Gerenciamento de urgências endodônticas: conhecimentos de acadêmicos de odontologia / Management of endodontic emergencies: knowledge of dental students

Objetivo: avaliar do conhecimento dos alunos de odontologia sobre os protocolos de atendimento para as urgências endodônticas. Método: 182 alunos dos últimos anos do curso de Odontologia do Centro Universitário Doutor Leão Sampaio, responderam a um questionário contendo perguntas referente ao protocolo adotado em casos de urgência de origem endodôntica. Os dados foram analisados pelo teste de Qui-quadrado de Pearson (p<0,05). Resultados: foram observadas diferenças entre a conduta relata pelos alunos do quarto e quinto ano de graduação quanto a indicação da incisão para drenagem em abscesso periapical agudo submucoso (evoluído), indicação de antibióticos nos casos de flare-up e indicação de antibióticos na dor com edema póstratamento endodôntico. A prescrição de antibióticos foi excessiva para os casos de dor entre consultas (flareup) e dor no pós-operatória. Para as patologias da polpa, a maioria dos alunos indicou protocolos de urgência recomendados na literatura. Conclusão: os resultados indicam a necessidade de melhoria dos programas de treinamento dos alunos em urgências endodônticas, principalmente quanto aos protocolos farmacológicos. (AU)

Objective: to evaluate the knowledge of dentistry students about care protocols for endodontic emergencies. Method: 182 students from the last years of the Dentistry course at Doctor Leão Sampaio University Center answered a questionnaire containing questions regarding the protocol adopted in urgent cases of endodontic origin. Data were analyzed using Pearson's Chi-square test (p<0.05). Results: differences were observed between the conduct reported by fourth- and fifth-year undergraduate students regarding the indication of incision for drainage in submucosal acute periapical abscess (evolved), indication of antibiotics in cases of flare-up and indication of antibiotics in pain with edema after endodontic treatment. The prescription of antibiotics was excessive for cases of pain between appointments (flare-up) and postoperative pain. For pulp pathologies, most students indicated emergency protocols recommended in the literature. Conclusion: the results indicate the need to improve student training programs in endodontic emergencies, especially regarding pharmacological protocols. (AU)

Conhecimento de estudantes de Educação Física de Juazeiro do Norte-CE sobre o atendimento emergencial ao trauma dental, avulsãom e reimplante dental / Knowledge of Physical Education students from Juazeiro do Norte-CE about emerrgency care dental trauma, avulsion and dental reimplant

Objetivo ­ Avaliar o conhecimento dos estudantes de graduação em Educação Física do Centro Universitário Doutor Leão Sampaio (UnilLeão), Juazeiro do Norte-CE sobre o atendimento emergencial ao trauma dental. Métodos ­ Foi realizada uma pesquisa transversal junto aos estudantes de graduação de Educação Física, mediante aplicação de um questionário, contendo perguntas sobre idade, gênero, conhecimento sobre primeiros socorros ao traumatismo dental e simulação de casos clínicos de fratura coronária e avulsão e reimplante. Resultados ­ Participaram 120 estudantes, sendo 62% homens e 38% mulheres, dos quais 86% responderam que o tratamento deve ser imediato, 56% reimplantariam o dente no alvéolo, apenas 44% sabiam o que era reimplante dental. Em relação ao acondicionamento do dente, 36% o manteriam em água, 29% em guardanapo, 14% soro fisiológico e 7,5% lavaria no leite. Dos participantes 39% afirmaram não saber o que fazer com o dente avulsionado coberto de sujeira, 20% o escovaria com escova de dente, e 17,5% lavaria em água corrente. Em relação à fratura coronária, 19% procuraria o pedaço do dente e o acondicionaria corretamente. Em relação ao reimplante dental 46% escolheram o reimplante imediato. Conclusão ­ Verificou-se um conhecimento insuficiente sobre o manuseio dos dentes traumatizados, indicando a necessidade de promover campanhas educativas além da inclusão deste tema durante a formação dos profissionais.

