What do Brazilian paediatric dentists know about bruxism in children? Cross-sectional study.

PURPOSE: Little is known about the knowledge of paediatric dentists on bruxism in children. The aim of this cross-sectional study was to assess the knowledge of paediatric dentists on the concept, associated factors of bruxism and management of sleep bruxism (SB) in children'. METHODS: An electronic questionnaire was sent to paediatric dentists in the state of Goiás, Brazil. Information was collected on (1) characteristics of the participants; (2) the concept of bruxism; (3) diagnosis; (4) associated factors; (5) strategies for the management of SB; and (6) updated knowledge on bruxism in children. The data were analysed descriptively. RESULTS: Fifty-seven paediatric dentists participated (10.7% of the total number of professionals). A high level of agreement was found with statements on the concepts of SB (94.7%) and awake bruxism (96.5%). The main strategy for the diagnosis was the combination of a parental report and a clinical examination (79.0%). Most participants indicated that bruxism is associated with anxiety/stress (96.5%), screen use (93%), airway obstruction (91.2%), and sleep apnoea (91.2%). In suspected cases of bruxism, the dentists would send the child for assessment by other health care providers (87.7%). The management options frequently indicated were the use of an occlusal splint, aromatherapy, and homeopathy. More than 70% of them considered themselves to be updated on the issue and sought information through scientific articles and discussions with colleagues. CONCLUSION: Paediatric dentists have knowledge on the concept of bruxism and associated factors. However, further information is needed on the management of this condition in children.

Randomized trial of dentists' understanding: treatment benefit in absolute numbers vs relative risk reduction.

This study aimed to assess whether dentists correctly understand the benefit of a dental treatment when it is presented using absolute numbers or relative risk reduction (RRR). This parallel-group randomized controlled trial recruited dentists from 3 postgraduate courses in Rio de Janeiro, Brazil. Participants received, in sequentially numbered sealed opaque envelopes, the description of a hypothetical scenario of the benefit (avoidance of multiple tooth loss) of nonsurgical periodontal treatment without or with antibiotics. Treatment benefit was presented in 2 different formats: absolute numbers or RRR. Dentists were given 10 minutes to read the treatment scenario and answer 5 questions. The final sample for analysis included 101 dentists. When asked to estimate the number of patients out of 100 who would avoid multiple tooth loss without antibiotics, 17 dentists (33%) in the absolute numbers group and 12 (25%) in the RRR group provided the correct response (p = 0.39). Regarding treatment with antibiotics, 26 dentists (50%) in the absolute numbers group and 14 (29%) in the RRR group provided the correct response (p = 0.04). Only 16 dentists (31%) in the absolute numbers group and 12 (25%) in the RRR group gave correct answers for both questions (p = 0.51). Most dentists did not correctly understand the benefit of the treatment, irrespective of the format it was presented. Slightly more dentists correctly understood the benefit of the treatment when it was presented as absolute numbers than as RRR.

Atuação do cirurgião-dentista na atenção primária à saúde: experiências a partir da residência multiprofissional / Performance of the dentist in primary health care: experiences from the multiprofissional residency program / El rol del cirujano dentista en laatención primaria de salud: experiencias del programade residencia multiprofesional

Introdução:A inserção das equipes de saúde bucal na Estratégia Saúde da Família, embora tardia, representa um avanço significativo para a ampliação da cobertura e da qualidade dos serviços odontológicos no Brasil. No entanto, aindaexistem muitosdesafiosnas práticas do cirurgião-dentista na Estratégia Saúde da Família. A atuação majoritariamente clínica prejudica a realização deum trabalho humanístico, resolutivo, interdisciplinar e multiprofissional. Objetivo:Relatar a experiência de atuação de uma cirurgiã-dentista residente na Atenção Primária em Saúde no município de Santo Estêvão, Bahia, Brasil, durante o Programa de Residência Multiprofissional em Saúde da Família da Universidade Estadual de Feira de Santana. Metodologia:Trata-se de um estudo qualitativo, do tipo relato de experiência, que visa descrever as atividades desenvolvidas durante o Programa de Residência Multiprofissional em Saúde da Família, da Universidade Estadual de Feira de Santana, no município de Santo Estêvão, Bahia, Brasil, no período de março de 2022 a novembro de 2023. Resultados:As atividades descritas abrangem as diferentes possibilidades de trabalho do cirurgião-dentista na Atenção Primária, envolvendo ações assistenciais através das consultas individuais e levantamento epidemiológico, educação permanente e em saúde com atuação nos grupos operativos e capacitações com os profissionais da rede e as ações de planejamento e gestão, através do desenvolvimento de estratégias para fortalecer a rede de atenção à saúde. Conclusões:É preciso motivar os profissionais de saúde bucal a repensarem suas práticas, tendo como ponto de partida o investimento e o estímulo à educação permanente e continuada. A especialização em saúde da família permite que cirurgiões-dentistas que atuam ou têminteresse em trabalhar no serviço público desenvolvam habilidades e práticas voltadas para uma assistência integral e multiprofissional da saúde, contribuindo para a consolidação do Sistema Único de Saúde (AU).

Introduction:The oral health team inclusion in the Family Health Strategy represents a significant advance in expanding the coverage and quality of dental services in Brazil. However, there arestill many challenges in the dental surgeons practices in the Family Health Strategy. The ppredominantly clinical approach hinders the achievement of ahumanistic, problem-solving, and interdisciplinary and multidisciplinary. Objective:To report the experience of a dental surgeon resident in Primary Health Care in the city of Santo Estêvão, Bahia, Brazil, during the Multidisciplinary Residency Program in Family Health at the Universidade Estadual de Feira de Santana. Methodology:This is a qualitative study, experience report type, which aims to describe the activities developed during the Multidisciplinary Residency Program in Family Health at the Universidade Estadual de Feira de Santana, in the city of Santo Estêvão, Bahia, Brazil, from March 2022 to November 2023. Results:The activities described cover the different work possibilities of dental surgeons in Primary Care, involving assistance actions through individual consultations and epidemiological surveys, ongoing health education with work in operative groups and training with network professionals, and planning and management actions through the development of strategies to strengthen the health care network. Conclusion:It is necessary to motivate oral health professionals to rethink their practices, with investment and encouragement for permanent and continuing education as a starting point. Specialization in family health allows dental surgeons who work or are interested in working in the public service to develop skills and practices aimed at comprehensive and multidisciplinary health care, contributing to the consolidation of the Unified Health System (AU).

