Factors associated with the number of filled teeth in adolescents from public schools: a cohort study.

This study aimed to assess the association of demographic conditions, socioeconomic status, clinical variables, and psychosocial factors with the number of filled teeth in adolescents from public schools. This cohort study comprised 1,134 12-year-old adolescents enrolled in public schools in Santa Maria, Brazil, in 2012. They were followed-up in 2014, where 743 individuals were reassessed (follow-up rate of 65.52%) for the number of filled teeth. Data were collected via dental examinations and structured interviews. Demographic and socioeconomic characteristics were collected from parents or legal guardians. The psychosocial factor comprised students' subjective measurement of happiness (Brazilian version of the Subjective Happiness Scale - SHS). Dental examinations were performed to assess the number of filled teeth through decay, missing, and filled teeth index (DMF-T). Unadjusted and adjusted Poisson regression analyses were performed to assess the association between baseline variables and filled teeth at follow-up. The number of filled teeth in 2012 and 2014 were 193 (17.02%) and 235 (31.63%), respectively. The incidence of filled teeth in 2014 was 42 (5.65%). Adolescents with untreated dental caries, those who visited the dentist in the last 6 months, those that exhibited being happier, and those who had filled teeth at baseline were associated with a higher number of filled teeth at follow-up. We conclude that the number of filled teeth in adolescents was influenced by clinical and psychosocial factors, emphasizing the need to focus on oral health policies in individuals with higher disease burden and those who feel psychologically inferior.

Factors associated with the number of filled teeth in adolescents from public schools: a cohort study

Abstract This study aimed to assess the association of demographic conditions, socioeconomic status, clinical variables, and psychosocial factors with the number of filled teeth in adolescents from public schools. This cohort study comprised 1,134 12-year-old adolescents enrolled in public schools in Santa Maria, Brazil, in 2012. They were followed-up in 2014, where 743 individuals were reassessed (follow-up rate of 65.52%) for the number of filled teeth. Data were collected via dental examinations and structured interviews. Demographic and socioeconomic characteristics were collected from parents or legal guardians. The psychosocial factor comprised students' subjective measurement of happiness (Brazilian version of the Subjective Happiness Scale - SHS). Dental examinations were performed to assess the number of filled teeth through decay, missing, and filled teeth index (DMF-T). Unadjusted and adjusted Poisson regression analyses were performed to assess the association between baseline variables and filled teeth at follow-up. The number of filled teeth in 2012 and 2014 were 193 (17.02%) and 235 (31.63%), respectively. The incidence of filled teeth in 2014 was 42 (5.65%). Adolescents with untreated dental caries, those who visited the dentist in the last 6 months, those that exhibited being happier, and those who had filled teeth at baseline were associated with a higher number of filled teeth at follow-up. We conclude that the number of filled teeth in adolescents was influenced by clinical and psychosocial factors, emphasizing the need to focus on oral health policies in individuals with higher disease burden and those who feel psychologically inferior.

Adaptação infantil ao tratamento odontológico: relato de caso / Child adaptation to dental treatment: a case report

Na odontopediatria, o ambiente odontológico gera medo e ansiedade, demonstrados de diversas formas pela criança, de modo que há necessidade de promover sua adaptação para que entenda o processo e se sinta parte dele. É importante, ainda, que se identifiquem situações em que o desconforto estético possa gerar constrangimento na convivência diária das crianças. Objetivo: relatar um caso clínico de resolução de comprometimento estético causado por defeito de desenvolvimento do esmalte (DDE) e utilização de técnicas de adaptação de comportamento. Relato de caso: uma paciente do sexo feminino, 3 anos de idade, nascida prematura, apresentava DDE no incisivo central superior esquerdo, que, ao sorrir, cobria com as mãos. O perfil da criança foi avaliado e, a partir das suas características, foram escolhidas as técnicas de dizer-mostrar-fazer, controle de voz, reforço positivo, distração e repetição, usando-as de forma associada para melhores resultados, considerando a necessidade da repetição das visitas ao consultório. Após cinco consultas, foi possível realizar a restauração com resina fotopolimerizável, restabelecendo a estética e o conforto para a criança. Considerações finais: para o atendimento odontológico de crianças, é de fundamental importância conhecer técnicas de manejo infantil e usá-las de acordo com as necessidades individuais, com a finalidade de tornar as crianças participativas no processo, diminuindo a ansiedade, o medo e as reações que podem dificultar ou impedir o atendimento. (AU)

