Prisoners' perceived oral and general health and their experience with accessing, understanding and assessing health information: A qualitative study.

Prisoners' oral health and general health are closely connected and generally poorer than that of the wider population. Moreover, knowledge of prisoners' health literacy is scarce. This study aimed to explore prisoners' perceived oral and general health and how they accessed, understood and assessed health information to gain insight into their health literacy. Twelve prisoners in a high-security prison and a halfway house participated in individual semi-structured interviews. Data was analysed through thematic analysis, which identified five themes: inconsistent self-reporting of general and oral health; autonomous health behaviour through utilizing personal resources; preference for personalized adapted health information; psychological and physical proximity; and barriers. The prisoners perceived their oral and general health as good despite several health problems. They expressed scepticism towards health information from public authorities and made their own health-related choices based on previous experiences, their own 'common sense' and the experiences of people they trusted. Health information was considered useful when adjusted to their needs. Obtaining health-related information through physical encounters was considered more accessible than through online platforms. Adapting the communication to prisoners' expressed needs and their health literacy can enhance the accessibility to improve their oral and general health. In-person encounters would be preferable.

Legislation in Hospital Dentistry: Gaps, Perspectives and Desires

Abstract Objective: To analyze the existing state legislation, including not only the ordinary laws, but also their infralegal regulation and the state legislation on Hospital Dentistry. Material and Methods: A survey was carried out in the databases of the Legislative Assemblies of the Brazilian States and the Federal District, as well as the Regional and Federal Councils of Dentistry in Brazil. Subsequently, a survey was carried out in the databases of the Ministry of Health, State Dental Councils and Federal Dental Council in Brazil. Results: Only 8 Brazilian states have legislation in force regarding hospital dentistry, which represents 29.63% of the federative units. Among the Brazilian regions, the Midwest presented the highest prevalence of the laws found (37.50%), followed by the North (25%) and the other regions with the same coverage (12.50%). Also, an orientation and an ordinance from the Ministry of Health, six resolutions from the Federal Council of Dentistry, and a technical note from the National Health Surveillance Agency were found. Conclusion: Several States do not have rules on the subject, making it imperative to create a federal rule that not only imposes the presence of the dentist, but also regulates the proportion of the team, workload, and availability.

Desinfección y esterilización en odontología frente al COVID-19 / Disinfection and sterilization in dentistry against COVID-19 / Desinfecção e esterilização em odontologia contra a COVID-19

A partir de la declaración de la Organización Mundial de la Salud del comienzo de la pandemia COVID-19 causada por el virus SARS-CoV-2 en marzo de 2020, los profesionales de la salud se vieron expuestos a esta enfermedad altamente contagiosa y potencialmente mortal que generó múltiples desafíos a toda la comunidad científica. Provocando cambios de paradigmas en la atención de los pacientes y en el uso de las barreras de protección personal. A nivel mundial se crearon múltiples protocolos para la atención odontológica a medida que se iba desarrollando e investigando el comportamiento del virus. Esta revisión bibliográfica resume las indicaciones y recomendaciones basadas en las evidencias disponibles para disminuir las posibilidades de contaminación ante la exposición a este virus, incluyendo medidas a utilizar desde el ingreso del paciente, los métodos de protección personal, la descontaminación y esterilización del material, así como también la desinfección del área de trabajo. Aunque se ha hecho un gran esfuerzo por mejorar los procesos de bioseguridad a nivel científico tecnológico, hay evidencias de que el factor humano sigue siendo el eslabón más débil de esta cadena.

Since the declaration by the World Health Organization of the beginning of the COVID-19 pandemic caused by the SARS-CoV-2 virus in March 2020, health professionals were exposed to this highly contagious and potentially fatal disease that generated multiple challenges to the entire scientific community. It caused paradigm shifts in patient care and in the use of personal protective barriers. Multiple protocols for dental care were created worldwide as the behavior of the virus was developed and investigated. This bibliographic review summarizes the indications and recommendations based on the available evidence to reduce the possibilities of contamination when exposed to this virus, including measures to be used from patient admission, personal protection methods, decontamination and sterilization of material, as well as disinfection of the work area. Although a great effort has been made to improve biosafety processes at the scientific and technological level, there is evidence that the human factor continues to be the weakest link in this chain.

