Odontologia para Pacientes com Necessidades Especiais: uma análise das estruturas curriculares dos cursos de Odontologia da região Nordeste / Dentistry for Patients with Special Needs: an analysis of the curricular structures of Dentistry courses in the Northeast region

O estudo objetivou analisar as estruturas curriculares dos cursos de Odontologia da região Nordeste e investigar a presença do componente curricular Odontologia para Pacientes com Necessidades Especiais(OPNE). Trata-se de um estudo seccional, descritivo e quantitativo. Os dados foram coletados entre junho e dezembro de 2020 no sítio eletrônico do Ministério da Educação (e-MEC) e nos portaisdas instituições de ensino identificadas,comanálise das estruturas curriculares dos cursos. Havia138 cursos de Odontologia autorizados e cadastrados na plataformaedestes, seteforam excluídos por ausência de portal atualizado ou por ainda não ter formado pelo menos umaturma. Dos 131 cursos de graduação em Odontologia analisados, verificou-se que 62 IES (47,30%) ofertavam o componente OPNE, dentre as quais53 (40,50%) o ofertavam como componente obrigatório.O estado da Paraíba apresentou a maior frequência (n=13, 86,7%) de cursos que ofertam o componente curricular, enquanto o estado de Sergipe obteve a menor frequência (n=1, 16,7%).Conclui-se que o componente curricular OPNE é pouco ofertado nos cursos de graduação em Odontologia na região Nordeste,o que pode impactardiretamente na capacitação dos profissionais para prestar um melhor cuidado de saúde bucal para essa população (AU).

The study aimed to analyze the curricular structures of the Dentistry courses in the Northeast region and investigate the curricular component named DPSN (Dentistry for Patients with Special Needs). This is a sectional, descriptive and quantitative study. The data were collected between June and November 2020 on the Ministry of Education's (e-MEC) website and the educational institutions' portals identified by analyzing the curricular structures of the courses. There were 138 authorized Dentistry courses registered on the platform; and, of these, seven were excluded for lack of an updated portal or for not having at least one formed class. Of the 131 analyzed undergraduate courses in Dentistry, it was found that 62 HEI (47.30%) offered the DPSN component, among which 53 (40.50%) offered it as a compulsory component. The state of Paraíba showed the highest frequency (n=13, 86.7%) of the courses offering the curricular component, while the state of Sergipe obtained the lowest frequency (n=1, 16.7%). It is concluded that the DPSN curricular component islittle offered in the undergraduate courses in Dentistry in the Northeast region and directly impacts professionals' training to provide better oral health care for this population (AU).

Aspectos clínicos e demográficos de pessoas com deficiência atendidas em uma clínica-escola de Odontologia / Clinical and demographic characteristics of people with disabilities attending a dental teaching clinic

O objetivo deste artigo foi descreveras característicasclínicase demográficasde pessoas com deficiência atendidas em uma clínica-escolade Odontologia do Nordeste brasileiro, relacionando estes perfis àsnecessidades acumuladas e aos tratamentos realizados no período de marçoa julho de 2019. Tratou-se de um estudode análise de banco de dados no qualforam avaliadosos prontuários em relação a sexo, idade, diagnóstico médico, uso de medicamentos, motivo da consulta e tratamentos realizados. Foi utilizada uma amostra deconveniência de 55 prontuários,referentes aos indivíduos em atendimento neste período.Os testes Qui-quadrado e exato de Fisher foram utilizados para verificar associação entre as variáveis estudadas. Foi adotado o intervalo de confiança de 95% e a margem de erro de 5%.Verificou-se queamaioria dos pacientes erado sexo masculino(52,7%)e possuíaentre20 e59 anos(54,5%).As patologias de base de maior prevalênciaforam as doenças sistêmicas (34,5%)e deficiência intelectual (32,7%). Em relação às medicações, 80% faziamuso contínuo de algum fármaco. A respeito das consultas odontológicas, a procurade 60% da amostrafoi por motivo de dor e os procedimentos mais realizados, os restauradores (63,6%).Além disso, a estabilização física e sedação medicamentosa foram amplamente utilizadas nos pacientes com deficiência intelectual.Oatendimento odontológico incluiu pacientes com diversas necessidades especiais e, apesar da clínica-escola em questão priorizar a conduta preventiva, a maior parte dos procedimentos executados foi curativo, podendo estar relacionado com a procura tardia pelo tratamento odontológicoe dificuldades de acesso (AU).

