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1.
Braz. dent. j ; 30(4): 404-409, July-Aug. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1011571

RESUMO

Abstract Crossover studies continue to be published in spite of warnings about their inherent risks in relation to behavioral outcomes. This study took the opportunity of access to secondary data analysis in order to demonstrate the impact of a crossover design on the outcomes of randomized clinical trials aimed at the behavior of children during dental treatment. We evaluated the effect of the sequence of sedative administration, the sedative and the participant's age on the behavior of children undergoing two sequential dental visits. Eighteen uncooperative healthy young children were equally randomly assigned to: (G1) 1.0 mg/kg oral midazolam (first session) and oral placebo (second session); (G2) oral placebo (first) and 1.0 mg/kg oral midazolam (second). One trained observer assessed children's behavior. Data were analyzed by three-way mixed ANOVA. Both midazolam [mean(SD); 71.7%(16.5)] and placebo [48.6%(33.1)] produced more struggling behavior when they were administered in the first session compared to the second one (p=0.001). For the placebo, children aged 2-3 years exhibited more struggling behavior [G1 54.9%(36.2); G2 80.5%(8.3)] than those aged 4-5 years (p=0.04). Also, the reduction of percentage of struggling behavior was higher in G1 for older children (76.2%) and in G2 for younger children (32.9%). There were significant interactions between drug and sequence of administration, and between drug and age. The results of our study confirm the conventional wisdom that crossover study design is inappropriate to evaluate children's behavior/anxiety related-dental treatment under sedation and the results of crossover studies of dental sedation should be treated with extreme caution.


Resumo Pouco se sabe sobre o impacto de um delineamento cruzado nos desfechos de ensaios clínicos randomizados voltados ao comportamento de crianças durante tratamento odontológico. Este estudo objetivou avaliar o efeito da sequência de administração do sedativo, da droga em si e da idade dos participantes no comportamento de crianças que receberam duas consultas odontológicas consecutivas. Dezoito crianças saudáveis não colaboradoras, 2-5 anos de idade, foram randomizadas em dois grupos: G1 - 1,0 mg/kg midazolam oral (primeira sessão) e placebo oral (segunda sessão); G2 - placebo (primeira) e 1,0 mg/kg midazolam oral (segunda). Um observador treinado avaliou o comportamento infantil. Os dados foram analisados por ANOVA de três fatores (alfa=0,05). Midazolam [média(DP); 71,7%(16,5)] e placebo [48,6%(33,1)] resultaram em mais comportamento não cooperativo quando administrados na primeira sessão comparado com a segunda (p=0,001). Com o uso do placebo, crianças de 2-3 anos de idade exibiram mais comportamento não cooperativo [G1 54,9%(36,2); G2 80,5%(8,3)] que as de 4-5 anos de idade (p=0,04). Além disso, a porcentagem de redução do comportamento não cooperativo foi maior em crianças mais velhas em G1 (76,2%) e em crianças mais novas em G2 (32,9%). Considerando a avaliação do comportamento infantil sob sedação, a primeira sessão odontológica influenciou a segunda visita. Os resultados deste estudo confirmam a especulação de que o delineamento cruzado é inadequado para avaliar o comportamento odontológico relacionado à ansiedade/comportamento infantil; os resultados dos ensaios cruzados de sedação odontológica devem ser tratados com extrema cautela.

2.
Braz Dent J ; 30(4): 404-409, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340232

RESUMO

Crossover studies continue to be published in spite of warnings about their inherent risks in relation to behavioral outcomes. This study took the opportunity of access to secondary data analysis in order to demonstrate the impact of a crossover design on the outcomes of randomized clinical trials aimed at the behavior of children during dental treatment. We evaluated the effect of the sequence of sedative administration, the sedative and the participant's age on the behavior of children undergoing two sequential dental visits. Eighteen uncooperative healthy young children were equally randomly assigned to: (G1) 1.0 mg/kg oral midazolam (first session) and oral placebo (second session); (G2) oral placebo (first) and 1.0 mg/kg oral midazolam (second). One trained observer assessed children's behavior. Data were analyzed by three-way mixed ANOVA. Both midazolam [mean(SD); 71.7%(16.5)] and placebo [48.6%(33.1)] produced more struggling behavior when they were administered in the first session compared to the second one (p=0.001). For the placebo, children aged 2-3 years exhibited more struggling behavior [G1 54.9%(36.2); G2 80.5%(8.3)] than those aged 4-5 years (p=0.04). Also, the reduction of percentage of struggling behavior was higher in G1 for older children (76.2%) and in G2 for younger children (32.9%). There were significant interactions between drug and sequence of administration, and between drug and age. The results of our study confirm the conventional wisdom that crossover study design is inappropriate to evaluate children's behavior/anxiety related-dental treatment under sedation and the results of crossover studies of dental sedation should be treated with extreme caution.