Desde a declaração pela Organização Mundial da Saúde do início da pandemia de COVID-19 causada pelo vírus SARS-CoV-2 em março de 2020, os profissionais de saúde foram expostos a essa doença altamente contagiosa e potencialmente fatal, que criou vários desafios para toda a comunidade científica. Ela causou mudanças de paradigma no atendimento ao paciente e no uso de barreiras de proteção individual. Em todo o mundo, vários protocolos para atendimento odontológico foram criados à medida que o comportamento do vírus foi desenvolvido e pesquisado. Esta revisão da literatura resume as indicações e recomendações baseadas em evidências para reduzir a probabilidade de contaminação por exposição a esse vírus, incluindo medidas a serem usadas desde a admissão do paciente, métodos de proteção individual, descontaminação e esterilização de equipamentos, bem como desinfecção da área de trabalho. Embora muitos esforços tenham sido feitos para melhorar os processos de biossegurança em nível científico e tecnológico, há evidências de que o fator humano continua sendo o elo mais fraco dessa cadeia.

Odontologia hospitalar no ambiente digital: o que se pública sobre esta habilitação? / Hospital dentistry in the digital environment: what is published about this qualification?

Objetivo: O objetivo deste trabalho foi caracterizar as publicações sobre odontologia hospitalar disponíveis em páginas da internet e em páginas do Instagram, além de avaliar a qualidade dos conteúdos disponíveis do ponto de vista da evidência científica e do uso de referências. Métodos: Foi realizado um estudo transversal e exploratório. A partir da pesquisa da chave de busca "odontologia hospitalar" foram localizadas páginas do Instagram e da Internet via Google. Resultados: No Instagram foram localizadas 15 páginas que atendiam aos critérios de inclusão, e as últimas 5 publicações foram analisadas (n=75). Para o Google foram avaliados conteúdos que correspondessem à projeto de lei, entre os primeiros 25 resultados da pesquisa, já que se trata dos mais relevantes a partir da marcação do algoritmo. Percebeu-se que o uso de referências não é frequente nem nas publicações do Instagram, tampouco nos conteúdos da Internet. Tal fato é tão importante, que os resultados deste trabalho demonstram essa urgência na mudança de cenário dos conteúdos publicados na rede mundial de computadores. Conclusão: Nesse sentido, os professores e os próprios conselhos podem atuar como bússolas, na orientação da divulgação e consumo de conteúdo aos estudantes e aos profissionais de saúde.(AU)

Aim: The objective of this study was to characterize the publications on hospital dentistry available on websites and Instagram pages, in addition to evaluating the quality of the available content from the point of view of scientific evidence and the use of references. Methods: A cross-sectional and exploratory study was carried out. From the research of the search key "hospital dentistry", Instagram and Internet pages were located via Google. Results: On Instagram, 15 pages that met the inclusion criteria were located, and the last 5 publications were analyzed (n=75). For Google, content that corresponded to the bill was evaluated, among the first 25 search results, since these are the most relevant based on the algorithm's marking. It was noticed that the use of references is not frequent either in Instagram publications or in Internet content. This fact is so important that the results of this work demonstrate this urgency in changing the scenario of content published on the World Wide Web. Conclusion: In this sense, professors and the councils themselves can act as compasses, guiding the dissemination and consumption of content to students and health professionals. (AU)

Myiasis on the tongue of a patient hospitalized in a psychiatric ward: A case report with a focus on diagnosis and clinical management.

INTRODUCTION: Myiasis is a disease caused by the infestation of fly larvae in the skin, which complete part of their life cycle by feeding on host tissues. OBJECTIVE: To report a rare case of tongue myiasis in a patient admitted to a psychiatric ward, focusing on clinical management. CASE REPORT: A dependent care and mentally challenged 55 years old male patient was hospitalized in a psychiatric ward. After 42 days, during the intraoral examination, it was noted numerous larvae peeking from inside of a wound on the dorsum of the tongue. The clinical diagnosis of myiasis was rendered. For the treatment, manual removal was performed initially and ivermectin (15 mg), metamizole sodium (500 mg/ml), and chlorhexidine digluconate (0.12%) were prescribed. After one week, larvae were no longer observed, and the wound was completely healed. CONCLUSION: Myiasis occurrence is uncommon in the mouth, however, its correct diagnosis and treatment are necessary to avoid further damage to patients, especially those who are hospitalized.

Patch test results in dental staff with dermatitis.

BACKGROUND: Dental workers are exposed to allergenic materials in the workplace. OBJECTIVES: To summarize patch test results in dental staff with work-related dermatitis. MATERIALS AND METHODS: Cross-sectional study of dental staff with dermatitis was conducted. Symptoms, clinical findings and results from patch tests with 40 dental allergens were summarized. RESULTS: Of 329 participants, 155 (47.1%) had at least one positive patch reaction. The highest frequency of positive reactions was observed for metals (38.6%), acrylics (7.3%) and additives in acrylic resins (3.6%). One hundred and eighty-five (56.2%) participants were currently symptomatic; in this group, 79 (42.7%) had current dermatitis. Thirty-eight patients had at least one positive patch test considered occupationally related to their current dermatitis. CONCLUSION: Almost half of the dental staff with dermatitis had at least one positive patch test and approximately 12% had current occupational relevance of the allergens. Our results underscore the importance of patch testing in the evaluation of dental staff with dermatitis.