Objective ­ To assess the knowledge of Physical Education students of the Centro Universitário Doutor Leão Sampaio (UniLeão), Juazeiro do Norte-CE on emergency care to dental trauma. Methods ­ A cross-sectional survey was conducted among students, by applying a questionnaire containing questions about age, gender, knowledge of first aid to dental trauma and simulation of clinical cases of coronary fracture and avulsion and replantation. Results ­ Participants were 120 students, 62% men and 38% women, of which 86% responded that treatment should be immediately, 56% reimplant the tooth in the dental alveolus, only 44% knew about the technique to dental reimplant. Regarding the preparation of the tooth, 36% responded put on water, 29% put on napkin, 14% put on the saline solution and 7.5% put on milk. Of the participants 39% said they did not know what to do with the tooth avulsed covered in dirt, 20% would use the toothbrush, and 17,5% would use the wash in running water. Regarding coronary fracture, 19% seek for the piece of tooth and kept it properly. Regarding to dental reimplant, 46% chose the immediate reimplantation. Conclusions ­ There was insufficient knowledge about the handling of traumatized teeth, indicating the need to promote educational campaigns and training of professionals about this issue.

Avaliação dos tratamentos propostos pelos dentistas em casos de fraturas coronárias / Evaluation of treatments plans for managment of crown fractures proposed by dentists

Introdução: a odontologia prioriza a manutenção e integridade dos dentes na boca e a ocorrência de traumatismos dentais vem dificultando o cumprimento desta meta, uma vez que suas consequências envolvem danos funcionais, estéticos, psicológicos, sociais e terapêuticos, além dos altos custos para a reabilitação e acompanhamento por longos períodos de tempo. Objetivo: avaliar o conhecimento dos cirurgiões dentistas da região metropolitana de Juazeiro do Norte sobre as condutas clínicas baseadas nos planos de tratamentos propostos por estes profissionais sobre fraturas coronárias com ou sem exposição pulpar. Método: a partir de um questionário descritivo, foram abordadas questões referentes ao perfil dos profissionais entrevistados e procedimentos empregados na conduta frente a fraturas coronárias. Setenta e cinco questionários foram devidamente preenchidos, sendo 34 mulheres e 41 homens. Resultados: dos entrevistados 13 relataram nunca terem atendido casos de trauma dental, 26% relataram serem incapazes de tratar todos os casos de traumatismo dentário. E mesmo a maioria tendo formação especializada, grandes dificuldades foram encontradas nos planos de tratamento propostos em relação a fraturas mais complicadas. Discussão: as lesões dentais traumáticas envolvendo tecidos duros e de sustentação podem representar padrões de cicatrização bastante complexos. As lesões traumáticas do tipo fraturas coronárias apresentam um prognóstico favorável para a manutenção da vitalidade pulpar em relação às fraturas coronárias complicadas. As fraturas corono-radiculares com ou sem envolvimento pulpar, foram as que apresentaram mais indicações inadequadas de tratamento, provavelmente por necessitarem de uma abordagem multidisciplinar. Conclusão: considera-se primordial a multidisciplinaridade durante a formação acadêmica do clinico geral, bem como o aperfeiçoamento ao atendimento a pacientes com trauma dental. (AU)

Introduction: Dentistry prioritizes the maintenance and integrity of teeth in the mouth and the occurrence of dental trauma is hampering the achievement of this goal, since its consequences involve functional, aesthetic, psychological, social and therapeutic damage, in addition to high costs for rehabilitation and monitoring for extended periods of time. Objective: The objective of this study was to assess the knowledge of dentists in the metropolitan region of Juazeiro do Norte on the clinical management based on treatment plans proposed by these professionals on crown fractures with or without pulp exposure. Methods: For that, starting from a descriptive questionnaire, some questions regarding the profile of inquired professionals and procedures used in the performance of treatment of crown fractures. Results: Seventy-five questionnaires were fully completed, 34 women and 41 men. Only 13 reported ever having met cases of dental trauma, 26% reported being unable to deal with all cases of dental trauma. And even most having specialized training, great difficulties were encountered in the proposed treatment plans for the most complicated fractures. Discussion: Traumatic injuries involving pulp and periapical tissues can represent very complex healing patterns. The crown fractures have a favorable prognosis for the maintenance of pulpal vitality in relation to coronary complicated fractures. The corono-root fractures with or without pulp involvement, were the ones that had more inadequate treatment, probably because they require a multidisciplinary approach. Conclusion: it is essential for multidisciplinary academic training of general practitioner as well as improving service to patients with dental trauma. (AU)