In pediatric dentistry, the clinical environment generates fear and anxiety, which children show in a number of ways, causing the need to promote their adaptation so they understand the process and feel part of it. It is also important to identify situations in which the aesthetic discomfort may lead to embarrassment in the daily lives of the children. Objective: to report a clinical case of resolution of aesthetic impairment caused by the developmental defect of enamel (DDE) and the use of behavioral adaptation techniques. Case report: female patient, three years old, born premature, presented DDE in the upper left central incisor and, when smiling, covered it with her hands. The profile of the child was evaluated and, based on her characteristics, the techniques of tell-show-do, voice control, positive reinforcement, distraction, and repetition were chosen and used in association for better results, considering the need for repeat visits to the dental office. After five consultations, it was possible to perform the restoration with light-curing resin, restoring the aesthetics and comfort of the child. Final considerations: for the dental care of children, it is essential to know child management techniques and use them according to the individual needs, with the purpose of promoting the participation of the children in the process, decreasing their anxiety, fear, and reactions that may hinder or prevent the treatment. (AU)

Longitudinal evaluation of the impact of dental caries treatment on oral health-related quality of life among schoolchildren.

This study aimed to evaluate the impact of dental caries treatment on oral health-related quality of life (OHRQoL) among schoolchildren and the responsiveness of the Child Perceptions Questionnaire (CPQ8-10 ) instrument. Brazilian schoolchildren, 8-10 yr of age, were randomly selected and assigned to two groups--dental caries treatment (DCT) and caries-free (CF)--according to their caries experience [decayed, missing, or filled primary teeth (dmft) and decayed, missing or filled secondary teeth (DMFT) values of ≥ 0]. The CPQ8-10 instrument was administered at baseline and at 4 wk of follow-up (i.e. 4 wk after completion of dental treatment). In the DCT group, increases in CPQ8-10 scores were observed between the baseline and follow-up results. However, longitudinal evaluation of the CF group demonstrated no statistically significant difference in CPQ8-10 scores. Responsiveness of the CPQ8-10 instrument (magnitude of change in CPQ8-10 scores) in the DCT group was greater (effect size >0.7) than in the CF group. The findings of this study show that dental caries treatment has an important impact on OHRQoL of children. The CPQ8-10 was considered an acceptable instrument for longitudinal measurement of changes in OHRQoL.

An experimental elective report examining and comparing current levels of dental anxiety and disease in child populations in Peru and the UK.

INTRODUCTION: Dental anxiety is an important factor in influencing patients' decisions to access treatment. It is crucial dental care professionals understand its causative factors in order to prevent and manage it, particularly as dentally anxious patients often have poor oral health. This report is of an elective study that tried to ascertain whether children with signs of dental neglect suffered greater dental anxiety, as existing research suggests that anxiety can stem from previous experiences. METHOD: 100 children in both the United Kingdom and Peru were examined for signs of dental neglect using the PUFA (Pulpal exposures, Ulcers, Fistulas & Abscesses) system, and their anxiety levels surveyed with the Modified Child Dental Anxiety Scale. A Spearman's rank analysis was performed. RESULTS: Both groups showed similar disease levels, but Peruvian children were significantly less anxious. The r values (United Kingdom r=-0.020 Peru r=-0.0099) were less than rc=0.165 at a significance level of P=0.05, showing that increased dental neglect does not make children more anxious. DISCUSSION: It appears that having a neglected dentition as a child does not make you more anxious, but the resultant invasive treatment procedures likely to have been experienced as a child may have a role. Ultimately, cultural background and attitude to dental care are suggested as being more important in determining the dental anxiety levels of children.