Introducción: La inclusión de los equipos de salud dental en la Estrategia de Salud Familiar, aunque tardía, representa un avance significativo en la ampliación de la cobertura y la calidad de los servicios dentales en Brasil. Sin embargo, los cirujanos dentistas siguen enfrentándose a muchos retos em la Estrategia de Salud Familiar. El enfoque mayoritariamente clínico obstacualiza la realización de um enfoque humanista, resolutivo, interdisciplinario y multiprofesional.Objetivo:Reportar la experiencia de un cirujano dentista residente en Atención Primaria de Salud en el ayuntamiento de Santo Estêvão, Bahía, Brasil, durante el Programa de Residencia Multiprofesional en Salud Familiar de la Universidad Estadual de Feira de Santana.Metodología:Se trata de un estudio cualitativo, del tipoinforme de experiencia, que tiene como objetivo describir las actividades desarrolladas durante el Programa de Residencia Multiprofesional en Salud Familiar de la Universidad Estadual de Feira de Santana, en el ayuntamiento de Santo Estêvão, Bahía, Brasil, de marzo de 2022 a noviembre de 2023. Resultados:Las actividades descritas abarcan las diferentes posibilidades de trabajo del cirujano dentista en la Atención Primaria, implicando actividades asistenciales mediante consultas individuales y encuestas epidemiológicas, educación sanitaria continuada con actuación en los grupos operativos y capacitaciones con los profesionales de la red y actividades de planificación y gestión mediante el desarrollo de estrategias de fortalecimiento de la red de atención sanitaria.Conclusiones:Es necesario motivar a los profesionales de la salud dental a replantear sus prácticas, con la inversión y el fomento de la formación permanente y continua como punto de partida. La especialización en salud familiar permite a los cirujanos dentistas que trabajan o están interesados en trabajar en el servicio público desarrollar competencias y prácticas dirigidas a la atención sanitaria integral y multiprofesional, contribuyendo a la consolidación del Sistema Único de Salud (AU).

Comparison of factors associated with the evidence-practice gap as perceived by Japanese and Brazilian dentists.

OBJECTIVES: To identify 1) factors of the evidence-practice gap (EPG) in Japan and Brazil as perceived by dentists and compare these factors between two countries, and 2) mechanisms to close this EPG. METHODS: The study employed a cross-sectional design by administering a web-based questionnaire to 136 Japanese and 110 Brazilian dentists. The survey queried dentists' reports of which factors possibly cause an EPG, using a newly developed 20-item questionnaire. RESULTS: An international comparison of 20 items related to factors of the EPG between Japan and Brazil revealed that "Dentists' own experiences are sometimes given priority over evidence" and "Dentists' own thoughts are sometimes given priority over evidence" were common factors to both countries, with over 80 % agreement. In logistic regression, "Insufficient opportunity to learn about evidence in dental education at universities", "Evidence-based treatments are sometimes not covered by the dental insurance system", and "Insufficient evidence which helps dentists choose an appropriate treatment for a patient after careful consideration of his/her own background" were significantly associated with the EPG in Japan (p < 0.05). In Brazil, "Insufficient case reports in which evidence-based dentistry (EBD) is applied to clinical practice" and "Image-based information and devices used for diagnosis vary depending on individual dentists" were significantly associated with the EPG (p < 0.05). CONCLUSIONS: This study suggests that EPG could be improved in Japan: by promoting EBD education at universities, improving the dental insurance system, and accumulating evidence according to patient background; and in Brazil: by promoting EBD case reports and standardizing diagnostic information and devices. CLINICAL SIGNIFICANCE: Two factors of EPG common to Japan and Brazil, namely the prioritization of dentists' own "experiences" and "thoughts" over evidence, are urgent issues for improving EPG. In addition, it will be necessary to address the country-specific factors of EPG that were identified in this study.

Analysis of patients hospitalized by Covid-19 regarding oral care during hospitalization

Oral health interferes with the general condition of the individual, because the oral cavity is a gateway and habitat for pathogens, especially in hospitalized people. There are several diseases that directly interfere in the oral cavity, such as Covid 19. Studies report oral changes in patients infected by SARS-CoV2 and point to the need for satisfactory oral hygiene during hospitalization in order to avoid the occurrence of oral lesions that increase the risk for the individual. The objective of this research is to emphasize the importance of the dentist in hospitals, pointing out the oral diseases that can be caused by poor oral hygiene during hospitalization. For the execution of the work, a questionnaire was carried out with patients who were hospitalized in Covid-19, clarifying if, during the hospitalization period, these patients received help in oral hygiene and if they noticed oral changes. The results achieved are in accordance with the literature, taking into consideration the age range of those affected by covid, over 50 years old, and the length of hospitalization, ran-ging from 10 days. Many hospitals still neglect the dental service and the patient himself performs the oral hygiene. The most common lesions reported by those infected by the virus were taste alteration, xerostomia and thrush, besides caries and dental calculus. We concluded the relevance of the odontologist far beyond the prevention of lesions, but in contributing to the recovery of the individual and the importance of adopting measures for the oral adequacy of hospitalized patients. (AU)

Comparison of smile attractiveness in cases with gummy smile treated with botulinum toxin and maxillary impaction surgery: A retrospective study.

