Knowledge, attitudes, and practices of prenatal care practitioners regarding oral health in pregnancy-A systematic review.

BACKGROUND: Hormonal and behavioral changes during pregnancy may impact the oral health of women, which can influence the pregnancy course. Prenatal care practitioners (PCP) must be aware of this bidirectional relation in order to include an oral assessment in routine prenatal care. OBJECTIVES: To characterize the knowledge and attitudes of PCP regarding oral health in pregnant women. SEARCH STRATEGY: The search was carried out in PubMed, Web of Science, Lilacs, Scopus, and Embase on May 2022. SELECTION CRITERIA: Peer-reviewed cross-sectional studies published in English within the last 5 years that assessed the knowledge, attitudes, and practices of PCP towards oral health in pregnancy were selected. DATA COLLECTION AND ANALYSIS: Data were standardly extracted by the three reviewers from the selected articles and their bias was assessed. MAIN RESULTS: From a total of 996 articles, 24 were selected. Overall, most PCP have an adequate level of knowledge regarding the importance of oral health during pregnancy. Although several professionals reported referring their patients to a dentist, the attitudes and practices of the majority of PCP were still inadequate. CONCLUSIONS: PCP are aware of the importance of oral health during pregnancy but still lack translating this knowledge into clinical practice.

Socioeconomic Inequalities in Oral Health-related Behaviors in 18-Year-Old Adolescents: A Cross-sectional Study.

AIMS: This study aimed to assess the socioeconomic inequalities in oral health-related behaviors, such as frequency of toothbrushing, flossing, and dental appointments, in 18-year-old Portuguese adolescents. MATERIALS AND METHODS: Data were obtained from the third National Prevalence Study of Oral Health Diseases (III ENPDO), which was carried out in Portugal between 2012 and 2013. This study included 1075 adolescents aged 18 years. The information on socioeconomic status and oral health behaviors was collected using a semi-structured questionnaire. Binary logistic regression models were used to assess the association between social determinants and oral health-related behaviors. Unadjusted and adjusted odds ratios and confidence intervals were estimated. RESULTS: The results found that father's educational level and both father's and mother's employment status were associated with adolescents not visiting a dental professional before the last 12 months. Male sex, living in a rural area, and lower adolescent's educational level were associated with toothbrushing less than twice a day. Furthermore, father's educational level and mother's employment status were also associated with a lower frequency of toothbrushing, whereas only mother's employment status was associated with a lower frequency of flossing. CONCLUSION: These findings demonstrated that socioeconomic inequalities in oral health-related behaviors of 18-year-old adolescents were associated with parental employment status and educational level, adolescent's educational level, sex, and residential zone.

Influence of delivery and feeding mode in oral fungi colonization - a systematic review.

Postnatal acquisition of microorganisms from maternal and environmental sources contributes to the child microbiome development. Several studies showed that the mode of delivery and breastfeeding may have impact on the oral bacterial colonization, however, the influence on oral fungal colonization is still unknown. We performed a systematic literature review on mother to child oral fungi transmission, namely regarding the association between the mode of delivery and breastfeeding in oral yeast colonization. Our analysis revealed no significant differences between the oral mycobiome of breastfed and bottle-fed children. As for the delivery mode, the majority of studies found a relation between fungal colonization and vaginal delivery. Candida albicans was the most commonly isolated fungi species. Our analysis suggests that maternal breastfeeding does not seem to influence oral mycology, but vaginal delivery appears to promote oral yeast colonization in early life.

Os cuidados de enfermagem e a satisfação dos consumidores no puerpério / The nursing care and consumer satisfaction during postpartum / Cuidados de enfermería y satisfacción de los consumidores en el puerperio

O presente estudo, de natureza transversal e analítica, teve como objetivo investigar a satisfação das puérperas, em internação, com os cuidados especializados prestados pelos enfermeiros num serviço de obstetrícia de uma unidade de saúde de Portugal. A amostra incidiu sobre 120 puérperas selecionadas de acordo com os critérios de inclusão: internação, ter como motivo o parto e esse período não ser inferior a três dias. A coleta de dados decorreu de fevereiro a abril de 2013. Os dados revelaram que as mulheres se encontravam muito satisfeitas quanto aos cuidados recebidos em geral (50%) e satisfeitas quanto aos cuidados acerca da técnica do banho (99%), da amamentação (94%) e do autocuidado (89%). A evidência dos resultados permite fundamentar a necessidade de maior eficácia dos profissionais nos cuidados prestados, para que as puérperas se tornem mais autônomas e satisfeitas nos seus cuidados.