Impact of aesthetic restorative treatment on anterior teeth with fluorosis among residents of an endemic area in Brazil: intervention study.

BACKGROUND: Endemic dental fluorosis has already been described in some regions of the world. The aim of this study was to evaluate the functional and psychosocial impact of direct aesthetic restorative treatments in endemic fluorosis patients in the northern state of Minas Gerais, Brazil. Was a quasi-experimental intervention study. METHODS: The reference population consisted of individuals between 9 and 27 years of age that were served by a project intended to recover the smiles of patients with severe fluorosis. The questionnaires were administered on two occasions, 24 months apart (before and after dental treatment). Initially, descriptive analyses were conducted. Prevalence and severity, as well as the extent of the functional and psychosocial impact of oral disorders were estimated based on the Oral Health Impact Profile instrument (OHIP-14). Comparisons between baseline and follow-up and between treatment techniques were carried out using the McNemar, Wilcoxon, and Mann-Whitney tests. RESULTS: The study involved 53 individuals, with a mean age of 15.9 years, treated with microabrasion, dental composite, or a combination of both techniques. The treatments performed proved to be competent for reducing the functional and psychosocial impact of oral disorders as measured by the OHIP-14, pointing to the possibility of establishing protocols to be used in programs aimed at restoring the aesthetics and functionality of the anterior teeth in large populations. CONCLUSIONS: After performing the direct aesthetic restorative treatments in patients with endemic fluorosis, a significant improvement was observed in the prevalence and severity, as well as the extent of the functional and psychosocial impact of oral disorders.

Effect of different protocols for treating cavities in primary molars on the quality of life of children in Brazil--1 year follow-up.

The aim of this study was to test the hypothesis that the conventional restorative treatment (CRT) and the atraumatic restorative treatment (ART) protocols, in comparison with the ultra-conservative treatment (UCT) protocol, would increase the quality of life of children over a period of 1 year. Cavitated primary molars of 302 children 6-7 years of age were treated according to the CRT, ART and UCT protocols at the school compound. Children's parents completed the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) at baseline and one year later. Paired t-test, Chi-square test and ANOVA were applied in analysing the data. Questionnaires from 277 and 160 children were collected at baseline and after 1 year, respectively. A statistically significant difference in B-ECOHIS scores over the 1-year period was found for domains 'child symptoms' (P = 0.03) and 'child psychology' (P = 0.02). Treatment protocols did not statistically significantly influence the changes in B-ECOHIS scores over the 1-year period (P = 0.78). It can be concluded that the UCT protocol was as good as the two restorative protocols. All treatment protocols were effective in reducing children's experience of pain, their sleeping problems and their irritability and/or frustration levels over the 1-year period.

Traumatic dental injury with treatment needs negatively affects the quality of life of Brazilian schoolchildren.

BACKGROUND: Traumatic dental injury (TDI) has been considered a significant problem in youth, not only because of its consequences to the craniofacial structures but also for its potential impact on the quality of life of affected individuals. AIM: The aim of this study was to investigate the impact of TDI with treatment needs on the oral health-related quality of life (OHRQoL) of South Brazilian schoolchildren. DESIGN: A cross-sectional study was performed in Porto Alegre, Brazil, using a multistage probability sampling strategy. Of 1837 eligible 12-year-old schoolchildren attending public and private schools, 1528 were examined. OHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11-to 14-year-old children (CPQ11-14) - 16-item short form. Clinical examination was conducted to assess the presence of TDI in permanent incisors (Children's Dental Health Survey criteria), malocclusion, and dental caries. Parents/legal guardians answered questions on socioeconomic status. Statistical analyses were performed using Poisson regression models. RESULTS: The overall CPQ11-14 score was not associated with TDI. In the functional limitations domain, individuals presenting TDIs with treatment needs experienced significantly higher mean CPQ11-14 than individuals with no TDI or without treatment needs (RR = 1.21; 95% CI = 1.05-1.39), after adjusting for malocclusion, dental caries, gender, and socioeconomic status. No other domains were associated with TDI. CONCLUSIONS: This study revealed that TDI with treatment needs negatively affects the OHRQoL in this population of 12-year-old schoolchildren and that this impact is related to oral functions.