3.
Artigo em Inglês | MEDLINE | ID: mdl-30941678

RESUMO

PURPOSE: Studies assessing the influence of neonatal complications on children's dental behaviour are lacking. We aimed to investigate whether prematurity, birth weight, and history of neonatal intensive care unit (NICU) hospitalisation are associated with distress during dental examination in children. METHODS: This preliminary longitudinal, retrospective study included 42 5- and 6-year-old children. Distress during dental examination was assessed using the observational FLACC Pain Assessment Tool through video files. Children self-reported their pain (Faces Pain Scale-Revised) at the end of the session. Information about neonatal complications was obtained through medical records. Bivariate analysis was performed (P < 0.05). RESULTS: Children with low birth weight (P = 0.047) and toothache history (P = 0.005) had higher frequency of distress during dental examination. There was no association between distress, prematurity and history of NICU hospitalisation (P > 0.05). CONCLUSIONS: Health professionals can help to disseminate the knowledge that children with history of low birth weight are more prone to perceive distress with apparently painless procedures.

4.
PLoS One ; 14(3): e0213074, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30856181

RESUMO

PURPOSE: The optimal sedative regime that provides the greatest comfort and the lowest risk for procedural sedation in young children remains to be determined. The aim of this randomized, blinded, controlled, parallel-design trial was to evaluate the efficacy of intranasal ketamine and midazolam as the main component of the behavioral guidance approach for preschoolers during dental treatment. MATERIALS AND METHODS: Children under seven years of age, with caries and non-cooperative behavior, were randomized into three groups: (KMIN) intranasal ketamine and midazolam; (KMO) oral ketamine and midazolam; or (MO) oral midazolam. The dental sedation appointments were videotaped, and the videos were analyzed using the Ohio State University Behavioral Rating Scale (OSUBRS) to determine the success of the sedation in each group. Intra- and postoperative adverse events were recorded. Data analysis involved descriptive statistics and non-parametric tests (P < 0.05, IBM SPSS). RESULTS: Participants were 84 children (28 per group; 43 boys), with a mean age of 3.1 years (SD 1.2). Children's baseline and the dental sedation session characteristics were balanced among groups. The success of the treatment as assessed by the dichotomous variable 'quiet behavior for at least 60% of the session length' was: KMIN 50.0% (n = 14; OR 2.10, 95% CI 0.71 to 6.30), KMO 46.4% (n = 13; OR 1.80, 95% CI 0.62 to 5.40), MO 32.1% (n = 9) (P = 0.360). Adverse events were minor, occurred in 37 of 84 children (44.0%), and did not differ among groups (P = 0.462). CONCLUSION: All three regimens provided moderate dental sedation with minor adverse events, with marked variability in the behavior of children during dental treatment. The potential benefit of the ketamine-midazolam combination should be further investigated in studies with larger samples. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02447289. Registered on 11 May 2015, named "Midazolam and Ketamine Effect Administered Through the Nose for Sedation of Children for Dental Treatment (NASO)."

5.
Oral Dis ; 25(2): 543-549, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30537164

RESUMO

OBJECTIVE: Developmental defects of enamel (DDE) in preterm infants still require clarification and may favour dental caries, lower food intake and greater difficulty with weight-height gain. We evaluated factors associated with DDE in preterm infants. SUBJECTS AND METHODS: In this prospective cohort study, we monitored 54 prematurely born infants from birth to 24 months of age. Trained and calibrated dentists examined the oral cavity of these children to identify and categorize DDE. Information on perinatal variables was collected from the infants' medical records and interviews with their mothers. The data were analysed using Student's t test, a chi-squared test and Pearson's product-moment correlation coefficient. RESULTS: A total of 46.3% of the 54 children presented DDE, which was observed more frequently in the left hemiarch in children born extremely (<28 weeks of gestation) or very preterm (28 to <32 weeks; RR = 2.2; 95% CI 1.3-3.6), with very low birthweight (<1,500 g; RR = 2.0; 95% CI 1.1-3.5), who were admitted to the neonatal intensive care unit (RR = 1.3; 95% CI 1.0-1.7), and who were intubated (RR = 1.6; 95% CI 1.1-2.2). CONCLUSIONS: The high incidence of incisor enamel defects, particularly on the left side, was related to higher risk prematurity and to local trauma from intubation.