This study aimed to compare the smile's attractiveness in patients submitted to the treatment of gummy smiles with botulinum toxin or maxillary impaction surgery. The retrospective sample comprised 26 patients divided into two groups: Group 1 (BTX): 13 patients (12 females and 1 male) with a mean age of 28.06 years (s.d. = 6.09) and mean gingival exposure during smile of 5.18 mm (s.d. = 1.51) treated with botulinum toxin; Group 2 (SURGICAL): 13 patients (9 females and 4 males) with a mean age of 30.59 years (s.d. = 5.72) and mean gingival exposure during smile of 5.21 mm (s.d. = 1.55) treated with orthognathic maxillary impaction surgery. The group of evaluators comprised 317 participants, divided into 143 orthodontists (85 females and 58 males) with a mean age of 41.40 (s.d. = 9.30); 62 dentists (47 female and 15 male) with a mean age of 35.44 (s.d. = 10.44), and 112 lay people (74 female and 38 male) with a mean age of 46, 91 (s.d. = 10.11) in a questionnaire on Google Forms. Without knowing the therapy used, the evaluators assigned scores to the photographs of the posed smile taken before (T1) and after (T2) treatment. Intergroup comparison of smile attractiveness was performed using the t-independent, one-way ANOVA, and Tukey tests. There was a significant improvement in smile attractiveness with treatment in both groups; however, the improvement was significantly better in the surgical group than in the BTX group. Orthodontists rated smile attractiveness significantly higher than dentists and laypersons for the final phase of the BTX and surgical groups. There was a significant improvement in the smile attractiveness with botulinum toxin application and orthodontic-surgical treatment. However, orthognathic surgery promoted a greater improvement in smile attractiveness than the application of botulinum toxin.

Fear of COVID-19 associated with burnout syndrome in dentists of the Health Directorate of the National Police of Peru: a cross-sectional study at national level under multivariable regression model.

BACKGROUND: During the pandemic, many police dentists had the crucial responsibility of ensuring law and order while providing dental care by taking government-approved health measures to stop the spread of the coronavirus. The aim of this study was to assess the association between the fear of COVID-19 and Burnout syndrome in Peruvian dentists belonging to the Health Department of the National Police of Peru (PNP), taking into account possible confounding variables. METHODS: This cross-sectional and analytical study included 182 PNP dentists. The Fear COVID-19 Scale assessed fear of COVID-19 and the Maslach Burnout Inventory Test assessed burnout syndrome. The association between the fear of COVID-19 and Burnout syndrome (self-fulfilment) was analyzed using Spearman's Rho. A multivariable Poisson regression model with a robust variance estimation method was employed to evaluate the impact of fear of COVID-19 on the various dimensions of Burnout syndrome, considering possible confounding variables. The statistical significance level was set at p < 0.05. RESULTS: Under bivariate analysis, fear of COVID-19 was significantly linked with low direct intensity toward emotional exhaustion (Rho = 0.325, p < 0.001), very low direct intensity toward depersonalization (Rho = 0.180, p = 0.015), and very low inverse intensity toward self-fulfilment (Rho =-0.186, p = 0.012). Under multivariable analysis, it was observed that dentists who exhibited fear of COVID-19 were 3.4 and 3.7 times more likely to experience emotional exhaustion and depersonalization, respectively (APR = 3.40, 95% CI: 1.74-6.63 and APR = 3.68, 95% CI: 1.31-10.37), as compared to those who did not display fear of COVID-19. Moreover, none of the potential confounding factors were found to have a significant impact on emotional exhaustion (p > 0.05), depersonalization (p > 0.05), and self-fulfilment (p > 0.05). CONCLUSION: Fear of COVID-19 was significantly associated with emotional exhaustion and depersonalization, and inversely associated with self-fulfilment. PNP dentists who exhibited fear of COVID-19 were at greater risk for emotional exhaustion and depersonalization. In developing Burnout syndrome, no significant impact was observed from factors such as age, gender, marital status, children, hierarchy, years of service, work area, private practice, work over 40 h per week, type of service, work performed, sport practice and daily exercise time.

Acceptability of dental students and professionals concerning child behaviour management techniques: Systematic review.

INTRODUCTION: During child dental treatment, different behavior management techniques (BMTs) are applied and it is important to understand the possible discomfort in the operator. OBJECTIVE: The present systematic review aimed to evaluate the acceptability of dental students and professionals concerning BMTs applied with paediatric dentistry patients. MATERIALS AND METHODS: A systematic search was conducted, following the PEOS strategy: Population (P) - dental students/professionals (S); Exposure (E) - BMTs preconized by the American Academy of Paediatric Dentistry, Outcome (O) - proportion of BMT acceptance; and Study design (S) - observational studies based on data from PubMed, Scopus, Web of Science, BVS (Lilacs/BBO), Cochrane, and Open Grey databases up to September 2021. The eligible studies were submitted to data extraction and to the evaluation of methodological quality, using the Joanna Briggs Institute Critical Appraisal Tool. The certainty of evidence was evaluated by GRADE. RESULTS: The search retrieved 710 articles; a total of 21 fulfilled the eligibility criteria and were used for qualitative analysis. Among the undergraduate students and dentists, the most accepted techniques were tell-show-do and positive reinforcement, while paediatric dentists preferred the tell-show-do technique and dental professionals with graduate degrees preferred sedation using nitrous oxide and positive reinforcement. The least accepted technique was protective stabilization. Seven students presented a low risk for bias, while 14 presented a high risk. The certainty of evidence was classified as very low. CONCLUSION: Although the basis of available certainty of evidence is scarce and with a considerable risk for bias, it is still possible to conclude that the more accepted techniques were based on communication.

Análise do nível de conhecimento do cirurgião dentista geral sobre o diagnóstico das diferentes más oclusões / Analysis of the level of knowledge of the general dental surgeon about the diagnosis of different malocclusions

A má oclusão é um dos fatores que influenciam no estado de saúde bucal do paciente. A OMS estima as mal oclusões como o terceiro problema de saúde bucal mais prevalente, após cárie dentária e doenças periodontais, apresentando diversos fatores e podem apresentar como consequência impacto na qualidade de vida dos portadores de tais condições oclusais. O trabalho tem como finalidade avaliar o conhecimento do acadêmico de odontologia e do cirurgião dentista em relação ao conhecimento sobre a mal oclusão e relaciona os tipos de mal oclusões relacionadas a hábitos deletérios dos pacientes e a qualidade de vida. através do método de aplicação de questionário sobre o conhecimento do profissional de odontologia sobre a mal oclusão, voltado para acadêmicos e profissionais formados em odontologia. Para esta pesquisa foi confeccionado um questionário com o auxílio do Google Forms que foi enviado por meio de redes sociais para 892 profissionais e acadêmicos. Foi obtido um índice de retorno de 2,34% (38 respostas) no prazo estipulado. Os resultados da pesquisa mostram que os profissionais sabem a teoria, porém não conseguem aplicá-la na prática. Sendo assim, os profissionais não aparentam estar aptos o bastante para indicar o tratamento adequado para um paciente com mal oclusão. É de suma importância aumentar o nível de conhecimento de profissionais e acadêmicos de odontologia sobre como reconhecer e diagnosticar a má oclusão tornando-os aptos para encaminhar para o correto tratamento. Reconhecendo a importância do assunto na vida do acadêmico de odontologia e do cirurgião dentista.