The present analytical cross-sectional study had the aim to investigate the satisfaction of hospitalized post-partum women with the specialized care provided by nurses at the obstetrics service of a health unit in Portugal. The sample comprised 120 post-partum women who were selected as per the following inclusion criteria: being hospitalized due to the delivery and for a period not shorter than three days. Data were collected between February and April 2013. The collected data revealed that the women were very satisfied as for the care received in general (50%) and satisfied with the care received toward bathing techniques (99%), breastfeeding (94%) and self-care (89%). The evidence of the results allows to support the need for more efficacy from professionals in the care provided so that post-partum women become more autonomous and satisfied with their care

Estudio de naturaleza transversal, analítica, objetivando investigar la satisfacción de las puérperas bajo internación con cuidados especializados prestados por los enfermeros en un servicio de obstetricia de una unidad de salud de Portugal. La muestra incluyó a 120 puérperas seleccionadas conforme criterios de inclusión: internadas en razón del parto por un período no menor a tres días. Datos recolectados entre febrero y abril de 2013. Los datos revelaron que las mujeres se encontraban muy satisfechas respecto de los cuidados recibidos en general (50%) y satisfecha s en relación a la técnica del baño (99%), de la lactancia (94%) y del autocuidado (89%). La evidencia de los resultados permite fundamentar la necesidad de mayor eficacia por parte de los profesionales en los cuidados prestados, para que las puérperas consigan mayor autonomía y satisfacción en sus cuidados

Use of medicines by homeless people in Porto, Portugal.

The objective of this study was to describe patterns of medication use among homeless adults from the city of Porto, Portugal. We recruited 146 homeless participants in four social services institutions. Data on the use of medicines in the previous week were collected using face-to-face interviews. We described the prevalence and main correlates of use of medicines from different Anatomical Therapeutic Chemical classification (ATC) groups. A total of 56.8% of the homeless reported to have used at least one medicine in the previous week. The most frequently reported were benzodiazepines (21.9%) and antipsychotics (15.1%); socio-demographic characteristics, lifestyle variables and use of health care were not found to be significantly associated with their use. The prevalence was 1.4% for anti-inflammatory and antirheumatic products, and 6.2% for antihypertensives, diuretics and beta-blocking agents. Medicines pertaining to the nervous system ATC group were by far the most frequently used, while those for the treatment of other common chronic and acute conditions seem to be underused.

Saúde da mulher: boas práticas e autonomia após a alta clínica / Women's health: good practices and autonomy after clinical discharge

Aplicar boas práticas de Enfermagem no puerpério é importante sendo fundamental avaliar a qualidade de assistência e preparação para os desafios após a alta clinica. Objetivo: Identificar a satisfação das utentes puérperas face às práticas desenvolvidas pelos Enfermeiro especialista de saúde materna e obstétrica (EESMO) no serviço de Obstetrícia da Unidade local de saúde nordeste (ULSNE) Bragança. Metodologia: Estudo epidemiológico observacional transversal realizado com uma amostra de 120 puérperas internadas entre o mês de fevereiro e o mês de abril de 2013. Definimos como critérios de inclusão, internamento por parto independentemente do tipo e período de internamento hospitalar não inferior a três dias. Consideramos boas práticas os cuidados relativos à técnica do banho ao recém-nascido, da amamentação e do autocuidado. A colheita de dados foi realizada, por questionário no período de fevereiro a abril de 2013 no serviço, sendo selecionado o terceiro dia de permanência das puérperas para a colheita, a aplicar em qualquer dia da semana entre as 10:00 e as 20:00h. Para a análise dos dados utilizou-se o software IBM SPSS 20. Foi obtido parecer favorável da Comissão de Ética. Resultados: As puérperas apresentam-se muito satisfeitas quanto aos cuidados recebidos pelos Enfermeiros (50%), referindo como excelentes: cuidados e atenção, resposta às chamadas, atenção prestada e informação recebida. Relativamente à técnica do banho ao recém-nascido, 97% da amostra afirma que a técnica foi explicada e 99% está satisfeita com a informação disponibilizada; quanto à técnica da amamentação, 96% afirma que a técnica foi explicada e 94% está satisfeita com a informação; quanto ao autocuidado após o parto, 86% afirma que recebeu explicações sobre a técnica e 89% revela que está satisfeita com a informação disponibilizada. Verifica-se associação estatisticamente significativa entre a satisfação global das puérperas e a importância do trabalho dos Enfermeiros para o bom funcionamento da unidade de internamento (p=0,001); e entre a satisfação com a informação disponibilizada sobre a amamentação e o autocuidado e a explicação de cada tópico a abordar em cada uma das técnicas (p <0,000).Conclusão: As puérperas encontram-se satisfeitas relativamente às práticas desenvolvidas pleo EESMO e sentem-se confiantes na sua execução após a alta clínica.