Assuntos
Esmalte Dentário/anormalidades , Incisivo/anormalidades , Intubação Intratraqueal , Nascimento Prematuro/epidemiologia , Anormalidades Dentárias/epidemiologia , Dente Decíduo/anormalidades , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Unidades de Terapia Intensiva Neonatal , Masculino , Admissão do Paciente , Estudos Prospectivos , Fatores de Risco
6.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 36(4): 428-436, out.-dez. 2018. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-977076

RESUMO

RESUMO Objetivo: No Brasil, não há escala que avalie a catastrofização dos pais sobre a dor das crianças. O objetivo deste estudo foi traduzir e adaptar transculturalmente o Pain Catastrophizing Scale-Parents para a língua portuguesa do Brasil e avaliar preliminarmente as propriedades psicométricas de pais/outros parentes de crianças com e sem dor de dente. Métodos: Foi realizado um estudo transversal com 237 pais/outros parentes de 237 crianças. A adaptação transcultural da escala para o português brasileiro foi feita conforme a abordagem universalista. Para avaliar a confiabilidade e a validade da escala, os pais/outros parentes fizeram um relato sobre a dor de dente da criança e preencheram as versões brasileiras da Escala de Catastrofização da Dor-Pais e o Questionário de Desconforto Dentário. Resultados: Houve equivalência semântica com a versão original após pequenas modificações. O alfa de Cronbach para os 13 itens da escala foi 0,83 e os respectivos coeficientes de correlação intraclasse do teste-reteste variaram de 0,63 a 0,97. Os escores obtidos na Escala de Catastrofização da Dor-Pais e no Questionário de Desconforto Dentário apresentaram baixa correlação (rho=0,25; p<0,001). O escore total da Escala de Catastrofização da Dor-Pais diferiu significativamente (p<0,001) em crianças com dor de dente à noite (mediana: 30,0; percentil 25-75: 25,0-35,5) quando comparado com o daquelas sem dor de dente (25,5; 20,0-31,0). Conclusões: A versão brasileira da Escala de Catastrofização da Dor-Pais apresentou características aceitáveis nesta avaliação preliminar e pode ser utilizada no Brasil tanto na prática clínica quanto em pesquisas.


ABSTRACT Objective: In Brazil, there is no scale to assess parental catastrophizing about their child's pain. This study aimed to translate and cross-culturally adapt the Pain Catastrophizing Scale-Parents to the Brazilian Portuguese language, as well as to preliminarily evaluate its psychometric properties among parents/guardians of children with and without a toothache. Methods: A cross-sectional study was conducted with 237 parents/other relatives of 237 children. Across-cultural adaptation of the scale into Brazilian Portuguese was carried out according to the universalistic approach. To assess the reliability and validity of the scale, parents/other relatives reported on the child's toothache and filled out the Brazilian versions of the Pain Catastrophizing Scale-Parents and the Dental Discomfort Questionnaire. Results: There was semantic equivalence with the original version after minor modifications. TheCronbach's alpha for the 13 items of the scale was 0.83, and the respective test-retest intraclass correlation coefficients ranged from 0.63 to 0.97. The scores obtained from the Pain Catastrophizing Scale-Parents and the Dental Discomfort Questionnaire had a low correlation (rho=0.25; p<0.001). Thetotal score of the Pain Catastrophizing Scale-Parents differed significantly (p<0.001) in children with a toothache at night (median: 3.0, 25-75 percentile: 25.0-35.5) compared to those who did not have a toothache at night (25.5; 20.0-31.0). Conclusions: The Brazilian version of the Pain Catastrophizing Scale-Parents was acceptable in this preliminary evaluation and can be used in Brazilian clinical and research practice.

7.
Rev Paul Pediatr ; 36(4): 428-436, 2018 Oct-Dec.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30540108

RESUMO

OBJECTIVE: In Brazil, there is no scale to assess parental catastrophizing about their child's pain. This study aimed to translate and cross-culturally adapt the Pain Catastrophizing Scale-Parents to the Brazilian Portuguese language, as well as to preliminarily evaluate its psychometric properties among parents/guardians of children with and without a toothache. METHODS: A cross-sectional study was conducted with 237 parents/other relatives of 237 children. Across-cultural adaptation of the scale into Brazilian Portuguese was carried out according to the universalistic approach. To assess the reliability and validity of the scale, parents/other relatives reported on the child's toothache and filled out the Brazilian versions of the Pain Catastrophizing Scale-Parents and the Dental Discomfort Questionnaire. RESULTS: There was semantic equivalence with the original version after minor modifications. TheCronbach's alpha for the 13 items of the scale was 0.83, and the respective test-retest intraclass correlation coefficients ranged from 0.63 to 0.97. The scores obtained from the Pain Catastrophizing Scale-Parents and the Dental Discomfort Questionnaire had a low correlation (rho=0.25; p<0.001). Thetotal score of the Pain Catastrophizing Scale-Parents differed significantly (p<0.001) in children with a toothache at night (median: 3.0, 25-75 percentile: 25.0-35.5) compared to those who did not have a toothache at night (25.5; 20.0-31.0). CONCLUSIONS: The Brazilian version of the Pain Catastrophizing Scale-Parents was acceptable in this preliminary evaluation and can be used in Brazilian clinical and research practice.