Degree of dental anxiety in children with and without toothache: prospective assessment.

BACKGROUND: Few prospective studies on the anxiety of children in the dental office have been published. AIMS: To monitor dental anxiety levels in children with and without previous experience with toothache over a period of six consecutive visits. DESIGN: A longitudinal study was carried out involving 167 children treated at a public dental service. Levels of anxiety in the dental setting were assessed in children without toothache (G1) and those with toothache (G2) using the modified Venham picture test (VPT). Data acquisition was carried out over a 6-week period, with each child treated in the dental office once a week. Six assessments of anxiety were performed in the waiting room prior to dental treatment. RESULTS: A significant reduction in anxiety scores occurred between appointments in both groups. In the inter-group comparison, G2 had significantly higher anxiety scores than G1. Although statistically significant reductions in anxiety scores occurred through to the fifth appointment, a tendency toward stagnation in anxiety scores was observed beginning with the fourth appointment. CONCLUSIONS: Dental anxiety scores were reduced over the course of six appointments. Children with toothache had higher levels of dental anxiety than those that had never experienced toothache.

Percepção de responsáveis sobre medo odontológico e técnica alternativa para remoção de cárie / The caregivers’ perception of dental fear and alternative technique for caries removal

O objetivo deste estudo foi avaliar a percepção de responsáveis sobre os fatores preditores de medo odontológico infantil e aceitação de uma técnica alternativa (abrasão ultrassônica) para a remoção de cárie. Cento e sessenta e dois responsáveis por crianças atendidas em uma instituição pública responderam a um questionário semiestruturado. A média de idade das crianças foi de 9 anos, sendo 52,5% meninos. Resultados mostraram que, gostavam de ir ao dentista 73,5% e 34% apresentavam-se nervosas/ansiosas antes de serem atendidas. A maioria dos responsáveis julgou importante a realização de estudos para descoberta de novos métodos para substituição do motor (p> 0,05) e autorizariam a utilização da abrasão ultrassônica (p > 0,05). Conclui-se que, aproximadamente, metade das crianças tinha medo ou ficavam ansiosas durante o atendimento, e que os responsáveis são receptivos à utilização de técnicas alternativas de remoção de cárie.

Patterns of dental anxiety in children after sequential dental visits.

AIM: To determine whether gradually exposing Brazilian children to the dental environment would decrease their levels of dental anxiety over a 14.5-month period. STUDY DESIGN AND METHODS: The study was carried out on 302 children of both genders, aged 6-7 years old. Dental anxiety was assessed using the Facial Image Scale (FIS) at five time points: 1) before an epidemiological examination; 2) before the first treatment session; 3) before the second treatment session; 4) before the first evaluation session 5) before the second evaluation session. STATISTICS: ANOVA, Student-t tests and ANCOVA were used to analyse the data. RESULTS: There was a statistically significant decrease in levels of dental anxiety between time points 1 and 5. Eighty-nine percent of the children with FIS score 1 or 2 at baseline had the same scores at the last time point, whereas 82% of children with FIS score 4 or 5 at baseline had a FIS score of 1 or 2 at the last time point. CONCLUSION: A gradual exposure of children to the dental environment in sequential dental visits of different natures in a school premise decreased their levels of dental anxiety over a 14.5-month period.

Impact of oral health on the quality of life of 3-6-years old HIV-infected children. Quality of life in HIV+ children.