Malocclusion is one of the factors that influence the patient's oral health status. The WHO estimates malocclusions as the third most prevalent oral health problem, after dental caries and periodontal diseases, presenting several factors and may impact the quality of life of patients with such occlusal conditions. The objective of this work is to evaluate the knowledge of dental students and dentists in relation to the knowledge about malocclusion and to relate the types of malocclusions related to harmful habits of patients and quality of life. through the method of applying a questionnaire on the knowledge of dental professionals about malocclusion, aimed at academics and professionals trained in dentistry. For this research, a questionnaire was made with the help of Googles Forms that was sent through social networks to 892 professionals and academics. A return rate of 2.34% (38 responses) was obtained within the stipulated period. And the survey results show that professionals know the theory but cannot apply it in practice. Therefore, professionals do not appear to be able enough to indicate the appropriate treatment for a patient with malocclusion. It is extremely important to increase the level of knowledge of dental professionals and academics on how to recognize and diagnose malocclusion, making them able to refer to the correct treatment. Recognizing the importance of the subject in the life of the dental student and the dental surgeon.

Principais dificuldades enfrentadas por cirurgiões-dentistas no atendimento domiciliar na estratégia saúde da família / Main difficulties faced by dental surgeons in home care in the family health strategy

O objetivo da pesquisa foi apresentar uma revisão narrativa de literatura sobre as principais dificuldades enfrentadas por cirurgiões-dentistas no atendimento domiciliar na Estratégia Saúde da Família (ESF). Realizou-se um levantamento bibliográfico com base nos bancos de dados eletrônicos (Google Acadêmico, SCIELO, BVS), com captação de documentos do Ministério da Saúde e artigos de língua inglesa e portuguesa, nos anos de 2000 a 2021. Elegeu-se 21 artigos que apresentaram o objeto de estudo com visão crítica. Foi realizada pesquisa e descrição sobre a Estratégia Saúde da Família, sobre o atendimento domiciliar e também sobre os profissionais de saúde bucal que participam do atendimento domiciliar na Estratégia Saúde da Família. O atendimento domiciliar é usado pela equipe da Estratégia Saúde da Família com foco nos usuários que não se deslocam até a Unidade Básica de Saúde (UBS) por motivos físicos, mentais e/ou sociais. Após o acréscimo da Equipe de Saúde Bucal (ESB) na Estratégia Saúde da Família, os mesmos também passaram a realizar atendimentos domiciliares. Os principais afazeres realizados pela equipe em domicílio são com foco na promoção, prevenção e tratamento. Contudo os cirurgiões-dentistas enfrentam dificuldades que atrapalham os atendimentos domiciliares, podendo-se citar: vias urbanas precária; violência; tráfico de drogas; falta de transporte; demanda de equipamentos e instrumentai; biossegurança e ergonomia que são difíceis alcançar em domicílio.

The objective of the research was to present a narrative review of the literature on the main difficulties faced by dentists in home care in the Family Health Strategy (ESF). A bibliographical survey was carried out based on electronic databases (Google Academic, SCIELO, BVS), with collection of documents from the Ministry of Health and articles in English and Portuguese, in the years 2000 to 2021. 21 articles were chosen that presented the object of study with a critical view. A research and description was carried out on the Family Health Strategy (ESF). Home care is usedby the Family Health Strategy team, focusing on users who do not go to the Basic Health Unit (UBS) for physical, mental and/or social reasons. After the addition of the Oral Health Team (ESB) to the ESF, They also began to provide home care. The main tasks performed by the theam at home are focused on promotion, prevention and treatment. However, dentists face difficulties that hinder home care, such as: prearious urban roads; violence; drug trafficking; lack of trasportation; demand for equipment and instruments; biosafety and ergonomics that are difficult to achieve at home.

Validating evidence for the knowledge, management and involvement of dentists in a dental approach to sickle-cell disease.

This study validated the content of an instrument designed to assess the knowledge, involvement (attitudes) and management (practice) of dentists relative to sickle-cell disease (KAPD-SCD). The instrument consisted of five domains composed of a total of thirteen items: I. Dentist's self-assessment relative to sickle-cell disease; II. Dentist's knowledge of the repercussions of sickle-cell disease on the stomatognathic system; III. Dentist's knowledge of the complications of sickle-cell disease in the stomatognathic system; IV. Dentist's knowledge concerning the dental management of sickle-cell disease patients; and V. Dentist's involvement in an approach to sickle-cell disease. Twelve experts assigned scores to each item of the instrument. The criteria were clarity, understanding and appropriateness, leaving open fields for comments. Descriptive and content analyses of the data were made. Each expert analyzed 39 assessment units. The percentages considered for agreement were high (>80%), medium (70%-80%), or low (<70%), and each item was maintained or revised according to the percentage observed. There was high consensus in 74% of the assessment units (the corresponding items were maintained), medium consensus in 24% of them (the corresponding items were revised), and disagreement in 2% of them, namely as regards the "appropriateness" of item 5 ("Are there oral complications in sickle-cell disease?"), which was revised. The final version of the instrument had 16 items for different applications such as in the clinical care program, teaching program, or research program, with different cut-off scores for each application. In conclusion, the level of agreement among experts showed evidence of the content validity of the instrument.

Teleconsultations in oral medicine: dentist perception during the COVID-19 pandemic in Brazil.