The application of best nursing practices at the puerperal period is crucial being of paramount importance to assess the satisfaction with the assistance quality and the preparation for the challenges after discharge. Objectives: Identificate the puerperal women's satisfaction regarding the practices developed by the Nurses specialized in maternal obstetric health at the Obstetric service of ULSNE in Bragança. Methods: Epidemiological transversal study made with a sample of 120 puerperal women hospitalized from February to April of 2013. The inclusion criteria include puerperal women with hospitalization for delivery of any type and hospitalization not inferior of 3 days. The care related to techniques of newborn bath, breastfeeding and selfcare were considered best practices. The data was collected through an inquiry from February to April of 2013 at the service, at the third day of puerperal women hospitalization, at any week´s day between 10 a.m. and 8 p.m.. The "IBM SPSS statistics 20" software was used for the analysis of the data. It was achieved the favorable permission by the Ethics Comission. Results: The puerperal women are very satisfied about the nursing care (50%), considering as excellent: care and attention, answer to calls, attention that was given and information received. Concerning the newborn bath technique, 97% of data sample say that the technique was exposed and clarified and 99% are satisfied with the information available; relatively to breastfeeding technique, 96% indicate that the procedure was explained and 94% are satisfied; about women selfcare after delivery, 86% say that the technique was explained and 89% are satisfied with the available information. It´s encountered a statistically significant association between the puerperal global satisfaction and the work´s importance of Nurses for the good functioning at the hospital unit (p=0.001); and between the satisfaction with the available information about the breastfeeding and selfcare and the topics explanation of each one of the techniques (p <0.000). Conclusions: The puerperal women reveal satisfaction with the available information given by the Nurse about the practices that were developed and feel confident in making the same ones after the clinical discharge.

Characterization of the oral fungal microbiota in smokers and non-smokers.

This study aimed to assess the effect of smoking on the biodiversity of the oral fungal microbiota of healthy young subjects, using an improved culture method that assesses both total and pathogenic viable fungi. Forty individuals (20 smokers and 20 non-smokers) were selected. All individuals presented fungal growth (100% for molds and 92.5% for yeasts), a prevalence higher than previously reported. The most commonly occurring molds were Penicillium sp., Aspergillus sp., and Cladosporium sp. Smokers presented significantly higher levels of yeasts and pathogenic molds than did non-smokers. No differences in fungal prevalence and diversity were observed in smokers and non-smokers following a 30-wk observation period. In conclusion, tobacco smoking may alter the oral mycobiota and facilitate colonization of the oral cavity with yeasts and pathogenic molds. The effect of chronic fungal colonization on the oral health of tobacco smokers cannot be neglected.

Reduced salivary flow and colonization by mutans streptococci in children with Down syndrome.

OBJECTIVES: Although individuals with Down syndrome have considerable oral disease, the prevalence of dental caries in this group is low. The present study aimed to compare known risk factors for dental caries development in children with Down syndrome and a matched population (siblings). In both populations, the number of acidogenic microorganisms, such as mutans streptococci, lactobacilli and Candida species, and the paraffin-stimulated pH, flow rate and IgA concentration in whole saliva were evaluated and compared. METHOD: Saliva was collected, and the caries index was evaluated in 45 sibling pairs aged between 6 and 18 years old. The salivary IgA concentration was determined by immunoturbidimetry. Salivary mutans streptococci, lactobacilli and Candida species were quantified on mitis salivarius agar containing bacitracin and 20% sucrose, rogosa agar supplemented with glacial acetic acid and sabouraud agar supplemented with chloramphenicol, respectively. RESULTS: Down syndrome children had a higher caries-free rate (p<0.05) and lower salivary mutans streptococci counts (p<0.03) compared to their siblings. Similar numbers of lactobacilli and Candida species were found in both groups. Salivary flow rates were 36% lower in Down syndrome children compared to their siblings (p<0.05). The salivary pH did not differ between Down syndrome children and controls. The Down syndrome children had an IgA secretion rate 29% lower than that of their siblings, but this difference was not statistically significant. CONCLUSIONS: In conclusion, the lower number of mutans streptococci in the saliva may be one of the factors contributing to the lower caries rate observed in Down syndrome children, despite evidence of hyposalivation.

Reduced salivary flow and colonization by mutans streptococci in children with Down syndrome

OBJECTIVES: Although individuals with Down syndrome have considerable oral disease, the prevalence of dental caries in this group is low. The present study aimed to compare known risk factors for dental caries development in children with Down syndrome and a matched population (siblings). In both populations, the number of acidogenic microorganisms, such as mutans streptococci, lactobacilli and Candida species, and the paraffin-stimulated pH, flow rate and IgA concentration in whole saliva were evaluated and compared. METHOD: Saliva was collected, and the caries index was evaluated in 45 sibling pairs aged between 6 and 18 years old. The salivary IgA concentration was determined by immunoturbidimetry. Salivary mutans streptococci, lactobacilli and Candida species were quantified on mitis salivarius agar containing bacitracin and 20% sucrose, rogosa agar supplemented with glacial acetic acid and sabouraud agar supplemented with chloramphenicol, respectively. RESULTS: Down syndrome children had a higher caries-free rate (p<0.05) and lower salivary mutans streptococci counts (p<0.03) compared to their siblings. Similar numbers of lactobacilli and Candida species were found in both groups. Salivary flow rates were 36% lower in Down syndrome children compared to their siblings (p<0.05). The salivary pH did not differ between Down syndrome children and controls. The Down syndrome children had an IgA secretion rate 29% lower than that of their siblings, but this difference was not statistically significant. CONCLUSIONS: In conclusion, the lower number of mutans streptococci in the saliva may be one of the factors contributing to the lower caries rate observed in Down syndrome children, despite evidence of hyposalivation.