The aim of this article was to describe the clinical and demographic characteristics of people with disabilities attending a dental teaching clinic in northeastern Brazil, and to associate these profiles with the cumulative needs and treatments performed from March to July 2019. This was a database study in which sex, age, medical diagnosis, medication use, reason for consultation, and previous treatments obtained from the medical records were evaluated. A convenience sample of 55 records from patients seen during this period was used. The chi-square test and Fisher's exact test were applied to evaluate the association between the variables studied, adopting a 95% confidence interval and an error margin of 5%. Most patients were male (52.7%) and were between 20 and 59 years old (54.5%). The most prevalent underlying diseases were systemic diseases (34.5%) and intellectual disability (32.7%). Regarding medications, 80% of the patients continuously used some drug. The reason for consultation was pain in 60% of the sample and restorative procedures were the most frequently performed (63.6%). Moreover, patients with intellectual disability commonly required physical restraint and sedatives. The dental consultations comprised patients with different special needs. Although the teaching clinic prioritizes preventive management, most of the procedures performed were curative, a fact that might be related to the late seeking of dental treatment and difficulties of accessing health services (AU).

COVID-19 e atenção a pessoas com deficiência e grupos especiais na clínica-escola de Odontologia / COVID-19 and assistance to people with disabilities and special groups in dental school clinic

O presente artigo tem como finalidade abordar orientações e sugestões para o atendimento odontológico de pacientes com necessidades especiais(pessoas com deficiência)e idosos nas clínicas de graduação, considerando as implicações daCOVID-19.A partir da publicação de orientações nacionais e internacionais de biossegurança, cuidados em saúde bucal e condutas odontológicas, foram elaboradasdiretrizespara esta abordagem clínica.Espera-se a disseminação do conhecimento, informações e adaptações necessárias no ensino para uma melhor assistência e contribuição educacional aos graduandos, além da realização das atividades práticas de maneira segura no ambiente universitário (AU).

The aim of the currentarticle is toaddress the guidelines and suggestions for dental care of patients with special needs (people with disabilities) and elderly in undergraduate dental clinicsbytaking into account the impacts caused bythe COVID-19 pandemic. Guidelines for the Special Care Dentistry clinical approach were developed based on the publication of national and international guidelines on biosafety, oral health care,and dental procedures. Knowledgeandinformationpromotion,and the necessary adaptations in teaching areexpected to allowbetter assistance and educational contribution to undergraduate students, in addition to performingpractical activities ina safer wayin collegeenvironment (AU).

Perfil dos endodontistas de uma metrópole brasileira quanto ao atendimento odontológico a pacientes com necessidades especiais / Profile of endodontists in a Brazilian metropolis regarding dental care for patients with special needs

O objetivo do estudo foi caracterizar o perfil dos endodontistas do estado de São Paulo, Brasil em relação ao tratamento odontológico depacientes com necessidades especiais (PNE). Um questionário onlinesobre capacitação do profissional e dados sobre o atendimento odontológico de PNEfoi enviado para 3.500 endodontistas registrados no Conselho Regional de Odontologia de São Paulo. Dentre os 138 profissionais que retornaram, 57,2% eram do sexo feminino; 34,8% estavam na faixa etária entre 31e 40 anos; 42,8% tinham entre 11 e20 anos de formados; e 38,4% possuíam 11 a 20 anos de especialidade. Apenas 22,5% eram capacitados para o atendimento de PNE, sendo que desses, 58,1% tiveram apenas aula teórica. Dos que não receberam capacitação na pós-graduação, 80,4% gostariam de ter recebido. Com relação ao interesse em cursos de atendimento a PNE após a especialização, observou-se que apenas 15,9% realizaram algum tipo de curso, a maioria apenas teórico. Em relação às dificuldades durante o atendimento de PNEa "falta de colaboração do paciente durante o atendimento" foi citada por 74,6%, a "insegurança devido àfalta de preparo profissional" por 55,0%. A análise da associação das variáveis pelo teste Qui-quadrado apontou que quanto maior o tempo de formação, menor essa dificuldade (p=0,0415). Os especialistas encontram mais dificuldades comparados aos que tem formação associada (mestrado e doutorado) (p=0,0369). Não houve associação significativa entre as dificuldades e o tipo de instituição de formação(pública ou privada) (p>0,05). O panorama atual da formação do endodontista não contempla o atendimento as pessoas com necessidades especiais (AU).