BACKGROUND: The aim of this study was to describe the perception of dentists from the North macroregion of Minas Gerais, Brazil, users of telediagnosis in Oral Medicine, during the COVID-19 pandemic. MATERIAL AND METHODS: This is a cross-sectional and descriptive study. Data collection was carried out online, between May and October 2022. The information was transferred to the Statistical Package for the Social Sciences for Windows (SPPS)® version 24. RESULTS: The sample consisted of 255 dentists, predominantly female. Regarding perception, a significant percentage (47.8%) of respondents agreed that they would like to use telediagnosis frequently, more than half (60.6%) agreed that the technology is easy to use, only a small percentage (8.8%) needed technical support to use it and almost half (48.2%) mentioned the desire to continue using it after the pandemic. When asked if patients felt confident and comfortable when passing on information, more than half disagreed or remained neutral (58.4%), a similar result was found in relation to confidence in the application of the instrument by professionals. CONCLUSIONS: It is concluded that, during the pandemic, telediagnosis in Oral Medicine was an easy and adequate tool. However, professionals must be trained and prepared to be comfortable and ready for use.

The Relationship between Professional Variables and Burnout Syndrome in Brazilian Dentists during the COVID-19 Pandemic.

Burnout syndrome (BS) is a highly prevalent occupational disease among dentists who, during the COVID-19 pandemic, have been at greater risk of contracting the disease, generating stress and distancing. The aim of this study was to assess the association of social conditions, professional factors and perceptions of COVID-19 with Burnout Syndrome. This was a cross-sectional study of 302 Brazilian dentists working in the clinical and private sectors. The professionals completed the Oldenburg Burnout Inventory online and answered sociodemographic and professional questions and questions related to their perception of the pandemic. Poisson regression with unadjusted and adjusted robust variance was used to estimate the association between burnout syndrome (dependent variable) and the independent variables. The presence of BS was strongly associated with age, training in a private institution, professionals who claimed to have sufficient protective knowledge and fear of being contaminated by SARS-CoV-2 during patient care (p < 0.05). The findings of this study show that there has been an impact of the COVID-19 pandemic on the occurrence of Burnout syndrome in dentists, especially, those who worked in the public sector and those who were afraid to work with other health professionals.

Orientações de manutenção e higienização de prótese fixa total implantossuportada: revisão de literatura / Guidelines for maintenance and cleaning of implantssupported total fixed prosthesis: literature review

A evolução dos tratamentos em implantodontia possibilitou uma mudança nos tratamentos reabilitadores para pacientes edêntulos, tornando possível a colocação de próteses fixas, que proporcionam maior qualidade de vida para estes pacientes. Para que estas próteses tenham bom desempenho e longevidade satisfatórios é essencial que se mantenha um padrão adequado de higienização bucal e manutenção profissional. Assim, o objetivo deste trabalho foi realizar uma revisão de literatura a respeito dos principais recursos disponíveis para higienização e manutenção das próteses totais fixas sobre implante (protocolo de Branemark), tanto nos cuidados domiciliares dos pacientes quanto no atendimento profissional do cirurgião dentista. Foi realizada uma busca eletrônica, não sistemática, nas bases de dados Lilacs, Pubmed/Medline, Scielo e ScienceDirect, cruzando-se os seguintes descritores: "Higiene Oral"; "Implantes Dentários"; "Implantação Dentária"; "Manutenção"; "Prótese Dentária Fixada por Implante" e "Prótese Dentária". Foram consultados artigos de revisão de literatura, revisão sistemática, meta-análise, estudos clínicos randomizados, além de livros pertinentes ao assunto, publicados no período de 1995 a 2022.Verificou-se na literatura disponível que os principais instrumentos indicados para uso domiciliar são escova dental, fio dental, escova interdental, irrigador oral, dentifrício e enxaguatório. No atendimento profissional em consultório odontológico deve ser dispendida atenção especial às instruções passadas ao paciente e também fazer o possível para motivar e encorajar o seu engajamento na rotina de higienização, além do acompanhamento periodontal, possíveis substituições de parafusos e instalação de placa oclusal estabilizadora, quando necessário. Manter uma higiene oral adequada é essencial para o sucesso das próteses fixas sobre implantes e o cirurgião dentista desempenha um papel crucial não apenas ao realizar o acompanhamento periódico do paciente, mas também ao sugerir os instrumentos mais apropriados, instruir sobre a higiene oral adequada e motivar o paciente a manter a saúde bucal satisfatória(AU)

The evolution of treatments in implantology has enable a change in rehabilitation treatments for edentulous patients, making it possible to place fixed prostheses that provide a better quality of life for these patients. In order to ensure good performance and satisfactory longevity, it is essential to maintain an appropriate standard of oral hygiene and professional maintenance. Thus, the objective of this work was to conduct a literature review on the main resources available for cleaning and maintenance of complete fixed prostheses on implants (Branemark protocol), both in the patients' home care and in the professional care provided by the dentist. A nonsystematic electronic search was carried out in the Lilacs, Pubmed/Medline, Scielo, and ScienceDirect databases, crossing the following descriptors: "Oral Hygiene"; "Dental Implants"; "Dental Implantation"; "Maintenance"; "Dental Prosthesis, ImplantSupported"; and "Prosthodontics". Literature review articles, systematic reviews, meta-analyses, randomized clinical studies, and relevant books on the subject published from 1995 to 2022 were consulted. The literature available indicates that the main instruments recommended for home care are toothbrush, dental floss, interdental brush, oral irrigator, toothpaste, and mouthwash. In the professional dental office, special attention should be given to the instructions given to the patient, as well as to motivate and encourage their engagement in the hygiene routine, in addition to periodontal monitoring, possible screw replacements, and installation of an occlusal splint when necessary. Maintaining adequate oral hygiene is essential for the success of fixed prostheses on implants, and the dentist plays a crucial role, not only in providing periodic patient follow-up, but also in suggesting the most appropriate instruments, instructing on adequate oral hygiene, and motivating the patient to maintain satisfactory oral health(AU)

Alterações sistêmicas e bucais em pacientes usuários de cocaína: uma revisão integrativa da literatura / Cambios sistémicos y orales em pacientes consumidores de cocaína: una revisión bibliográfica integradora / Systemic and oral changes in cocaína-using patients: an integrative literature review