Assuntos
Catastrofização/diagnóstico , Dor , Pais/psicologia , Autorrelato , Brasil , Criança , Pré-Escolar , Estudos Transversais , Características Culturais , Feminino , Humanos , Lactente , Masculino , Psicometria , Odontalgia , Traduções
8.
Int J Paediatr Dent ; 2018 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-30450741

RESUMO

BACKGROUND: Evidence of time trends in early childhood caries in low and middle-income countries in the second decade of the years 2000 is scarce AIM: To assess trends in early childhood caries prevalence and severity in 2- to 5 year-old children over a 22 years period (1993-2015) in Goiânia, Midwest Brazil. Additionally, we aimed to investigate changes regarding affected dental arches and teeth DESIGN: A time-lag analysis of trends in caries was carried out using data from three cross-sectional studies based on the World Health Organization diagnostic criteria, in 1993 (N=1362), 2001 (N=1620) and 2015 (N=548) RESULTS: Caries prevalence declined from 45.1% in 1993 to 29.0% in 2015. Prevalence of severe caries (dmft>6) in 2015 was nearly one third of that found in 1993, and the SiC index (mean dmft of the highest tertile) decreased from 4.55 to 3.32. Decline was higher in the 1993-2001 than in the 2001-2015 time-lag. Posterior teeth and second molars had the greatest reductions. High proportions of untreated caries were found in all ages and survey years CONCLUSIONS: There were significant changes in caries prevalence and severity, marked by striking decline from 1993 to 2001, followed by less prominent decrease up to 2015, and high levels of untreated caries. This article is protected by copyright. All rights reserved.

9.
Pediatr Dent ; 40(5): 365-369, 2018 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-30355433

RESUMO

Purpose: Little is known about psychological factors associated with children's behavior during dental sedation. The purpose of this study was to investigate the associations between parental dental anxiety, coping style, pain catastrophizing (an exaggerated negative response to pain), and children's behavior during dental treatment under moderate sedation. Methods: Participants included 110 pairs consisting of mothers, fathers, or grandmothers and healthy children (60 boys, 50 girls; mean age equals 47.0 months, range equals 20 to 81 months) with a history of disruptive behavior during dental treatment. All children required one dental restoration under moderate sedation, using local anesthesia and rubber dam isolation. Children, s behavior was assessed using the Ohio State University Behavioral Rating Scale, based on the video files of the procedure. Parents completed the Dental Anxiety Scale, the Coping Orientation to Problems Experienced Scale, and the Pain Catastrophizing Scale-Parents. Results: Parents of children with more positive behavior scored higher on planning (P=0.02) and acceptance (P=0.02) strategies than parents of children in the regular and negative behavior groups. No associations were found between parental dental anxiety or pain catastrophizing and children's behavior. Conclusions: Parental adaptive coping strategies can have a positive impact on children's behavior during dental treatment under moderate sedation.

10.
J Indian Soc Pedod Prev Dent ; 36(3): 250-256, 2018 Jul-Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30246745

RESUMO

Background: Dental pain is one of the most common symptoms of untreated oral problems and exerts a strong impact on the well-being of children. Aims: The aim of this study was to evaluate the associated factors with dental pain in children aged 1-3 years using the Brazilian version of the Dental Discomfort Questionnaire (DDQ-B). Methods: A cross-sectional study was conducted in the city of Diamantina, Brazil. A total of 318 randomly selected children were submitted to an oral clinical examination for the evaluation of tooth injuries and dental caries (International Caries Detection and Assessment System, [ICDAS]). The caregivers of the children were asked to answer the DDQ-B as well as a questionnaire addressing demographic and socioeconomic aspects of the family. Statistical analysis was performed and involved the description of frequencies as well as Poisson hierarchical regression analysis. Results: Dental pain was associated with a household income less than the Brazilian minimum monthly wage (Prevalence ratios [PRs] = 1.33, 95% confidence interval [CI]: 1.07-1.66, P = 0.011) and dental caries in dentin - ICDAS codes 5 and 6 (PR = 1.48, 95% CI: 1.13-1.94, P = 0.004). Conclusions: Greater frequencies of dental pain were found in 1-3-year-old children from families with a low monthly income and dental caries with visible dentin with or without pulp involvement.