AIM: The objective was to assess the impact of oral health on the quality of life of HIV-infected patients aged 3-6 years based on their caregivers' perceptions. METHODS: A questionnaire for measuring the perception and the instrument Early Childhood Oral Health Impact Scale (ECOHIS) were applied to 31 caregivers whose children were being treated in a public hospital. Results The mean age of the children was 4.52 years (SD 1.22). The total ECOHIS score ranged from 0 to 26, with a mean value of 4.13 (SD 6.66). Seventeen children (54.8%) were found to have at least one impact: toothache (64.7%), herpetic gingivostomatitis (23.5%) or both (11.8%). Statistically significant difference was found between the ECOHIS score and presence of restored teeth, prior dental treatment, AIDS, and viral load. With respect to the caregivers' perception, it resulted to be adequate, as those caregivers whose children had a greater number of decayed teeth and higher biofilm index also considered the oral health to be bad (P<0.001). However, the children's general health was found to be good despite the worse immunological classification (P<0.017).Conclusion The quality of life of the HIV- infected children has been negatively affected by the oral health.

Dental anxiety in 6-7-year-old children treated in accordance with conventional restorative treatment, ART and ultra-conservative treatment protocols.

OBJECTIVE: To test the hypothesis that dental anxiety levels of children treated in accordance with the conventional restorative treatment (CRT) are higher than in children treated with the atraumatic restorative treatment (ART) or ultra-conservative treatment (UCT) protocols. MATERIALS AND METHODS: In total, 302 children aged 6-7-years old, with at least two dentine carious lesions, constituted the sample. A parallel group study design was used with ART and UCT as test groups and CRT as the control. The treatment was divided into two sessions. In the first session, one carious tooth (class II in a primary molar) was randomly selected and treated according to one of the treatments. All other treatments were performed in the second session. Before the first (FIS Tx-1) and before the second session (FIS Tx-2) the level of dental anxiety was assessed using the Facial Image Scale (FIS). The GLM test and Spearman's Rank Correlation Coefficient were used to analyse the data. RESULTS: No treatment group effect was observed on the FIS Tx-2 score (p = 0.64). A FIS Tx-1 score (p < 0.0001) effect on the FIS Tx-2 score was observed. The correlation coefficient between FIS Tx-1 and FIS Tx-2 scores was r = 0.30 (p < 0.0001). CONCLUSION: At the beginning of the second session there was no difference in dental anxiety levels of the children treated in the first session according to the three treatment protocols. A high dental anxiety score before the first session was a predictor of a high dental anxiety score at the second treatment session.

Anxiety and fear of dental treatment among users of public health services.

PURPOSE: The aim of the present investigation was to determine the degree of anxiety and fear in patients treated at the dental school clinics of the Universidade Federal de Pernambuco (Brazil) regarding the different types of treatment offered. MATERIALS AND METHODS: The sample was made up of 400 patients from both genders over 18 years of age treated between July and October 2007. Data collection was carried out through the administration of validated questionnaires by a calibrated researcher. The Modified Dental Anxiety Scale (MDAS) and Gatchel's Scale were used to evaluate the degree of anxiety and fear among the patients. RESULTS: There was a 23.0% prevalence of dental anxiety; 9.5% were very anxious, 13.5% were anxious and 77.0% were not anxious. Women were more anxious than men (20.7% and 11.3%, respectively, P = 0.995). The age group that exhibited the highest prevalence of anxiety was 30 to 39 years (29.3%). Regarding fear, 13.5% felt extreme fear; 30.5% felt moderate fear and 56% felt no fear. Schooling was the only significant socioeconomic factor for both anxiety and fear. In the association between fear and anxiety, 38.9% of the patients with extreme fear were classified as very anxious. CONCLUSION: The majority of individuals were classified as non-anxious and without fear regarding dental procedures.

[Does Jesus have metal-free teeth in a country of the toothless?: dentistry of vanities and desires]. / Jesus tem dentes metal-free no país dos banguelas?: odontologia dos desejos e das vaidades.