Empathy of dental students and educators in French hospitals: A cross-sectional study.

Empathy is a key factor in the dentist-patient relationship. The aim of this study was to determine empathy in dental students and educators in French hospital dental services. A cross-sectional study was conducted among dental students and educators who practiced in 10 hospital dental services affiliated with the Faculty of Dentistry of the University of Lorraine in France. A questionnaire was self-administered online using the Jefferson Scale of Physician Empathy (JSPE). The study included 209 participants comprising 50 students in fourth year, 66 students in fifth year, 48 students in sixth year, and 45 educators. Participants were 63.6% females, aged 27 ± 8 years. The mean empathy score was 109.40 ± 11.65. The sub-scores of the three dimensions were 57.02 ± 6.64 for Perspective Taking, 42.56 ± 6.22 for Compassionate Care, and 9.78 ± 2.61 for Walking in the Patient's Shoes. Females showed significant higher empathy scores than males (111.36 vs. 105.84). The empathy score was correlated with age and insignificantly decreased during clinical training (from 110.06 in fourth year to 106.63 in sixth year). French dental students and educators showed high levels of empathy.

Percepção de residentes de curso multiprofissional em saúde em relação à importância de cuidados odontológicos no hospital / Percepción de residentes de un curso multidisciplinario de salud sobre la importancia de la atención odontológica en el hospitalResumen / Perception of residents of a multiprofessionalresidency program in hospital care regarding the importance of oral careAbstract

O estudo objetivou conhecer a percepção de residentes multiprofissionais de um hospital público sobre a importância dos cuidados odontológicos no cenário hospitalar. Foi realizado um estudo do tipo transversal, observacional, descritivo com amostra por conveniência, composta por 63 residentes do Programa de Residência Multiprofissional Integral de Saúde Hospitalar (RIMUSH) do Hospital Universitário Lauro Wanderley. O instrumento de coleta de dados foi um questionário adaptado contendo sete perguntas. Para análise, os residentes foram divididos em dois grupos, o grupo 1 (G1) possui cirurgião-dentista (CD) na equipe multiprofissional e o grupo 2 (G2) não possui CD na equipe. A maioria dos residentes respondeu que avaliação odontológica nos pacientes hospitalizados é muito importante, que condições sistêmicas, medicações e condição de saúde bucal impactam na recuperação. Porém, os residentes do G1 compreenderam melhor as atribuições do CD na equipe, assim como quando indicar um pedido de consulta odontológica comparados aos do G2. Conclui-se que os residentes das demais áreas da saúde percebem a importância da Odontologia Hospitalar e que a presença do CD nas equipes de residência contribui para a capacitação desses profissionais, para a troca de saberes interprofissionais e para a promoção de assistência integral (AU).

El estudio tuvo como objetivo conocer la percepción de los residentes multidisciplinarios de un hospital público sobre la importancia de la atención odontológica en el ámbito hospitalario. Se realizó un estudio transversal, observacional, descriptivo, con una muestra de conveniencia, conformada por 63 residentes del Programa de Residencia Multiprofesional Integral en Salud Hospitalaria (RIMUSH) del Hospital Universitario Lauro Wanderley. El instrumento de recolección de datos fue un cuestionario adaptado que contenía siete preguntas. Para el análisis, los residentes fueron divididos en dos grupos, el grupo 1 (G1) tiene un cirujano dentista (CD) en el equipo multidisciplinario y el grupo 2 (G2) no tiene un dentista en el equipo. La mayoría de los residentes respondieron que la evaluación dental en pacientes hospitalizados es muy importante, que las condiciones sistémicas, los medicamentos y la condición de salud oral impactan en la recuperación. Sin embargo, los residentes de G1 entendieron mejor las funciones del CD en el equipo, así como cuándo indicar una solicitud de cita dental en comparación con G2. Los residentes de otras áreas de salud se dan cuenta de la importancia de la Odontología Hospitalaria y la presencia de CD en los equipos de residencia contribuye a la formación de estos profesionales, al intercambio de conocimientos interprofesionales y a la promoción de la atención integral (AU).