11.
Qual Life Res ; 27(12): 3191-3198, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30097914

RESUMO

PURPOSE: Untreated dental caries is a persistent oral problem among preschool children. Although there is vast evidence regarding the impact of dental caries on oral health-related quality of life (OHRQoL) in this age group, evidence on the impact of untreated caries severity is scarce. The purpose of this study was to investigate the impact of untreated caries severity on the OHRQoL of preschool children and their families. METHODS: A cross-sectional study was conducted with 563 individuals in the city of Goiania, Brazil. Data were collected through interviews with parents/caregivers and clinical examinations of their children. The OHRQoL was measured by the Brazilian version of the Early Childhood Oral Health Impact Scale. Untreated dental caries severity was assessed using validated indices. Other independent variables were socioeconomic, toothache prevalence, and the questionnaire respondent. Statistical analysis involved bivariate comparisons and Poisson regression analyses. RESULTS: A higher prevalence of impact on OHRQoL was found among preschool children with untreated dental caries with clinical consequences (PR 1.31; 95% CI 1.01-1.70) compared to those without caries; those aged 5 years (PR 1.47; 95% CI 1.18-1.82), compared to those aged two; and those with a toothache (PR 1.54; 95% CI 1.34-1.76), compared to those without toothache. Moreover, fathers (PR 0.71; 95% CI 0.55-0.92) and other respondents (PR 0.70; 95% CI 0.52-0.96) perceived less impact on the OHRQoL in comparison to mothers. CONCLUSIONS: Severe untreated dental caries with clinical consequences had a negative impact on the children's OHRQoL, regardless of toothache and socioeconomic factors.

12.
Int J Paediatr Dent ; 28(6): 602-607, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30091192

RESUMO

BACKGROUND: Breastfeeding plays an important role in child health, including the development of normal dental occlusion, but large epidemiological findings on the association breastfeeding-malocclusion are lacking. AIM: To investigate the association between the proportion of breastfed children in the city level and the prevalence of malocclusion in the primary dentition at age 5. DESIGN: This cross-sectional analysis used data from national population surveys on oral health and on breastfeeding practices. Data refer to 5278 5-year-old children and 44 Brazilian towns. Information on malocclusion and individual sociodemographic characteristics were obtained from the 2010 Brazilian Oral Health Survey. Breastfeeding rates during the first year of life were extracted from the Breastfeeding Prevalence Survey in Brazilian Towns. Population sociodemographic data were analysed as confounder. Multilevel Poisson analyses were performed. RESULTS: Malocclusion prevalence was 63.3%. Towns exhibiting higher prevalence of breastfeeding among 9- to 12-month-olds presented lower prevalence of malocclusion among children at age 5 (PR 0.98; 95% CI 0.98-0.99). CONCLUSIONS: Lower prevalence of malocclusion among 5-year-old children was associated with a higher proportion of children breastfed at ages 9 to 12 months at a city level, regardless of sociodemographic factors. These findings highlight the importance of encouraging breastfeeding during a child's first year.

13.
Rev. Bras. Odontol. Leg. RBOL ; 5(2): [2-11], mai.-ago. 2018.
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-912635

RESUMO

A formação do cirurgião-dentista deve ser pautada pelo respeito aos princípios éticos e legais da profissão. A popularização das redes sociais potencializa a exposição irregular de imagem de pacientes ao público leigo. Este trabalho buscou investigar a percepção de docentes sobre o uso de redes sociais virtuais para divulgar imagem de pacientes no âmbito da Odontologia. Para a coleta de dados foi utilizado um questionário autoaplicável direcionado a docentes que lecionam disciplinas clínicas em um curso de Odontologia da cidade de Anápolis-GO. A taxa de resposta foi de 59,6% (31 de 52); média de idade de 42,6 anos; maioria do sexo masculino (17; 54,8%); 28 (90,3%) atendem pacientes fora da instituição com vínculo predominantemente de natureza privada, 20 (64,5%); maioria (22; 70,9%), declarou ter perfil de usuário em ao menos uma rede social, sendo o Facebook® a mais citada. É importante que os cursos de graduação insistam na formação ética, daí a importância do docente propor e executar um processo de avaliação que o permita aferir conhecimentos, habilidades e atitudes. É crucial que os profissionais formados reconheçam a extensão da responsabilidade de suas ações nas esferas ética/administrativa, cível e penal. Os docentes do curso de Odontologia investigado identificaram o uso de redes sociais, inclusive com a publicação da imagem de paciente, por cirurgião-dentista, estudantes de odontologia e outros docentes. Compreendem que estas veiculações podem ser entendidas como uma forma de publicidade e que, de modo geral, a exposição dos pacientes deve respeitar os princípios do anonimato e da privacidade.