This paper describes how dentistry in Brazil currently participates in the transformations of the object of its activity into commodities with which consumers can indulge their aesthetic desires. It explores the construction of the dental object of desires and its relationship with the dentist and the patient-consumer in the contemporary world. The paper makes explicit the role of the mega-dental congresses, which provide a biotechnological self-service that allure and seduce, creating uniform consumer values eager for the new offerings from dental surgeons. Also analyzes the role of the media in dental practices. It concludes that the individuation of the dental surgeon has generated a petrified ontology and fragmented epistemology. The paper presents some pressing tasks for the academic and professional sectors and society as a whole, such as the development of strategies and discussion about communication related to oral health.

Relationship between mothers' sense of coherence and oral health status of preschool children.

OBJECTIVE: The aim of the present study was to investigate the relationship between mothers' sense of coherence (SOC) and oral health status in a representative sample of 5-year-old preschool children. METHODS: A cross-sectional study was conducted in Belo Horizonte (Brazil) on a sample of 546 mothers and their 5-year-old children, randomly selected from preschools. Data were collected through questionnaires (mothers), the short version of Antonovsky's SOC scale (SOC-13) and clinical dental examinations (children). Simple and multiple logistic regression analyses were performed on the data. The following 8 outcome variables were selected: dental caries, filled and missing teeth, dental pulp exposure due to caries, dental root fragment, visible plaque, gingivitis and supragingival calculus. The examination was carried out by 2 trained, calibrated examiners. RESULTS: Mothers with a lower SOC were more likely to have children with decayed teeth (OR = 1.59, 95% CI = 1.01-2.29), dental pulp exposure (OR = 1.99, 95% CI = 1.06-3.77) or filled teeth (OR = 1.85, 95% CI = 1.12-3.06) regardless of the child's social class and gender. CONCLUSION: The data indicate that mothers' SOC is an important psychosocial determinant of the oral health status among preschool children.

Avaliação clínica da técnica de tratamento restaurador atraumático associada ao Carisolv® em pacientes com deficiência mental / Clinical evaluation of the atraumatic restorative technique associated with Carisolv® in patients with mental impairment

Este estudo teve o objetivo de analisar a durabilidade de restaurações confeccionadas pela técnica de Tratamento Restaurador Atraumático (ART), realizadas em associação ou não ao emprego do Carisolv® em pacientes com deficiência mental. O protocolo foi aprovado pelo Comitê de Ética local e obteve-se o consentimento livre e esclarecido dos responsáveis. Dos 26 pacientes com deficiência mental que participaram desta pesquisa, 14 eram do sexo masculino e 12 do feminino; tinham entre oito a dezesseis anos (mediana e semi-amplitude interquartílica de 12 anos ± 1,50). As condições dentais e de higiene bucal puderam ser avaliadas pelos índices CPO-D, que foi igual a 6,27 (desvio padrão de 3,26); e IPV (índice de placa gengival) com resultado de 57,30 (desvio padrão de 25,79). Cada paciente selecionado recebeu pelo menos uma restauração da técnica ART (controle) e outra modificada em associação com Carisolv®, aleatoriamente escolhidas para tratamento. O número de dentes tratados foi 52 sendo 26 com a técnica ART (T1) e 26 com a técnica ART associada a Carisolv® (T2). Este grupo de pacientes com deficiência mental precisou de uma média de duas sessões de condicionamento cada. Quanto à profundidade cavitária, apenas dois dentes do total analisado foram considerados com cavidades profundas, os quais foram restaurados coincidentemente com a mesma técnica (T1), as outras cavidades se distribuíram igualmente entre rasas e médias. Quanto à dificuldade encontrada pelo operador no momento da remoção do tecido cariado, considerando-se as duas técnicas (T1 e T2) os registros foram muito próximos, isto é, a técnica de remoção mecânica do tecido cariado (T1) e a técnica de remoção química-mecânica (T2) apresentaram o mesmo grau de dificuldade. Como cada paciente foi submetido às duas técnicas, foi possível avaliar o grau de dificuldade sentida pela profissional...