This study aimed to investigate the perception of multiprofessional residents of a public hospital about the importance of oral care in the hospital setting. A cross-sectional, observational study of descriptive design was conducted with a convenience sample, including 63 residents of the Multiprofessional Integrated Residency Program in Hospital Care (RIMUSH) at the University Hospital Lauro Wanderley. The instrument used for data collection was an adapted questionnaire containing seven questions. For the analysis, residents were divided into two groups: group 1 (G1) included a dental surgeon (DS) in the multiprofessional team, and group 2 (G2) did not include a DS in the team. Most residents answered that dental evaluation of hospitalized patients was very important, and that systemic conditions, medications and oral health had a significant impact on recovery. However, G1 residents had better understanding of the duties of the DS in the team and of timely referral of hospitalized patients for a dental consultation, compared to G2. Residents of other Health Care courses realize the importance of Hospital Dentistry and understand that the presence of DSs in residency teams is acontributing factor to the qualification of these professionals, exchange of interprofessional knowledge and promotion of comprehensive care (AU).

Medical emergencies in dental practice: A nationwide web-based survey of Italian dentists.

Objective: Dentists must be prepared to manage medical emergencies, which are arisen during dental practice together with the increase of age population and medically compromised patients. This study aims at assessing the occurrence of medical emergencies in a cohort of Italian dentists, to ascertain their level of confidence in the management of these conditions, also based on their educational training and type of medical graduation, and, finally, to know their educational needs, in order to plan appropriate institutional interventions for specific training. Methods: A national-based cross-sectional study was carried out by means of an online survey sent to all dentists working in Italy. Results: The survey included 6818 questionnaires. Most of the respondents (n = 4443; 65.2%) reported the occurrence of at least one medical emergency during their professional life. The events rarely resulted in death as declared by only 62 (0.9%) of respondents. The commonest medical emergency was the vasovagal syndrome. Most medical emergencies occurred during the dental procedure (n = 4883; 71.6%). An average degree of satisfaction about the ability to diagnose and manage medical emergencies was reported by most of respondents, with high level of confidence in treating vasovagal syndrome, while a lack in preparedness about the management of myocardial infarction or transient ischemic attack (TIA) and stroke. Medical doctors were more confident in managing the emergencies than dentistry graduates (p < .01). Considering the educational needs, almost all of participants (n = 6721; 98.6%) declared the need to improve their training and expressed their interest in theoretical-practical institutional courses as well as in the establishment of an official national register for medical emergencies occurred in dental practice. Conclusions: Medical emergencies are not negligible and the dentist should receive adequate training and continuing education to be updated and ready for their correct management. Clinical significance: The dentist should be ready to deal with medical emergencies and provide first aid to the patient. The dentist is not always prepared to manage the most complex emergencies; therefore, there is the need to organize post-graduate courses and to set up an emergency register.

Geographic Distribution of Brazilian Dentists: Motivation and Perception for Migration / Distribuição Geográfica dos Dentistas Brasileiros: Motivação e Percepção para a Migração

The Human Resources for Health (HRH) are considered as being crucial for the organization of the health systems and for the population health conditions; in this context, the purpose of this work is 1) to identify the current geographic distribution situation of Brazilian dentists, 2) to identify and analyze the perception and motivations of Brazilian dentists who migrated to the interior of the country. A case study approach was used and the data were collected from different sources (Federal Council of Dentistry, Health Graduation Indicators System, Geocapes, Brazilian National Institute of Geography and Statistics) using the mixed method, from the quantitative-qualitative exploratory sequential model, the qualitative phase was analyzed by using the "grounded theory" approach. The findings point out that the county has a great stock of dentists and that it significantly increased in recent years; however, it is poorly distributed over the territory, particularly when the differences between the interior and the capitals of the country are analyzed. The main category of the grounded theory was "The opportunities changing the ways to consolidate the professional"; the interviews point out that the dentists' place of birth and the opportunities over their professional career were crucial to determine the distribution of dentists throughout the Brazilian territory. It's concluded that Brazil has a dentistry workforce stock; however, it faces the results of the lack of HRH regulation policies which include dentistry. Such reality enhances the health gaps in some country regions and market saturation in major urban centers.(AU)