The training of the dentist should be guided by respect for the ethical and legal principles of the profession. The popularization of social networks enhances the irregular image exposure of patients. This work aimed to investigate the perception of teachers about the use of virtual social networks as a tool to disseminate the image of dental patients. For data collection, a self-administered questionnaire was used directed to teachers who teach clinical subjects in a Dentistry course in the city of Anápolis-GO. The response rate was 59.6% (31 of 52); Mean age 42.6 years; Majority of males (17; 54.8%); 28 (90.3%) have other jobs with a predominantly private relationship, 20 (64.5%); Majority (22; 70.9%), declared to have user profile in at least one social network, being Facebook® the most cited. It is important that undergraduate courses insist on ethical training, hence the importance of teachers to propose and execute an evaluation process that allows them to measure knowledge, skills and attitudes. It is crucial that graduates recognize the extent of responsibility for their actions in the ethical / administrative, civil and criminal spheres. The teachers of the Dentistry course investigated identified the use of social networks, including the publication of the patient image, by dentists, dentistry students and other teachers. They understand that these placements can be understood as a form of advertising and that patient exposure should respect the principles of anonymity and privacy.


Assuntos
Humanos , Masculino , Feminino , Ética , Odontologia Legal , Rede Social , Confidencialidade , Docentes de Odontologia
14.
Int J Paediatr Dent ; 2018 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-29984460

RESUMO

BACKGROUND: There is a paucity of evidence about cognitive behaviour therapy in the management of dentally anxious children. AIM: To systematically review evidence of the effectiveness of cognitive behaviour therapy for children with dental anxiety or dental phobia. DESIGN: Clinical trial registries, grey literature, and electronic databases, including The Cochrane Library, EMBASE, PubMed, Scopus, Web of Science, LILACS/BBO, and PsycINFO, were searched (April 2018). The reference lists of relevant studies were hand-searched. Randomised controlled trials that evaluated the effects of cognitive behaviour therapy on dental anxiety or on acceptance of dental treatment in dental patients up to 18 years were included. Two trained and calibrated reviewers performed the study selection and risk of bias assessment. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: Six studies with a total of 269 patients, aged 41 months to 18 years, were included. Cognitive behaviour therapy decreased level of anxiety compared to control groups and improved cooperation/behaviour, although the quality of the evidence was low. CONCLUSIONS: Cognitive behaviour therapy produces better anxiety reduction than diverse behavioural management techniques but the evidence was of low quality and further studies in children are needed.

15.
Rev Saude Publica ; 52: 30, 2018 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-29641655

RESUMO

OBJECTIVE: To investigate the impact of dental pain on daily performances among five-year-old Brazilian children. METHODS: The study used data of 7,280 five-year-old children participating in the 2010 Brazilian Oral Health Survey (SBBrasil 2010 Project). Children were clinically examined and their parents or carers were interviewed at their homes. The outcome was the prevalence of the oral impacts on daily performance, and the explanatory variable was dental pain in the last six months. Other independent variables were children's gender and skin color/race, family income, household overcrowding, and caries experience (dmft). Rao-Scott test and Poisson regression for complex samples were carried out. RESULTS: The prevalence of impacts on daily performances was 26.1% (95%CI 22.3-30.2). Significant associations were found between the outcome and pain, caries experience, and sociodemographic variables. After adjusting for the independent variables, only pain and caries remained significant. Impacts on daily performances were more frequent among children with pain (PR = 1.14, 95%CI 1.06-1.23) compared to those without pain. Children with low dmft (PR = 1.90, 95%CI 1.39-2.60) and those with high dmft (PR = 3.53, 95%CI 2.78-4.49) had a higher prevalence of impact than those with no caries experience. CONCLUSIONS: Dental pain and caries had strong negative impacts on the five-year-old children's daily performances regardless of their demographic and socioeconomic characteristics.