The aim of this study was to characterize the profile of endodontic professionals from the state of São Paulo, Brazil in relation to dental treatment for patients with special needs (PSN). An online questionnaire on professional training and data on PSN dental care was sent to 3,500 endodontic professionals registered with the São Paulo Regional Dental Council in 2017. Of the 138 returning professionals, 57.2% were female; 34.8% aged 31-40 years; 42.8% had 11-20 years since graduation; 38.4% had 11-20 years of endodontic specialization. Only 22.5% were trained to provide dental care to PSNs and of these, 58.1% had only theoretical classes. Of those who did not receive post-graduation training, 80.4% would like to have received it. Regarding the interest in PSN care courses after specialization, it was observed that only 15.9% performed some type of course, most of them theoretical only. Regarding difficulties during PSN care, "lack of patient collaboration during care" was mentioned by 74.6%, and "insecurity due to lack of professional preparation" by 55.0%. The analysis of the association of variables by the Chi-square test showed that the longer the training time, the lower the difficulty during PSN care (p=0.0415). Specialists find more difficulties compared to those with associated training (masters and doctorate) (p=0.0369). There was no significant association between difficulties in PSN care and typeof HEI (public or private) (p> 0.05). The current panorama of endodontic professional training does not seem to include care for patients with special needs (AU).

Dental Students' Attitudes About Treating Populations That Are Low-Income Rural, Non-White, and with Special Needs: A Survey of Four Classes at a U.S. Dental School.

The aim of this study was to explore dental students' attitudes about treating populations that are low-income rural, non-white, and with special needs. All 259 students in all four years at one U.S. dental school were invited in January 2018 to participate in a survey with questions about treating these three populations in the following areas: personal value, perceived preparedness, comfort, future intent to treat, and professional responsibility. A total of 227 students completed the survey, for an overall 87.6% response rate. By class, participants were as follows: D1 n=63, 100% response rate; D2 n=60, 98.4% response rate; D3 n=67, 98.5% response rate; and D4 n=37, 53.6% response rate. The results showed that dental school class did not predict willingness to treat the specified populations. Regarding populations that are rural and non-white, personal value and professional responsibility significantly correlated with intent to treat. Women perceived stronger professional responsibility regarding treatment of populations that are low-income rural (M=1.97, SD=1.09; p=0.004) and non-white (M=1.95, SD=1.07; p=0.013) than did men (M=2.44, SD=1.23; M=2.34, SD=1.22, respectively). More advanced students reported greater preparedness regarding populations that are rural and non-white, but not patients with special needs. Preparedness correlated with intent to treat for patients with special needs only. Women were less comfortable than men in treating patients with special needs (χ2=6.10, p=0.014). Hometown residence had a limited effect for patients with special needs only. Rural residence did not predict students' attitudes about serving rural patients. Overall, the students reported positive intentions to serve populations that are low income, but showed less confidence and willingness in treating patients with special needs, especially among women. These results suggest that the students' comfort in serving patients with low income was more static and less malleable than preparedness. As preparedness and personal value were positively correlated, students may have found worthwhile what they felt prepared to do.

Parental Satisfaction with Ambulatory Anesthesia during Dental Treatment for Disabled Individuals and Their Preference for Same in Future.

