InfluA strain in comparison to povidone-iodine. Lower to none virucidal efficacy of CHX is expected for HCoV and SARS-CoV-2 strains for in vitro studies. Three RCT demonstrated that CHX was able to significantly reduce the viral load of SARS-CoV-2 for a short period. CHX may present an interesting virucidal efficacy against HSV-1 and InfluA viruses. CHX also presents transient efficacy against SARS-CoV-2 when used as a mouthwash.

Dental caries severity and oral health-related quality-of-life in Brazilian preschool children.

The impact of dental caries on oral health-related quality-of-life (OHRQoL) may be influenced by disease severity. This study evaluated the impact of caries severity on OHRQoL in preschool children. A school-based, cross-sectional study was conducted with 205 children (aged 2-5 years) in Southern Brazil. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and provided sociodemographic information. The Caries Assessment Spectrum and Treatment criteria were used to evaluate caries severity, and Poisson regression with robust variance estimation conducted to determine the rate ratio (RR) and 95% confidence intervals (CIs) of the mean OHRQoL scores according to severity level. Most children had at least one tooth in the morbidity (37%) or pre-morbidity (35%) stages, and the prevalence of impacts on OHRQoL was 40%. Caries severity was associated with the impact scores: after adjustments, the mean B-ECOHIS scores were 6.31 (95% CI: 4.24-9.38) higher for children in the morbidity stage, and 10.84 (95% CI: 6.51-18.05) higher in the severe morbidity stage, than for healthy children [RR = 10.84 (95% CI: 6.51-18.05)]. Children with carious lesions into dentine or with pulpally-involved or abscessed teeth had poorer OHRQoL than children without such lesions.

Fatores associados à redução de atendimentos odontológicos na Atenção Primária à Saúde no Brasil, com o surgimento da COVID-19: estudo transversal, 2020 / Factores asociados a la reducción de la atención odontológica en Atención Primaria de Salud en Brasil con la aparición de COVID-19: estudio transversal, 2020 / Factors associated with the reduction of dental care in Primary Health Care in Brazil after the emergence of COVID-19: a cross-sectional study, 2020

Objetivo: Analisar fatores associados à redução de atendimentos odontológicos na Atenção Primária à Saúde, durante pandemia de COVID-19 no Brasil. Métodos: Estudo transversal, com cirurgiões-dentistas das unidades básicas de saúde (UBS). O desfecho foi a redução dos atendimentos odontológicos, e as variáveis de exposição, dados sociodemográficos, disponibilidade de equipamentos de proteção individual (EPIs) e medidas adotadas pela UBS na pandemia. Realizou-se regressão de Poisson para determinar razão de prevalências e intervalo de confiança de 95% (IC95%). Resultados: A redução de atendimentos acima de 50% após o início da pandemia foi relatada por 62,6% dos 958 participantes. Adoção de protocolos de biossegurança (RP = 1,04; IC95% 1,01;1,07), disponibilidade de EPIs preconizados por novos protocolos (RP = 0,94; IC95% 0,89;0,99) e adoção da teletriagem (RP = 0,90; IC95% 0,85;0,96) estiveram associados à redução. Conclusão: A disponibilização dos novos EPIs e a implementação da teletriagem nas UBS parecem ter minimizado a redução dos atendimentos odontológicos após o início da pandemia.

Objetivo: Analizar factores asociados a la reducción de consultas odontológicas en Atención Primaria de Salud en Brasil durante el COVID-19. Métodos: Estudio transversal con cirujanos dentistas de las Unidades Básicas de Salud (UBS). El hecho investigado fue la reducción de consultas odontológicas y las variables de exposición incluyeron factores sociodemográficos, aspectos de los equipos de protección personal (EPPs) y las medidas adoptadas por la UBS tras la aparición del COVID. La regresión de Poisson se utilizó para determinar la razón de prevalencia y el intervalo de confianza del 95% (IC95%). Resultados: El 62,6% de los 958 participantes informó una reducción en la asistencia superior al 50% después del inicio de la pandemia. La adopción de protocolos (RP = 1,04; IC95% 1,01;1,07), disponibilidad de EPPs recomendados por los nuevos protocolos (RP = 0,94; IC95% 0,89;0,99) y la adopción de teletriaje (RP = 0,90; IC95% 0,85;0,96) fueron factores que se asociaron con esta reducción. Conclusión: La disponibilidad del nuevo EPP y la implementación de la teleprotección en las UBS parecen haber minimizado la reducción en la atención bucal después del inicio de la pandemia.

Objective: To analyze factors associated with the reduction of dental care in Primary Health Care, during the COVID-19 pandemic in Brazil. Methods: This was a cross-sectional study conducted with dentists in primary healthcare centers (PHCCs). The reduction of dental care was the outcome, and the exposure variables were sociodemographic data, availability of personal protective equipment (PPE) and measures adopted by PHCCs during the pandemic. Poisson regression was performed to determine the prevalence ratio and 95% confidence interval (95%CI). Results: Of the total of 958 participants, 62.6% reported a reduction of over 50% in dental visits after the beginning of the pandemic. Adoption of biosafety protocols (PR = 1.04; 95%CI 1.01;1.07), availability of PPE recommended by new protocols (PR = 0.94; 95%CI 0.89;0.99) and adoption of tele-screening (PR = 0.90; 95%CI 0.85;0.96) were associated with the reduction. Conclusion: The availability of new types of PPE and implementation of tele-screening in PHCCs seem to have minimized the reduction of dental care after the beginning of the pandemic.