Assuntos
Cárie Dentária/psicologia , Qualidade de Vida , Odontalgia/psicologia , Atividades Cotidianas , Brasil/epidemiologia , Pré-Escolar , Cárie Dentária/epidemiologia , Inquéritos de Saúde Bucal , Feminino , Humanos , Renda , Masculino , Pais , Prevalência , Odontalgia/epidemiologia
16.
Artigo em Inglês | LILACS-Express | ID: biblio-903462

RESUMO

ABSTRACT OBJECTIVE To investigate the impact of dental pain on daily performances among five-year-old Brazilian children. METHODS The study used data of 7,280 five-year-old children participating in the 2010 Brazilian Oral Health Survey (SBBrasil 2010 Project). Children were clinically examined and their parents or carers were interviewed at their homes. The outcome was the prevalence of the oral impacts on daily performance, and the explanatory variable was dental pain in the last six months. Other independent variables were children's gender and skin color/race, family income, household overcrowding, and caries experience (dmft). Rao-Scott test and Poisson regression for complex samples were carried out. RESULTS The prevalence of impacts on daily performances was 26.1% (95%CI 22.3-30.2). Significant associations were found between the outcome and pain, caries experience, and sociodemographic variables. After adjusting for the independent variables, only pain and caries remained significant. Impacts on daily performances were more frequent among children with pain (PR = 1.14, 95%CI 1.06-1.23) compared to those without pain. Children with low dmft (PR = 1.90, 95%CI 1.39-2.60) and those with high dmft (PR = 3.53, 95%CI 2.78-4.49) had a higher prevalence of impact than those with no caries experience. CONCLUSIONS Dental pain and caries had strong negative impacts on the five-year-old children's daily performances regardless of their demographic and socioeconomic characteristics.

17.
Artigo em Inglês | LILACS-Express | ID: biblio-903523

RESUMO

ABSTRACT OBJECTIVE To investigate the impact of dental pain on daily performances among five-year-old Brazilian children. METHODS The study used data of 7,280 five-year-old children participating in the 2010 Brazilian Oral Health Survey (SBBrasil 2010 Project). Children were clinically examined and their parents or carers were interviewed at their homes. The outcome was the prevalence of the oral impacts on daily performance, and the explanatory variable was dental pain in the last six months. Other independent variables were children's gender and skin color/race, family income, household overcrowding, and caries experience (dmft). Rao-Scott test and Poisson regression for complex samples were carried out. RESULTS The prevalence of impacts on daily performances was 26.1% (95%CI 22.3-30.2). Significant associations were found between the outcome and pain, caries experience, and sociodemographic variables. After adjusting for the independent variables, only pain and caries remained significant. Impacts on daily performances were more frequent among children with pain (PR = 1.14, 95%CI 1.06-1.23) compared to those without pain. Children with low dmft (PR = 1.90, 95%CI 1.39-2.60) and those with high dmft (PR = 3.53, 95%CI 2.78-4.49) had a higher prevalence of impact than those with no caries experience. CONCLUSIONS Dental pain and caries had strong negative impacts on the five-year-old children's daily performances regardless of their demographic and socioeconomic characteristics.

18.
BMC Res Notes ; 10(1): 253, 2017 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-28683764

RESUMO

BACKGROUND: Publication retraction is a mechanism to preserve the scientific literature against publications that contain seriously flawed or erroneous data, redundant publication, plagiarism, unethical research, and other features that compromise the integrity of science. An increase in the occurrence of retractions in recent years has been reported. Nevertheless, there is scarce information on this topic concerning publications in dentistry and related specialties. Thus, this study aimed to investigate retracted papers published in dental journals. METHODS: Data collection included an exploratory search in PubMed and a specific search in SCImago Journal Rank indexed journals, complemented by the cases reported on the Retraction Watch website and in PubMed. All 167 dental journals included in SCImago were searched for identification of retracted articles up to March 2016. The selected retracted articles and their corresponding retraction notices were recorded and assessed for classification according to the reason for retraction and other additional information. RESULTS: Forty of the 167 journals scrutinised at SCImago (23.9%) had at least one retracted article, and four additional journals were identified from the Retraction Watch website. A total of 72 retracted found were retracted for the reasons: redundant publication (20.8%), plagiarism (18.1%), misconduct (13.8%), overlap (13.6%) and honest error (9.7%). Higher number of retractions were reported in those journals with cites/doc <2.0-n = 49 (74.2%). The types of studies were mainly laboratory studies (34.7%), case reports (22.2%) and review articles (13.9%). CONCLUSIONS: The approach to ethical problems in papers published in dental scientific journals is still incipient; retractions were mostly due to the authors' malpractice and were more frequently related to journals with less impact.