Os Recursos Humanos em Saúde (RHS) são considerados fundamentais para a organização dos sistemas de saúde e para as condições de saúde de uma população, nesse contexto o objetivo desse trabalho é 1) identificar a situação atual da distribuição geográfica de dentistas brasileiros 2) identificar e analisar a percepção e motivações de dentistas brasileiros que migraram para o interior do país. Foi utilizada a abordagem de estudo de caso e os dados foram coletados a partir de diferentes fontes (Conselho Federal de Odontologia, Sistema de Indicadores das Graduações em Saúde, Geocapes, Instituto Brasileiro de Geografia e Estatística), utilizando o método misto, a partir do modelo exploratório sequencial quantitativo-qualitativo, a fase qualitativa foi analisada por meio da abordagem da "teoria fundamentada". Os achados apontam que o país apresenta um grande estoque de dentista, e que houve uma grande expansão nos últimos anos, no entanto este apresenta-se mal distribuídos pelo território, principalmente quando analisado as diferenças entre o interior e as capitais do país. A categoria central da teoria fundamentada foi "As oportunidades mudando os caminhos para consolidar o profissional", as entrevistas apontam que o local de nascimento dos dentistas e as oportunidades durante sua trajetória profissional foram decisivas para determinar a distribuição de dentistas no território brasileiro. Conclui-se, que o Brasil apresenta estoque de força de trabalho em odontologia, porém enfrenta os resultados da falta de políticas de regulação de RHS, que inclua a odontologia. Essa realidade acentua os vazios sanitários em algumas regiões do país e saturação do mercado nos grandes centros.(AU)

Characterization of dental dust particles and their pathogenicity to respiratory system: a narrative review.

OBJECTIVES: Dental professionals are exposed to large amounts of dust particles during routine treatment and denture processing. This article provides a narrative review to investigate the most prevalent dust-related respiratory diseases among dental professionals and to discuss the effects of dental dust on human respiratory health. MATERIALS AND METHODS: A literature search was performed in PubMed/Medline, Web of Science, and Embase for articles published between 1990 and 2022. Any articles on the occupational respiratory health effects of dental dust were included. RESULTS: The characterization and toxicity evaluation of dental dust show a correlation between dust exposure and respiratory system injury, and the possible pathogenic mechanism of dust is to cause lung injury and abnormal repair processes. The combination use of personal protective equipment and particle removal devices can effectively reduce the adverse health effects of dust exposure. CONCLUSIONS: Dental dust should be considered an additional occupational hazard in dental practice. However, clinical data and scientific evidence on this topic are still scarce. Further research is required to quantify dust in the dental work environment and clarify its pathogenicity and potential toxicological pathways. Nonetheless, the prevention of dust exposure should become a consensus among dental practitioners. CLINICAL RELEVANCE: This review provides dental practitioners with a comprehensive understanding and preventive advice on respiratory health problems associated with dust exposure.

Effect of the COVID-19 pandemic on depression, perceived stress and hypochondria of frontline dental staff (FDS): A cohort study.

BACKGROUND: The coronavirus 2019 (COVID-19) pandemic had several mental effects on medical staff. OBJECTIVE: This study intended to evaluate deviations in Frontline Dental Staff (FDS) depression, perceived stress and hypochondria during the COVID-19 outbreak, and to assess whether the existence of potential risk-factors influenced these symptoms over time. METHODS: This prospective cohort study surveyed FDS three periods from February 1, 2021 to April 8, 2022. FDSs' mental health was assessed through Beck Depression Inventory, Cohen Perceived Stress and the Evans Self-Illness Questionnaires; multivariate linear regression were used to identify potential factors associated with changes on each outcome (depression, perceived stress and hypochondria) over time. All analyses were performed in STATA ver. 14. RESULTS: In a total of 635 FDS, about 69%, 83%, and 71% reported relative depression, 77%, 87%, and 64% reported moderate to high stress level, and 60%, 76% and 74% reported moderate hypochondriac from first, second, and third survives, respectively. The mean and standard deviation of the variables increased dramatically at second survive (July 17 to October 21, 2021) and decreased again at third survive significantly. Being female, working in public sector, and low socioeconomic level were main predictors of higher levels of depression (p < 0.001) and perceived stress (p < 0.001). Perceived stress was a strong predictor of high-level depression (t  =  7.79, p < 0.001). CONCLUSION: FDSs' depression, stress and hypochondria were high and positively associated with being female, working in public-sector, and low socioeconomic level. To increase the effectiveness and decrease work burnout, psychological support should be provided.

Dentist Empathic Accuracy Is Associated With Patient-Reported Reassurance.