Avaliação do conhecimento popular, atitudes e práticas cotidianas em saúde bucal / Evaluate of popular knowledge, attitudes and daily practices in oral health

Objetivo ­ Avaliar os conhecimentos e as percepções relacionadas à saúde bucal dos pacientes da clínica escola da Faculdade Leão Sampaio-CE. Métodos ­ Estudo observacional, com amostra composta por 204 pacientes. Nesta amostra foram aplicados questionários sobre os temas conhecimento sobre a etiologia e prevenção da cárie dentária e autopercepção das condições de saúde bucal, além de questões sobre aspectos sócio econômico e educacionais. Resultados ­ Dos participantes, 143 eram do gênero feminino e 61 do gênero masculino, com faixas etárias predominantes situadas em 21 até 39 anos (46%). Em relação à renda mensal familiar, houve predominância da faixa salarial de um salário-mínimo. Dos 204 entrevistados 119 receberam IHO (Instrução de Higiene Oral) e 85 não receberam. Observou-se que os entrevistados com maior escolaridade também receberam mais IHO, sendo encontrada diferença estatisticamente significativa (p<0,05). Dos pacientes que receberam IHO, houve diferença estatisticamente significativa (p<0,05) para os itens analisados: técnica utilizada para escovação; frequência de uso do fio dental; o que fazer para não ter cárie; para que serve o flúor. Conclusão ­ Os pacientes apresentaram bons hábitos de higiene bucal, contudo apresentaram um limitado conhecimento sobre a etiologia da cárie e a forma mais adequada para preveni-la.

Objective ­ To assess the knowledge and perceptions related to oral health of patients attended in the Dental School ­ Leão SampaioCE. Methods ­ A cross-section study was conducted with 204 patients, aged from 18 years old and above. Self applicable questionnaires were applied about the perception of oral health, knowledge about the etiology and prevention of dental caries, self-perception of oral health conditions, and economic and educational aspects. Results ­ Of the participants, 143 were female and 61 were male, with aged to 21 to 39 years old (46%). The family income predominant was until minimum wage. Of the 204 interviewed, 119 received OHI (Oral Health Instructions) and 85 didn't. It was observed that respondents with higher education also received OHI, with a significant statistical difference (p <0.05). In relation of patients who received OHI, there was a statistically significant difference (p <0.05) to the items analyzed: technique to brushing as the most important item to tooth brushing; frequency of the use of dental floss; what to do to avoid caries; the utility of fluoride. Conclusions ­ The patients showed good oral hygiene habits, but had limited knowledge of the etiology of caries and the best way to prevent it.

Diagnóstico e manejo da ansiedade odontológica pelos cirurgiões-dentistas / Diagnosis and treatment of dental anxiety by dentists

O trabalho verifica o conhecimento e a prática profissional relacionados às formas de diagnóstico e manejo da ansiedade odontológica pelos cirurgiões-dentistas. Os profissionais preencheram um questionário autoaplicável sobre diagnóstico e tratamento da ansiedade odontológica. No total, 967 cirurgiões-dentistas responderam ao questionário, dos quais aproximadamente 65% relataram fazer algum tipo de avaliação da ansiedade. Nenhum participante relatou utilizar técnicas semi objetivas do tipo questionário estruturado. Aproximadamente 32% dos profissionais relataram utilizar um protocolo específico para a abordagem do paciente ansioso, sendo os mais utilizados a conversa (38%), a prescrição farmacológica (23%) ou algum tipo de condicionamento do paciente (17%). O trabalho discute a importância de incorporar no ensino da odontologia conhecimentos advindos da psicologia, favorecendo o desenvolvimento de habilidades relacionadas ao diagnóstico e o manejo da ansiedade odontológica