This study analyzes the durability of restorations accomplished by the Atraumatic Restorative Technique (ART), with or without utilization of Carisolv® in patients with mental impairment. The study design was approved by the local Institutional Review Board and the caretakers of patients signed an informed consent term. Among the 26 patients with mental impairment included in this study, 14 were males and 12 were females; patients were aged 8 to 16 years (median and interquartile semi-amplitude 12 years ± 1.50). The dental and oral hygiene status were evaluated by the DMFT index, which revealed a mean value of 6.27 (standard deviation 3.26); and GPI (gingival plaque index) with a mean value of 57.30 (standard deviation 25.79). Each patient received at least one restoration by the ART technique (control) and another restoration by the modified technique associated with Carisolv®, randomly selected for treatment. Overall, 52 teeth were treated, being 26 by the ART technique (T1) and 26 by the ART technique associated with Carisolv® (T2). ...

Influence of the patient's race on the dentist's decision to extract or retain a decayed tooth.

OBJECTIVES: The aim of this study was to investigate the influence of the patient's race on the dentist's decision to extract or retain a decayed tooth. METHODS: A probabilistic random sample of 297 dentists from Recife, Brazil, was used. Two case scenarios were presented to the dentists. Both scenarios showed a molar that was extensively decayed, but indicated for conservative treatment. The scenarios included a description of the patient and eight photographs of the clinical case, including a photograph of the patient's face. The dentists were asked to regard the patient as poor and then to decide whether to extract or retain the molar. However, although the scenarios were based on the same clinical case, the photographs of the patient's face were different. One scenario showed the photograph of a white patient whereas the other showed the photograph of a black patient. The first scenario was presented 2 months before the second so that the dentists would not remember the former. RESULTS: The dentist's decision varied significantly according to the patient's race, with dentists deciding to extract more frequently for the black patient than for the white patient (25.6% vs. 16.2%; P < 0.001). This racial variation occurred regardless of the demographic and socioeconomic variables of the dentists. It did, however, occur as a function of the setting of the dentist's practice. CONCLUSION: The patient's race may influence a dentist's decision whether to extract or retain a decayed tooth.

Eficacia de la técnica de modelado con video preoperatorio en pacientes de 4 a 6 años de edad / Efficacy of the modeling technique with preoperative video in 4- to 6-year-old patients

Este estudio se realizó para evaluar el comportamiento de niños de difícil manejo utilizando la técnica de modelado con video. La muestra consistió en 15 niños con experiencia odontológica previa, cuyo comportamiento fue clasificado como definitiva o levemente negativo de acuerdo a la escala de Frankl. Cada niño se atendió en dos citas: en la primera se sometió a un tratamiento restaurador convencional; previo a la segunda cita, los pacientes observaron un video donde se mostró la atención de un niño de buen comportamiento. Inmediatamente después, recibió tratamiento similar al de la primera cita. Todos los procedimientos fueron grabados y editados para ser evaluados por un juez, previamente estandarizado, quien clasificó el comportamiento de los niños en cada momento operativo y en forma global para cada cita. Al comparar el comportamiento de las dos citas, se encontró que hubo una mejoría del 53.3 por ciento (p=0.25 por ciento) durante la aplicación de la anestesia, 73.3 por ciento (p=0.02) durante el tallado de la cavidad y 60 por ciento (p=0.001) al momento de la restauración. En la evaluación global, la técnica de mostró ser efectiva en el 80 por ciento de los pacientes (p=0.008). Se concluyó que la técnica puede ser efectiva cuando es utilizada en niños de 4 a 6 años con comportamientos levemente negativos, logrando éxito en el mejoramiento del comportamiento disruptivo

Estética: a polêmica da beleza / Esthetics: the polemic for good look

Modismo, exploraçäo comercial ou futuro? As discussöes sobre a estética estäo esquentando. Apesar de polêmicos e, às vezes, pouco firmes, os argumentos, tanto pró como contra, deixam a impressäo bastante favorável de que, no final, quem sai ganhando é a odontologia