Introdução: A utilização de cocaína é bastante associada ao surgimento de algumas manifestações sistêmicas e também de algumas alterações orais. Objetivo: Identificaras alterações sistêmicas e bucais mais comuns a pacientes usuários de cocaína. Metodologia: Trata-se de uma revisão sistemática da literatura, considerando artigos com texto completo, com restrição de idioma em Português ou Inglês e que tenham sido publicados entre os anos de 2017 a 2022. Usou-se as bases de dados LiLaCS, MedLine e BBO, por via portal Biblioteca Virtual de Saúde, e SciELO. Os artigos excluídosf oram aqueles que não apresentaram relação explícita do uso de cocaína com alguma manifestação sistêmica e/ou bucal. Resultados: Após o processo de triagem,10 artigos foram salvos para serem analisados e 111 foram descartados por não atenderem aos critérios de inclusão. Dos 10 artigosselecionados,40% deles (n=4) trouxeram informações identificando possíveis riscos de desenvolvimento de doenças cardiovasculares sofridas pelos usuários de cocaína, 10%(n=1) identificou problemas cognitivos associados ao uso da cocaína,30% dos artigos (n=3) mostrou as alterações bucais associadas à utilização abusiva de cocaína. Conclusões: Houve a predominância de algumas manifestações sistêmicas e bucais nos indivíduos usuários de cocaína, como doenças cardiovasculares, xerostomia, perfurações no palato, etc. A partir disso, há algumas alterações sistêmicas e bucais provocadas por esse uso. Mediante o risco considerável, faz-se necessário que o Cirurgião-Dentista se atualize sobre essas alterações em pacientes usuários de cocaína visando promover um trabalho transdisciplinare multiprofissional para atender adequadamente às suas necessidades (AU).

Introduction: The use of cocaine is closely associated with the appearance of some systemic manifestations and also some oral alterations.Objective: To identify the most common systemic and oral alterations in cocaine-using patients.Methodology:This is a systematic review of the literature, considering full-text articles, with a language restriction of "Portuguese" or "English" and published between 2017 and 2022. We used the LiLaCS, MedLine and BBO databases, via the Virtual Health Library (VHL) portal, and SciELO.The articles excluded were those that did not explicitly relate cocaine use to some systemic and/or oral manifestation.Results: After the screening process, 10 articles were saved for analysis and 111 were discarded because they did not meet the inclusion criteria. Of the 10 articles selected, 40% (n=4) provided information identifying possible risks of developing cardiovascular diseases suffered by cocaine users, 10% (n=1)identified cognitive problems associated with cocaine use, 30% of the articles (n=3) showed oral alterations associated with cocaine abuse.Conclusions: There has been a predominance of some systemic and oral manifestations in cocaine users, such as cardiovascular diseases, xerostomia, perforations in the palate, etc. Based on this, there are some systemic and oral alterations caused by this use. Given the considerable risk, it is necessary for dentists to be up-to-date on these alterations in cocaine-using patients in order to promote transdisciplinary and multi-professional work to adequately meet their needs (AU).

Introducción: El consumo de cocaína está estrechamente asociado a la aparición de algunas manifestaciones sistémicas y también de algunas alteraciones orales. Objetivo:Identificar las alteraciones sistémicas y bucales más frecuentes en los consumidores de cocaína. Metodología: Se trata de una revisión sistemática de la literatura, considerando artículos a texto completo, con restricción de idioma en "portugués" o "inglés" y publicados entre 2017 y 2022. Se utilizaron las bases de datos LiLaCS, MedLine y BBO, a través del portal Biblioteca Virtual en Salud (BVS) y SciELO. Los artículos excluidos fueron aquellos que no mostraban una relación explícita entre el consumo de cocaína y alguna manifestación sistémica y/o oral. Resultados: Tras el proceso de cribado, se guardaron10 artículos para el análisis y se descartaron 111 por no cumplir los criterios de inclusión. De los 10 artículos seleccionados, el 40% (n=4) proporcionaba información que identificaba posibles riesgos de desarrollar enfermedades cardiovasculares sufridaspor consumidores de cocaína, el 10% (n=1) identificaba problemas cognitivos asociados al consumo de cocaína, el 30% de los artículos (n=3) mostraban alteraciones orales asociadas al abuso de cocaína.Conclusiones:Ha habido un predominio de algunas manifestaciones sistémicas y orales en los consumidores de cocaína, como enfermedades cardiovasculares, xerostomía, perforaciones en el paladar, etc. De acuerdo con esto, existen algunas alteraciones sistémicas y orales causadas por este uso. Dado el considerable riesgo, es necesario que los odontólogos estén al día sobre estas alteraciones en los pacientes consumidores de cocaína, con el fin de promover el trabajo transdisciplinar y multiprofesional para atender adecuadamente sus necesidades (AU).

Autopercepción del conocimiento de disfagia por profesionales de la salud oral / Self-perception of knowledge of dysphagia by oral health professionals

Introducción: la disfagia es la alteración en los mecanismos de la deglución que coexiste con múltiples enfermedades y condiciones. El conocimiento amplio de esta alteración generará mejores diagnósticos y tratamientos para el mejoramiento de la calidad de vida de estos pacientes. Aunque esta alteración podría ser del dominio común por especialistas en el área de la salud, principalmente la oral, no existe información reciente del nivel de conocimiento sobre la disfagia en el personal odontológico. Objetivo: determinar el nivel de conocimiento sobre la disfagia en un grupo de profesionales de la salud oral de Ciudad Juárez, Chihuahua. Material y método: se realizó un estudio trasversal descriptivo en un grupo de 241 odontólogos (pasantes de servicio social, odontólogos generales, periodoncistas, endodoncistas, rehabilitadores, odontopediatras y ortodoncistas) a través de una encuesta, los reactivos utilizados fueron sobre conocimiento de la disfagia, métodos de diagnóstico, signos y síntomas, tratamiento y complicaciones. Resultados: la mitad de la población encuestada refirió conocer los trastornos de la deglución (64.7%). Contrastantemente, al utilizar el término «disfagia¼, la postura del conocimiento disminuyó considerablemente (40.7%). Finalmente, los valores más bajos de la encuesta se mostraron en la falta de conocimiento sobre identificación de signos y síntomas de la disfagia (36.1%), métodos de diagnóstico (20.7%), tratamientos (18.7%) y complicaciones (23.2%). Conclusión: existe un bajo conocimiento de los trastornos de la deglución autopercibido por los profesionales de la odontología, lo que sugiere la búsqueda de los factores que ocasionan la falta del conocimiento de los profesionales del área odontológica (AU)