The purpose of this study was to survey parental satisfaction with ambulatory anesthesia during dental treatment in disabled patients. Factors associated with parental preference for general anesthesia during future dental treatment in such patients were also investigated. A questionnaire was mailed to the parents of 181 disabled individuals who underwent dental treatment under ambulatory anesthesia at Tokyo Dental College Suidobashi Hospital between 2012 and 2016. A total of 71 responses were received (39.2%). The mean patient age was 18 years, and disabilities included autism spectrum disorder, intellectual disability, cerebral palsy, and epilepsy. The items surveyed included dental treatment details, number of times patients received general anesthesia, type of anesthetic used, anesthesia induction method, durations of treatment and anesthesia, and the presence or absence of intraoperative or postoperative complications. Questionnaire items queried problems related to dental care, anesthesia history, preoperative anxiety, length of fasting period, induction of general anesthesia, nursing and hospital room environment, postoperative anxiety, overall evaluation, and whether the parent would prefer general anesthesia during future dental treatment. The patients were divided into 2 groups: those whose parents preferred general anesthesia during future dental treatment and those whose parents did not. The results revealed that, where disabled individuals had previously received general anesthesia during dental treatment, the parents were more likely to prefer general anesthesia during future dental treatment.

Effectiveness of an Educational Module on Dental Hygiene Students' Attitudes Towards Persons with Disabilities.

Purpose: Persons with disabilities (PWDs) perceive gaps in health care providers' understanding of their health care needs are more likely to delay or not seek health care as compared to persons without disabilities. Oral health is considered an essential component of overall health, however, disparities exist in the United States, especially for persons with disabilities. Improving the education and training of dentists and dental hygienists may contribute to reducing oral health care barriers for PWDs. The purpose of this study was to investigate whether offering an education module about individuals with disabilities would change dental hygiene students' attitudes and capacity for informed empathy for PWDs.Methods: An educational module utilizing a DVD featuring authentic representation of PWDs, along with student discussions and self-reflection was developed and delivered to 165 (n=165) dental hygiene students attending a 2-year community college and a 4-year university. Students consenting to participate in the study were assessed regarding their attitudes and comfort towards caring for PWDs prior to, and following the educational module. Pre- and post-assessment measures included the validated Attitude Toward Disabled Persons, and Attitudes toward Patient Advocacy Microsocial (AMIA) scale. The Interpersonal Reactivity Index (IRI) was used as a pre-assessment measure.Results: A total of 58 (n=58) dental hygiene students, 35 (n=35) from a 4-year university and 23 (n=23) from a 2-year community college, consented for this study, for an overall participation rate of 35%. Scores increased significantly for both student groups after delivering the education module on the AMIA patient advocacy scale. Differences in IRI scores between the 2-year and 4-year dental hygiene programs approached statistical significance.Conclusion: An education module based on informed empathy with a focus on the experiences of PWDs can result in improved attitudes toward advocacy for this population.

Impact of Dental Rehabilitation on Oral Health-related Quality-of-life in Healthy Children and Those with Special Health Care Needs.

Aim: The aim of this study is to compare the effect of dental rehabilitation on oral health-related quality-of-life (OHRQoL) in children with special health care needs (CSHCN) and healthy children. Materials and methods: The prospective study's sample consisted of 213 parents of caries-affected children, who were aged 6 years or younger and were scheduled for dental rehabilitation under general anesthesia (DRGA). The parent-child dyads were recruited from three public hospitals in Jeddah between October 2014 and May 2016. They comprised healthy children (n = 133) and CSHCN (n = 80). Parents self-completed the early childhood oral health impact scale (ECOHIS) before and 1 month after DRGA. The parents also rated the overall oral health status of their children by answering a global question before and after DRGA. Results: At baseline, the CSHCN had significantly worse OHRQoL in most of the scale domains at 25.9 [standard deviation (SD) 11.3] and 19.9 (SD 10.3) respectively. The OHRQoL significantly improved in both groups postoperatively (p = 0.005, Wilcoxon rank-sum test). The effect size of the improvement in the CSHCN group (+1.8) was greater than that in the healthy group (+1.5) in all domains, except for the family impact and parental distress sections. Conclusion: The DRGA markedly improves OHRQoL in children aged 6 years or younger, and the improvement is even greater in CSHCN. Clinical significance: The substantial improvement in OHRQoL after DRGA highlights the importance of oral health care in young children, which should receive higher priority than it has been done to date. Keywords: Children with special health care needs, Dental caries, Early childhood oral health impact scale, General anesthesia, Oral health-related quality-of-life.