OBJECTIVES: The aim of this work was to determine dentists' ability to accurately estimate patients' anxiety level during dental treatment (ie, "empathic accuracy") and to determine the strength of the association between empathic accuracy and patient-reported reassurance. METHODS: A cross-sectional study was conducted amongst 177 adult patients who underwent different invasive dental procedures (ie, extractions or procedures requiring injections and drilling) performed by 10 different dentists from 3 dental offices in the Netherlands. Patients reported their anxiety level during treatment and the extent to which they felt reassured by the dentist using a visual analogue scale (VAS). Simultaneously, the dentists estimated patients' anxiety level. Empathic accuracy was calculated as an absolute difference between patient-reported anxiety (100-point VAS) and dentist estimation of anxiety (100-point VAS). RESULTS: Agreement between dentists' assessment of patients' anxiety and patient-reported anxiety proved good, intraclass correlation coefficient (177) = 0.63; 95% confidence interval [CI], 0.53-0.71. A small to medium-sized positive correlation, r (177) = 0.15; 95% CI, 0.00-0.29, was found between dentists' empathic accuracy and patient-reported reassurance. A negative correlation was found between empathic accuracy and patients' anxiety scores, r (177) = -0.23; 95% CI, -0.38 to -0.09. CONCLUSIONS: Given that greater empathic accuracy was associated with higher patient-reported reassurance during treatment, training young dental professionals in empathic accuracy might help patients feel reassured. Importantly, our results also suggest that with elevated levels of patient anxiety it is increasingly challenging for dentists to recognise this emotion, and thus support the patient in anoptimal manner.

Does the presence of oral health teams influence the incidence of ventilator-associated pneumonia and mortality of patients in intensive care units? Systematic review.

AIMS: To verify whether oral health teams influence the oral health status, ventilator-associated pneumonia incidence and mortality rate of patients in Intensive Care Units (ICU). MATERIALS AND METHODS: Bibliographic searches were performed in PubMed, Scopus, Web of Science, Lilacs, Embase, Livivo, Open Grey, Academic Google, and Cochrane databases. The assessment of the methodological quality and risk of bias of the included studies and a random-effects meta-analysis to summarize relative risk data for ventilator-associated pneumonia (VAP) and mortality were performed. An analysis of the certainty of the evidence was performed for the main outcomes analyzed. RESULTS: Records of 518 studies were analyzed by reading titles and abstracts. Five studies were included according to eligibility criteria. The meta-analysis showed that ICU patients undergoing dental care by an oral health team had a lower incidence of VAP (OR = 0.33; 95% CI: 014-0.76) but did not lower mortality rates (OR = 0.46 95% CI: 0.16-1.32). The certainty of the evidence was considered very low. CONCLUSION: Dental care provided by oral health teams in a hospital environment did not influence oral health status or mortality, although it contributed to a reduction in VAP of patients admitted to the ICU.

Dental clinicians recognizing signs of dental anxiety: a grounded theory study.

INTRODUCTION AND OBJECTIVE: There is a knowledge gap in how dental clinicians recognise dental anxiety. The aim of this study was to identify, describe and generate concepts regarding this process. MATERIALS AND METHODS: Eleven semi-structured interviews were conducted with dental clinicians from the public dental service of Östergötland, Sweden. Purposive and theoretical sampling was used. Theoretical saturation was reached after eight interviews. The interviews were audio-recorded and transcribed verbatim. Classical grounded theory was used to inductively analyse data by constant comparative analysis. RESULTS: The core category was identified as; 'the clinical eye', clinicians noticing behaviours possibly due to dental anxiety based on their knowledge, experiences, or intuition. The core category comprises the five categories: Sympathetic activation, Patient-reported anxiety, Controlling behaviours, Avoidance and Accomplishment. Initially there is usually uncertainty about whether a behaviour is due to dental anxiety or part of a patient's normal behaviour. To gain additional certainty, clinicians need to recognise a stressor as something in the dental setting by observing a change in behaviour, for better or for worse, in the anticipation, presence or removal of the stressor. CONCLUSIONS: Clinicians identify patients as dentally anxious if their behaviour changes with exposure to a stressor.

Síntomas depresivos y grado de resiliencia durante el internado estomatológico en Perú / Depressive symptoms and degree of resilience during stomatological internship in Peru

Introducción: El internado odontológico tiene como principal objetivo permitir al alumno tomar contacto con un ambiente hospitalario. Sin embargo, se reportan algunos problemas que lo desmotivan y sobresaturan. Objetivo: Determinar la relación de la resiliencia y los síntomas depresivos en internos de Odontología. Métodos: Estudio transversal y observacional. La muestra estuvo conformada por 51 estudiantes, que cursaban el internado hospitalario en Lima, Perú (noviembre de 2019). Se utilizó la escala de autoevaluación para la depresión (10 ítems, respuestas Likert con puntuación del 1 a 4) y la escala de resiliencia (14 ítems, respuestas Likert con puntuación del 1 a 7). Las puntuaciones fueron relacionadas a través de la correlación de Spearman; mientras que el Odds ratio se utilizó para estimar la asociación entre la presencia de depresión, la resiliencia alta y el sexo. Resultados: La puntuación promedio de los síntomas depresivos fue de 21,62 ± 2,55, siendo mayor en los varones (22,52 ± 2,27). No se encontró correlación entre las puntuaciones de los síntomas depresivos y la resiliencia (p = 0,082). Los varones presentaron mayor riesgo de síntomas depresivos (OR = 2,143 IC95 por ciento:1,065 - 4,313). No se encontró asociación significativa en la presencia de resiliencia alta y el sexo (p = 0,087). Conclusiones: El 40 por ciento de los internos presentó síntomas depresivos, siendo más frecuente en varones, mientras que un 80 por ciento presentó resiliencia alta, más frecuentes en mujeres. No se encontró correlación entre las puntuaciones de los síntomas depresivos y la resiliencia(AU)