Introduction: dysphagia is the alteration in swallowing mechanisms that coexists with multiple diseases and conditions. The broad knowledge of this alteration will generate better diagnoses and treatments for the improvement of the quality of life of these patients. Although this alteration could be common domain by specialists in the area of health, mainly oral, there is no recent information on the level of knowledge about dysphagia in dental personnel. Objective: to determine the level of knowledge about dysphagia in a group of oral health professionals from Ciudad Juárez, Chihuahua. Material and methods: a descriptive cross-sectional study was carried out in a group of 241 dentists (social service intern, general dentists, periodontists, endodontists, rehabilitators, pediatric dentists and orthodontists) through a survey, the reagents used were on knowledge of dysphagia, diagnostic methods, signs and symptoms, treatment and complications. Results: half of the surveyed population reported knowing swallowing disorders (64.7%). In contrast, when using the term «dysphagia¼ the posture of knowledge decreased considerably (40.7%). Finally, the lowest values in the survey were found in the lack of knowledge about identification of signs and symptoms of dysphagia (36.1%), diagnostic methods (20.7%), treatments (18.7%) and complications (23.2%). Conclusion: there is a low knowledge of self-perceived swallowing disorders by dentists, which suggests the search for the factors that cause the lack of knowledge of dental professionals (AU)

Peri-implantitis: Knowledge and attitudes of implantology clinicians regarding the disease management: Peri-implantitis knowledge.

OBJECTIVES: Since peri-implantitis is an increasing and prevalent concern in clinical practice and there is no consensus regarding the best therapeutic protocol, this study evaluated the knowledge and behaviours of dentists working in Implantology regarding implant-related infections modulating factors and therapeutic protocols used in the management of peri-implantitis. METHODS: Cross-sectional study was conducted with 86 Brazilian Implantology clinicians. Data were collected using a structured and online questionnaire evaluating socioeconomic characteristics, education, work/clinical practice, knowledge and attitudes regarding the risk factors and management of peri-implantitis. The reliability of the questionnaire was evaluated by test-retest technique. The questionnaire was developed based on the last consensus on peri-implant diseases (2018) and the current evidence related to implant-related infections. Descriptive, bivariate and logistic regression analyses were conducted adopting a significance level of 5%. RESULTS: In this study, 89.5% of included dentists reported that already treated patients with peri-implantitis. Approximately 80% of dentists use antibiotics and mouth rinses during the treatment, and surgical procedures seem the main choice to treat peri-implantitis (91.8%) by dentists. As a preventive approach, 94.2% of dentists reported that routinely assessed biofilm accumulation in the follow-up visits after implant placement. Logistic regression showed that the self-reported ability to treat peri-implantitis was statistically (p < 0.05) higher among dentists who reported abilities to diagnose the disease and use laser for peri-implantitis treatment. CONCLUSION: Dentists working in Implantology have a good level of knowledge and behaviors in the management of peri-implantitis. However, the lack of consensus regarding the best treatment protocols may reflect dentist's behaviours because different treatment protocols have been used by evaluated clinicians.

Using Standardised International Oral Health-Related Datasets in 6 Countries.

INTRODUCTION: Oral diseases affect a significant proportion of the world's population, yet international comparisons involving oral health outcomes have often been limited due to differences in the way country-level primary data are collected. In response to this, the World Dental Federation (FDI) Oral Health Observatory project was launched with the goal of collecting and producing standardised international data on oral health across countries. The aim of this descriptive cross-sectional study was to examine associations between self-reported general health and a range of factors (sociodemographics, oral health-related behaviours, oral impacts, clinical variables) using these standardised international datasets. METHODS: Dentists within FDI member National Dental Associations who chose to take part in the project were selected using a multistage sampling method. The number of dentists in each cluster was set according to the proportion of the national population living in the area, and 50 patients per dentist were systematically approached to take part. Patients and dentists completed 2 separate questionnaires on a mobile app. Ordinal logistic regression (conducted in December 2022) was used to analyse the linked patient and dentist data from 6 countries: China (n = 2242); Colombia (n = 1029); India (n = 999); Italy (n = 711); Japan (n = 1271); and Lebanon (n = 798). Self-reported general health was the dependent variable, with age, sex, education, self-reported oral health-related behaviours, self-reported oral impacts, and clinical variables acting as the independent variables. RESULTS: The results demonstrated a different pattern of associations in the different countries. Better self-reported general health was associated with degree-level education in all 6 countries and with reporting no oral impact and no sensitive teeth in 4 countries. Several country-specific patterns were also found, including the importance of tooth brushing in Colombia, periodontal health in Italy, and differing associations with sugary drinks consumption in India and Japan. CONCLUSIONS: These descriptive findings provide a basis for further research and, importantly, for advocacy in identifying patient oral health care needs according to both person-reported and clinical aspects. This can facilitate optimisation of service provision and potentially influence policy and investments.