This work verifies the knowledge and use of psychometric scales and cognitive-behavioral techniques by dentists. Professionals completed a self-administered questionnaire on diagnosis and treatment of dental anxiety. The number of participants was 967 dentists of which approximately 65% reported making some type of anxiety assessment. No participant reported using semi-objective techniques of assessment. Approximately 32% of professionals reported using a specific protocol for addressing the anxious patient, the most utilized were conversation (38%), drug prescription (23%) or some kind of conditioning of the patient (17%). The paper discusses the importance of incorporating the teaching of psychological knowledge on dental education, favoring the development of skills related to the diagnosis and management of dental anxiety

Evaluation of elementary education teachers' knowledge on avulsion and tooth replantation

Introduction : Dental trauma care emergency is very important issue, especially in cases of avulsion and it is crucial for the prognosis. A preventive-educational approach had not been effective and there are many failures in handling dental trauma, mainly by lack of knowledge by health professionals, teachers and lay people. Objective: The aim of this study was to assess the knowledge of 89 teachers about dental trauma. Material and methods: A questionnaire divided into three parts containing questions about the emergency procedures in cases of dental trauma was applied. Results: Only 13% of teachers would replant the tooth in the socket, and only 7% said they would put the tooth in some liquid and 58% would store in a piece of paper, cloth or clean container. In relation to replantation, 75% reported that they would hold the tooth by the crown, 79% reported that first they would refer to the dentist, and 80% thought that the treatment had to be immediate. With regard to tooth preparation, 46% would keep it in saline, 24% in water, and only 11% in milk. Concerning to the avulsed tooth, only 15% correctly answered that they would replant the avulsed tooth and then referred to the dentist. Conclusion: It was concluded that the knowledge of teachers must be improved by educational and preventive campaigns on management of traumatized teeth.

Prevalence of traumatic dental injuries and associated factors among Brazilian schoolchildren.

PURPOSE: To assess the prevalence of traumatic dental injuries to permanent anterior teeth in 9- to 14-year-old schoolchildren attending public schools in Anápolis, Brazil, and to investigate the association between the occurrence of these injuries and the size of incisal overjet and type of lip coverage. MATERIALS AND METHODS: A cross-sectional survey and a two-stage cluster sampling technique were used. The sample size included 765 9- to 14-year-old schoolchildren. Data were collected through clinical examinations and interviews carried out by a trained, calibrated dentist. Oral examinations dealt with the type of traumatic dental injury (TDI), the treatment received, the size of incisal overjet and the type of lip coverage. The teeth examined were maxillary and mandibular incisors. RESULTS: A 16.5% prevalence of dental trauma was found. Boys experienced double the number of girls' injuries. The maxillary central incisors were the teeth most affected, totaling 84.8%. The most frequent type of injury found was enamel fracture (66%), followed by enamel-dentin fracture (27%) and enamel cracks (5%). Only 26% of traumatised teeth were restored. Children with an overjet size > 3 mm were 1.78 times (CI= 1.18 - 2.69) more likely to have a dental injury than children with an overjet size <= 3 mm. Children with inadequate lip coverage were 2.18 times (CI= 1.27 - 3.76) more likely to experience dental trauma than children whose lip coverage was adequate. CONCLUSION: This study shows that the prevalence of traumatic dental injuries among schoolchildren in Anápolis, Brazil is similar to that of other regions in Brazil. The teeth most affected by dental trauma are the maxillary central incisors. Boys run a 2.03-times higher risk of crown fracture than girls, and children with an overjet size > 3 mm are 1.78 times more likely to have dental injuries. In addition, children with inadequate lip coverage are 2.18 times more likely to present traumatic dental injuries than children with adequate lip coverage.