Introduction: The main objective of the dental internship is to allow the student to make contact with a hospital environment. However, some problems are reported that demotivate and oversaturate students. Objective: Determine the relationship between resilience and depressive symptoms in dental interns. Methods: Cross-sectional and observational study. The sample was made up of 51 students, who were in the hospital insternishp in Lima, Peru (November 2019). The self-assessment scale for depression (10 items, Likert responses with a score from 1 to 4) and the resilience scale (14 items, Likert responses with a score from 1 to 7). The scores were related through the Spearman correlation; while the Odds ratio was used to estimate the association between the presence of depression, high resilience and sex. Results: The mean score for depressive symptoms was 21.62 ± 2.55, higher in men (22.52 ± 2.27). No correlation was found between depressive symptom scores and resilience (p = 0.082). Males were at increased risk of depressive symptoms (OR=2.14395 percent CI: 1.065-4.313). No significant association was found in the presence of high resilience and sex (p = 0.087). Conclusions: 40 percent of the interns presented depressive symptoms, being more frequent in men, while 80 percent presented high resilience, more frequent in women. No correlation was found between depressive symptom scores and resilience(AU)

Relationship Between Mental Health and Death Anxiety During COVID-19 Pandemic in Dental Staff and Students: A Cross-Sectional Study.

Objective: We aimed to determine the mental health and death anxiety among dental staff and students in school of dentistry during COVID-19 pandemic. Methods: It was a cross-sectional study among students (n = 300) and staff (n = 60) in School of dentistry in Ahvaz University of Medical Sciences during 2020. The instruments were a demographic questionnaire, Death Anxiety Scale, and Kessler Questionnaire. Data was analyze by using SPSS version 22, in all tests, the significance level was set at <0.05. Results: The mean age of dental students and personnel was 23.96 and 40.08 years, respectively. The mean scores of death anxiety were higher in dental staff (8.53) than students (6.02) and the mean scores of mental health status were higher in students (14.78) than personnel (9.18). This indicates that death anxiety was higher in Dental staff, while students were in better mental health status. The correlation coefficient between death anxiety and mental health status was 0.366 among students (p < 0.001), while it was 0.429 among dental staff (p < 0.001), showing a medium relationship between death anxiety and mental health in both groups. Conclusion: The overall findings represent a significant but contradictory relationship between mental health status and death anxiety among dental staff and students during the prevalence of COVID-19 pandemic. This suggests the impact of confounding factors in this area, which can be studied by future researchers and policy makers to design health promotion interventions.

Aerosol exposure of staff during dental treatments: a model study.

BACKGROUND: Due to exposure to potentially infectious aerosols during treatments, the dental personnel is considered being at high risk for aerosol transmitted diseases like COVID-19. The aim of this study was to evaluate aerosol exposure during different dental treatments as well as the efficacy of dental suction to reduce aerosol spreading. METHODS: Dental powder-jet (PJ; Air-Flow®), a water-cooled dental handpiece with a diamond bur (HP) and water-cooled ultrasonic scaling (US) were used in a simulation head, mounted on a dental unit in various treatment settings. The influence of the use of a small saliva ejector (SE) and high-volume suction (HVS) was evaluated. As a proxy of aerosols, air-born particles (PM10) were detected using a Laser Spectrometer in 30 cm distance from the mouth. As control, background particle counts (BC) were measured before and after experiments. RESULTS: With only SE, integrated aerosol levels [median (Q25/Q75) µg/m3 s] for PJ [91,246 (58,213/118,386) µg/m3 s, p < 0.001, ANOVA] were significantly increased compared to BC [7243 (6501/8407) µg/m3 s], whilst HP [11,119 (7190/17,234) µg/m3 s, p > 0.05] and US [6558 (6002/7066) µg/m3 s; p > 0.05] did not increase aerosol levels significantly. The use of HVS significantly decreased aerosol exposure for PJ [37,170 (29,634/51,719) µg/m3 s; p < 0.01] and HP [5476 (5066/5638) µg/m3 s; p < 0.001] compared to SE only, even reaching lower particle counts than BC levels for HP usage (p < 0.001). CONCLUSIONS: To reduce the exposure to potentially infectious aerosols, HVS should be used during aerosol-forming dental treatments.

