Factors associated with pain and analgesic consumption following non-surgical periodontal therapy under local anaesthesia and carried out by dental students.

AIM: Evaluate factors associated with pain and analgesic consumption following non-surgical periodontal therapy. MATERIALS AND METHODS: The sample consisted of 218 patients with chronic periodontitis, submitted to non-surgical scaling and root planing under local anaesthesia at a public dental service in southern Brazil. The data collection instruments included a demographic questionnaire, as well as State-Trait Anxiety Inventory, Corah's Dental Anxiety Scale, Visual Analogue Scale, Numerical Rating Scale and Verbal Rating Scale. The presence and intensity of pain were evaluated at 2, 6, 12, 24 and 48 hr after scaling and root planing. RESULTS: A total of 52.3% of the patients reported mild intensity pain at some point during the 48 hr after scaling and root planing with local anaesthesia. Smoking (PR = 1.47; 95% CI = 1.16-1.65), severe periodontal inflammation (PR = 1.31; 95% CI = 1.09-1.58) and dental anxiety (PR = 1.24; 95% CI = 1.03-1.49) were associated with postoperative pain after adjusting for age, gender and state and trait anxiety scores. Moreover, 46.8% of the subjects used analgesics at some time during the 48-hr follow-up period and dental anxiety was the only factor associated with postoperative analgesic use. CONCLUSIONS: Smoking, severe periodontal inflammation and dental anxiety were identified as factors associated with pain after non-surgical scaling and root planing with local anaesthesia. Dental anxiety was also a factor associated with postoperative analgesic use.

Access and use of secondary dental care of a large city of Rio Grande do Sul, Brazil

Introduction: The Brazilian Dental Specialty Centers (CEOs) were created due to a limitation of Brazilian public dental care. In 2004, the specialized services corresponded to no more than 3.5% of total dental clinical procedures. These services are a reference for oral health teams in primary care in order to perform additional procedures at this level of attention. Despite the expansion of specialized procedures, the resolution of these services is subject to discussion between managers and researchers. Objective: To evaluate the access and use of the secondary dental care of a large city. Material and methods: The descriptive retrospective longitudinal study was conducted using CEO primary data from November 2012 to July 2013. These data were obtained from the Technical Department of Oral Health and the coordination of services were analyzed and then compared to the guidelines of Ordinance no. #1.464/MS. Results: The performance of services was low, ranging from 47.2 to 60.6% of the overall fulfillment of goals, in average. By analyzing per subgroup, endodontics was the subgroup with lower fulfillment (33.2%) and periodontics was that with the most fulfillment (88.3%). Absenteeism on the first appointments, the average per service ranged between 29.4 and 44.2%, and periodontics was the most affected subgroup (51%). The percentage of finished treatment ranged from 52.9 to 66.4%, and stomatology was the subgroup with less number of finished treatments (19.2%). Conclusion: The study revealed low utilization of the evaluated services associated with high absenteeism. Further studies and management initiatives are necessary to find ways to optimize secondary dental care integration to primary care services.

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