Assuntos
Pesquisa Biomédica/estatística & dados numéricos , Bases de Dados Bibliográficas/estatística & dados numéricos , Odontologia/estatística & dados numéricos , Publicações Periódicas como Assunto/estatística & dados numéricos , Retratação de Publicação como Assunto , Humanos
19.
PLoS One ; 12(7): e0180248, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28686702

RESUMO

BACKGROUND: Studies have suggested that benzodiazepines are amnestic drug par excellence, but when taken together, what level of evidence do they generate? Are other sedatives as amnestic as benzodiazepines? The aim of this study was to assess the level of scientific evidence for the amnestic effect of sedatives in pediatric patients who undergo health procedures. METHODS: The literature was searched to identify randomized controlled trials that evaluated anterograde and retrograde amnesia in 1-19-year-olds who received sedative drugs during health procedures. Electronic databases, including PubMed, Scopus and Cochrane Library besides clinical trial registries and grey literature were searched. Two independent reviewers performed data extraction and risk of bias assessment using the Cochrane Collaboration's Tool. The meta-analyses were performed by calculating relative risk (RR) to 95% confidence intervals (CI). The quality of the evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS: Fifty-four studies were included (4,168 participants). A higher occurrence of anterograde amnesia was observed when benzodiazepines, the most well-studied sedatives (n = 47), were used than when placebo was used (n = 12) (RR = 3.10; 95% CI: 2.30-4.19, P<0.001; I2 = 14%), with a moderate level of evidence. Higher doses of alpha2-adrenergic agonists (clonidine/dexmedetomidine) produced more anterograde amnesia than lower doses (n = 2) (RR = 1.83; 95% CI: 1.03-3.25; P = 0.038; I2 = 0%), with a low level of evidence; benzodiazepines' amnestic effects were not dose-dependent (n = 3) (RR = 1.54; 95% CI: 0.96-2.49; P = 0.07; I2 = 12%) but the evidence was low. A qualitative analysis showed that retrograde amnesia did not occur in 8 out of 10 studies. CONCLUSIONS: In children, moderate evidence support that benzodiazepines induce anterograde amnesia, whereas the evidence for other sedatives is weak and based on isolated and small studies. Further clinical trials focused on the amnesia associated with non-benzodiazepine sedatives are therefore needed. TRIAL REGISTRATION: PROSPERO CRD42015017559.


Assuntos
Amnésia Anterógrada/diagnóstico , Amnésia Retrógrada/diagnóstico , Benzodiazepinas/efeitos adversos , Hipnóticos e Sedativos/efeitos adversos , Adolescente , Amnésia Anterógrada/induzido quimicamente , Amnésia Retrógrada/induzido quimicamente , Criança , Pré-Escolar , Clonidina/efeitos adversos , Dexmedetomidina/efeitos adversos , Feminino , Humanos , Lactente , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
20.
Trials ; 18(1): 172, 2017 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-28399933

RESUMO

BACKGROUND: Uncooperative children may need to receive dental treatment under sedation, which is indicated when nonpharmacological behavior guidance is unsuccessful. There are randomized controlled trials (RCTs) comparing different sedative protocols for dental procedures; however, the evidence for superiority of one form over another is weak. The primary aim of this study is to investigate the efficacy of intranasally administered ketamine plus midazolam for the dental treatment of children. METHODS: We have designed a three-armed, parallel RCT to assess intranasal sedation using ketamine/midazolam in terms of the following measures: efficacy, safety, and cost-effectiveness. Two- to 6-year-old healthy children, referred for dental treatment in a dental sedation center in Brazil due to uncooperative behavior and requiring restorative dental procedures, will be recruited. Each child will be randomly assigned to one of the three groups: A - Intranasal administration of ketamine (4.0 mg/kg, maximum 100 mg) and midazolam (0.2 mg/kg, maximum 5.0 mg); B - Oral administration of ketamine (4.0 mg/kg, maximum 100 mg) and midazolam (0.5 mg/kg, maximum 20 mg); and C - Oral administration of midazolam (1.0 mg/kg, maximum 20 mg). The primary outcome is the child's behavior assessed through an observational scale using digital videos of the restorative dental treatment under sedation. The secondary outcomes are as follows: acceptance of sedative administration; memory of intraoperative events; the child's stress; adverse events; the child's pain during the procedure; the parent's, dentists', and child's perceptions of sedation; and economic analysis. Measures will be taken at baseline and drug administration and during and after the dental procedure. The necessary sample size was estimated to be 84 children after a blinded interim analysis of the first 30 cases. DISCUSSION: This study will provide data that can substantially add to science and pediatric dentistry as it examines the effect of sedative regimes from different perspectives (outcomes). TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02447289 . Registered on 11 May 2015, named "Midazolam and Ketamine Effect Administered Through the Nose for Sedation of Children for Dental Treatment (NASO)."


Assuntos
Sedação Consciente/métodos , Restauração Dentária Permanente/métodos , Ketamina/administração & dosagem , Midazolam/administração & dosagem , Administração Intranasal , Criança , Pré-Escolar , Humanos , Ketamina/efeitos adversos , Midazolam/efeitos adversos , Avaliação de Resultados (Cuidados de Saúde) , Tamanho da Amostra
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