Avaliação da usabilidade e utilidade de um aplicativo sobre traumatismos dentários para cirurgiões-dentistas e estudantes de Odontologia / Evaluación de usabilidad y utilidad de una aplicación para odontólogos y estudiantes de odontología en el manejo de traumatismos dentales / Usability and utility evaluation of an application for dentists and dental students to manage dental injuries

O objetivo deste estudo foi avaliar a usabilidade e a utilidade do aplicativo (app) Dental Trauma, disponível gratuitamente e em português nas lojas App Store e Play Store. Participaram do estudo estudantes de Odontologia e Cirurgiões-dentistas (CDs) (n =20). Utilizou-se o teste de Escala de Usabilidade do Sistema (System Usability Scale-SUS) para análise da usabilidade e o teste de Aceitação de Tecnologia (Technology Acceptance Model-TAM) adaptado ao contexto da pesquisa para a análise da utilidade. Foi aplicado o teste de Mann-Whitney para comparar o escore SUS entre estudantes e CDs e o teste de Spearman para correlacionar as questões da utilidade. A pontuação SUS no percentil 50 foi de 83,75. Valores acima de 68 são classificados como aceitáveis. O teste de Mann-Whitney não evidenciou diferença significativa na pontuação SUS ao analisar separadamente CDs e estudantes de Odontologia (p = 0,442). O app foi amplamente avaliado como útil (95% a 100%), sendo observadas correlações robustas, positivas e significas entre as respostas para cada questão. O app não contempla traumatismos em dentes decíduos, sendo uma oportunidade de atualização ou desenvolvimento de outros apps. O app Dental Trauma atendeu aos requisitos de usabilidade e utilidade, alcançando resultados classificados como "excelente". Os usuáriosreconheceram se tratar de uma tecnologia útil que pode auxiliar o profissional no diagnóstico e conduta e na compreensão dos conceitos relacionados ao traumatismo dentário (AU).

El objetivo de este estudio fue aplicar pruebas de usabilidad y utilidad a la aplicación (app) Dental Trauma, disponible de forma gratuita en portugués en App Store y Play Store. Participaron en el estudio estudiantes de odontología y Odontólogos(n = 20). Se utilizó la Escala de Usabilidad del Sistema (System Usability Scale-SUS) para el análisis de usabilidad y el Modelo de Aceptación de Tecnología (TAM), adaptado al contexto de la investigación, para el análisis de utilidad. Se aplicó la prueba de Mann-Whitney para comparar los puntajes SUS entre estudiantes y dentistas, y la prueba de Spearman para correlacionar preguntas de utilidad. El puntaje SUS en el percentil 50 fue de 83,75. Los puntajes por encima de 68 se clasifican como aceptables. La prueba de Mann-Whitney no mostró una diferencia significativa en el puntaje SUS al analizar por separado a los Odontólogosy estudiantes de odontología (p = 0,442). La aplicación fue ampliamente evaluada como útil (95% a 100%), observándose correlaciones robustas, positivas y significativas entre las respuestas a cada pregunta. Sin embargo, no aborda traumas en dientes deciduos, lo que representa una oportunidad para actualizar o desarrollar otras aplicaciones. La app Dental Trauma cumplió con los requisitos de usabilidad y utilidad, logrando resultados calificados como "excelentes". Los usuarios reconocieron que se trata de una tecnología útil que puede ayudar a los profesionales en el diagnóstico y manejo y en la comprensión de conceptos relacionados con el traumatismo dental (AU).

This study aimed to apply usability and utility tests to the Dental Trauma application (app), available for free in Portuguese on the App Store and Play Store. Students and dentists participated in the study (n = 20). The System Usability Scale (SUS) test was used for usability analysis, and the Technology Acceptance Model (TAM) test, adapted to the dental trauma context, was used for utility analysis. The Mann-Whitney test was applied to compare SUS scores between students and dentists, and the Spearman test was used to correlate utility questions. The SUS score at the 50th percentile was 83.75. Scores above 68 are classified as acceptable. The Mann-Whitney test did not show a significant difference in the SUS score when analyzing dentists and dental students separately (p = 0.442). The app was widely evaluated as useful (95% to 100%), with robust, positive, and significant correlations observed between responses to each question. However, it does not cover traumas in deciduous teeth, presenting an opportunity for updating or developing other apps. The Dental Trauma app fulfilled both usability and usefulness criteria, garnering an "excellent" rating in its outcomes. Users acknowledged its utility as a valuable technological tool aiding professionals in diagnosis, management, and comprehension of dental trauma-related concepts (AU).

[The evolution of inequalities in the distribution of dentists in Brazil]. / Evolução das desigualdades na distribuição de dentistas no Brasil.

The scope of this article is to analyze the evolution of the distribution of dentists and undergraduate courses in Dentistry in Brazil between 1960 and 2022, based on institutional data and its correlation with economic and demographic data. The proportions between number of dentists and population were calculated for the federative units in different periods, and the Herfindahl-Hirschman Index (HHI) was used. to determine the concentration of dentists, population and undergraduate courses in Dentistry. The Pearson test was used, with a significance level of 95%, to test the correlation between variables. In the period from 1960 to 2022, the ratio of dentists per 10,000 inhabitants increased from 3.3 to 16.9. Moreover in 2022, the federative units with the highest average household income per capita were closely correlated with the highest concentration of dentists (R2= 0.90; p < 0.00). However, from 1975 to 2022, the concentration of dentists measured by the HHI dropped from 45.1 to 33.4. The decrease in the geographic concentration of Dentistry courses was even more pronounced, with the HHI rising from 39.3 in 1991, to 25.6 in 2022.

O objetivo deste artigo é analisar a evolução da distribuição de dentistas e cursos de graduação em odontologia no Brasil entre 1960 e 2022, a partir de dados institucionais e de sua correlação com dados econômicos e demográficos. Foram calculadas as proporções entre número de dentistas e população para as unidades federativas em diferentes períodos, e para determinar a concentração de dentistas, da população e dos cursos de graduação em odontologia,foi utilizado o índice Herfindahl-Hirschman (HHI). Para testar a correlação entre variáveis foi empregado o teste de Pearson, com um nível de significância de 95%. Entre 1960 e 2022, a proporção de dentistas por 10 mil habitantes aumentou de 3,3 para 16,9. Ainda em 2022, as unidades federativas com maior renda média domiciliar per capita estavam fortemente correlacionadas à maior concentração de dentistas (R2 = 0,90; p < 0,00). Entretanto, de 1975 a 2022, a concentração de dentistas medida pelo HHI caiu de 45,1 para 33,4. A diminuição da concentração geográfica dos cursos de odontologia foi ainda mais pronunciada, tendo o HHI passado de 39,3 em 1991 para 25,6 em 2022.