Anxiety symptoms and alcohol abuse during the COVID-19 pandemic: A cross-sectional study with Brazilian dental undergraduate students.

AIM: The aim of this study is to assess whether anxiety symptoms are associated with alcohol abuse in Brazilian undergraduate dental students during the COVID-19 pandemic. METHOD: A cross-sectional study was conducted. A semi-structured questionnaire addressing the variables of interest was hosted on Google Forms and shared with dental undergraduate students from all Brazilian regions between July 8 and 27, 2020. Alcohol abuse was measured using the Cut down, Annoyed, Guilty, Eye opener (CAGE) questionnaire score of ≥2. All participants responded to the seven-item Generalized Anxiety Disorder Scale (GAD-7). Hierarchical logistic regression was also conducted. RESULTS: Among the 1050 students evaluated, 18.7% (n = 196) had a positive screening for alcohol abuse during the pandemic. The prevalence of mild (GAD-7 = 5-9), moderate (GAD-7 = 10-14), and severe (GAD-7 ≥15) anxiety among students were 31.3%, 29.6%, and 24.2%, respectively. The final hierarchical logistic regression model showed that during the COVID-19 pandemic, anxiety levels predict the likelihood of alcohol abuse among students with moderate (OR 10.05 [95% IC: 4.12-24.52]) or severe (OR 15.82 [95% IC: 6.46-38.73]) anxiety, especially for male students (moderate anxiety: OR 17.06 [95% CI: 8.36-34.78]; severe anxiety: OR 28.38 [95% CI: 8.62-38.24]). CONCLUSION: The prevalence of alcohol abuse and moderate or severe anxiety in Brazilian undergraduate dental students during the COVID-19 pandemic was high. Male students may be more sensitive to the presence of anxiety symptoms in this period, thus contributing to higher levels of alcohol consumption, in comparison to female students. Intervention strategies that promote the adoption of healthier lifestyles can enable the effective management of anxiety symptoms during the pandemic and thus, hold the potential to reduce exacerbated alcohol intake in this population.

Salivary characteristics may be associated with burning mouth syndrome?

BACKGROUND: Burning mouth syndrome (BMS) it is characterized by burning and uncomfortable sensations with no clinical alterations or laboratory findings. The evaluation of the salivary characteristics of people with BMS can help the understanding of the pathogenesis of this condition. This case-control study aimed to trace the salivary profile of women with burning mouth syndrome (BMS). MATERIAL AND METHODS: 40 women with BMS and 40 control women were recruited. Unstimulated salivary flow rate (uSFR), pH, salivary cortisol levels, salivary viscosity, and oral health impact profile (OHIP-14 questioner) were determined. P< 0.05 was considered statistically significant. RESULTS: For uSFR, mean values obtained for BMS and for control group respectively were 0.35 and 0.61 mL/min; for pH, 7.23 and 7.34; for cortisol levels, 0.36 and 0.15 µg/dL; for viscosity values, 31.1 and 45.01 mPas and for OHIP-14 scores, 21.7 and 5.7. To uSFR, cortisol levels, viscosity values and OHIP-14 scores, differences were statistically significant. Salivary cortisol levels and OHIP-14 scores were correlated positively (rho = 0.624; p< 0.05). CONCLUSIONS: BMS women have lower uSFR and salivary viscosity and higher salivary cortisol levels that were associated with worse quality of life, compared with the control group. Key words:Xerostomia, Burning mouth syndrome, Viscosity.

Displasia dentinária Tipo I: relato de caso clínico / Dental dysplasia Type I: a clinical case report

As anomalias de desenvolvimento dos dentes, como a displasia dentinária, podem ser observadas durante os exames clínicos e radiográficos em alguns pacientes. O presente relato de caso discute sobre a Displasia Ectópica Dentinária (DD), sendo um distúrbio de desenvolvimento relacionado a formação da dentina que possui obliteração da polpa e defeito da formação da raiz. Descrita como uma condição rara e transmitida geneticamente. Ela pode ser dividida em tipos I e II, uma vez que ambas podem afetar as dentaduras decídua e permanente. O tratamento clínico transformou-se com o passar dos anos, sendo que o protocolo indicava a necessidade de exodontia para um tratamento menos invasivo, utilizando métodos que consistem na manutenção da higiene oral, a idade do paciente, a gravidade da doença, a extensão dos sintomas e atendimento odontológico regular. Este trabalho tem como objetivo apresentar o caso clinico de um menino de 8 anos, diagnosticado com displasia dentinária do tipo I e com presença de restaurações insatisfatórias na dentição mista. Dessa forma é significativo o planejamento adequado, em favor de melhorias na manutenção profilática... (AU)

Anomalies in the development of teeth, such as dentin dysplasia, can be observed during clinical and radiographic examinations in some patients. The present case report discusses Dentinal Dysplasia Ec topic (DD), being a developmental disorder related to the formation of dentin that has pulp oblitera tion and root formation defect. Described as a rare and genetically transmitted condition. It can be divided into types I and II, since both can affect deciduous and permanent dentures. Clinical treatment has changed over the years, and the protocol indicated the need for extraction for a less invasive treat ment, using methods that consist of maintaining oral hygiene, the age of the patient, the severity of the disease, the extent of symptoms and regular dental care. This paper aims to present the clinical case of an 8-year-old boy, diagnosed with type I dentin dysplasia and with the presence of unsatisfactory restorations in the mixed dentition. Thus, adequate planning is significant, in favor of improvements in prophylactic maintenance... (AU)