Workforce Planning Models for Oral Health Care: A Scoping Review.

BACKGROUND: For health care services to address the health care needs of populations and respond to changes in needs over time, workforces must be planned. This requires quantitative models to estimate future workforce requirements that take account of population size, oral health needs, evidence-based approaches to addressing needs, and methods of service provision that maximize productivity. The aim of this scoping review was to assess whether and how these 4 elements contribute to existing models of oral health workforce planning. METHODS: A scoping review was conducted. MEDLINE, Embase, HMIC, and EconLit were searched, all via OVID. Additionally, gray literature databases were searched and key bodies and policy makers contacted. Workforce planning models were included if they projected workforce numbers and were specific to oral health. No limits were placed on country. A single reviewer completed initial screening of abstracts; 2 independent reviewers completed secondary screening and data extraction. A narrative synthesis was conducted. RESULTS: A total of 4,009 records were screened, resulting in 42 included articles detailing 47 models. The workforce planning models varied significantly in their use of data on oral health needs, evidence-based services, and provider productivity, with most models relying on observed levels of service utilization and demand. CONCLUSIONS: This review has identified quantitative workforce planning models that aim to estimate future workforce requirements. Approaches to planning the oral health workforce are not always based on deriving workforce requirements from population oral health needs. In many cases, requirements are not linked to population needs, while in models where needs are included, they are constrained by the existence and availability of the required data. It is critical that information systems be developed to effectively capture data necessary to plan future oral health care workforces in ways that relate directly to the needs of the populations being served. KNOWLEDGE TRANSFER STATEMENT: Policy makers can use the results of this study when making decisions about the planning of oral health care workforces and about the data to routinely collect within health services. Collection of suitable data will allow for the continual improvement of workforce planning, leading to a responsive health service and likely future cost savings.

Identificación de factores asociados a la pérdida de capacidad auditiva en estudiantes, docentes y auxiliares de odontología / Identification of factors associated with hearing loss in teaching, students and dental assistants

Introducción: La exposición continua al ruido en el ambiente laboral, generado durante la atención clínica, afecta la capacidad auditiva del personal del área de odontología. No obstante, hay otras características que pudieran estar asociadas a una mayor expresión de esta condición. Objetivo: Identificar factores asociados a capacidad auditiva en estudiantes, docentes y auxiliares de una facultad de odontología. Material y Métodos: Estudio analítico de corte transversal; se seleccionaron aleatoriamente los participantes y se excluyeron personas con diagnóstico clínico de pérdida auditiva hereditaria o previa al inicio del ejercicio profesional o estudiantil. Se realizaron mediciones del ruido en el ambiente laboral y valoraciones audiométricas. Se evaluó asociación entre capacidad auditiva y las variables independientes con Chi2 o Test Exacto de Fisher (significancia estadística p<0,05). Se propone un modelo predictivo para pérdida de capacidad auditiva. Resultados: 193 participantes fueron incluidos, el 35,8% presentaron disminución leve o moderada de su capacidad auditiva (37,2% estudiantes y 30% en docentes-auxiliares). No hubo diferencias entre estudiantes y docentes/auxiliares ni entre el oído derecho e izquierdo. Conclusión: Los años de experiencia clínica, el semestre cursado y el antecedente de tinnitus predicen la aparición de pérdida de capacidad auditiva (AU)

Introduction: Continuous exposure to noise in the work environment, generated during clinical care, affects the hearing capacity of dental staff. However, there are other characteristics that could be associated with a greater expression of this condition. Objective: Identify factors associated with hearing capacity in students, teachers and assistants of a dental school. Material and Methods: Analytical cross-sectional study; participants were randomly selected and people with a clinical diagnosis of hereditary hearing loss or prior to the start of professional or student practice were excluded. Noise measurements were made in the work environment and audiometric evaluations. The association between hearing capacity and the independent variables was evaluated with Chi2 or Fisher’s Exact Test (statistical significance p <0.05). A predictive model for hearing loss is proposed. Results: 193 participants were included, 35.8% had a slight or moderate decrease in their hearing capacity (37.2% students and 30% in teaching assistants). There were no differences between students and teachers / assistants or between the right and left ears. Conclusion: The years of clinical experience, the semester attended and the history of tinnitus predict the appearance of hearing loss (AU)