A study of special care dental patient preference toward choice of mask and visor use by dental clinicians.

BACKGROUND: Do patients have a preference for the clinician's choice of face protection (visor or mask), and can this make a difference to the patient's feelings of anxiety? METHOD: In a normative sample (n = 72) of patients from Special Care Dentistry, different combinations of face protection were studied to see whether the patients clearly preferred one type over another, and whether that was related to the levels of anxiety they suffered, based on the modified dental anxiety scale. RESULTS: The majority of patients, 68% had the visor only as their first choice of face protection. This was followed by 22% having the mask only as their first choice and 10% having the visor and mask combination as their first choice. Patients with higher anxiety levels were more likely to believe that the type of face protection worn by the dentist would affect their levels of anxiety. CONCLUSION: The patients preferred the visor only option. As the level of anxiety rose, so did the percentage of patients that felt the style of protection worn by the dentist would affect their level of anxiety. The comments from patients referred to the benefit of nonverbal communication offered by the visor.

State, trait, and dental anxiety in caregivers of individuals with disabilities.

PURPOSE: The aim of this study was to compare state anxiety, trait anxiety, and dental anxiety in caregivers of patients with special needs and caregivers of pediatric patients without special needs at dental clinics. MATERIALS AND METHODS: A quantitative, cross-sectional study was conducted. Data were collected using a semistructured questionnaire. All respondents were older than 18 years of age. Individuals with cognitive impairment and those taking anxiolytics, antidepressants, or sleep-inducing medication were excluded from the study. The sample consisted of 55 caregivers of patients with special needs and 55 caregivers of pediatric dental patients. A questionnaire was administered to determine the sociodemographic profile of the patients based on the 2015 Brazilian Economic Classification Criteria. Anxiety regarding dental treatment was measured using the dental anxiety scale. The state-trait anxiety inventory was used to identify state and trait anxiety levels. RESULTS: Caregivers of individuals with disabilities had a similar level of anxiety as caregivers of pediatric dental patients. Most caregivers of individuals with disabilities were mothers with an older age and a greater frequency of trait anxiety, especially when these mothers had health problems. State anxiety was associated with a lower education level. CONCLUSIONS: Higher dental anxiety levels were found among caregivers with a higher level of trait anxiety, independently of the type of patient to which care was given.

Evaluation of Visual Pedagogy in Dental Check-ups and Preventive Practices Among 6-12-Year-Old Children with Autism.

This study was aimed to evaluate the impact of visual pedagogy in dental check-ups and preventive practices among children with autism aged 6-12. In this randomized double-blind clinical trial, the cooperation of 40 children with autism age 6-12. The selected children were equally divided into two groups of case and control (n = 20). The obtained data were analyzed by statistical tests, including Chi square and independent t test. The results of Cochran showed a significant increase in children's cooperation with regard to fluoride therapy in the case group by repeating the visit and training sessions (p ≤ 0.001). The findings of this study demonstrated, visual pedagogy was merely effective in the case of fluoride therapy in the case group.

Specialised dental care for children with complex disabilities focusing on child's functioning and need for general anaesthesia.

PURPOSE: To describe and analyse dental care and treatment modalities for children with complex disabilities from a biopsychosocial perspective, with special focus on dental treatment under general anaesthesia (GA) and its relationship to child's functioning. METHOD: An ICF-CY Checklist for Oral Health was completed using structured interview, direct observations, and dental records for patients attending a specialist paediatric dentistry clinic. Descriptive and comparative data analysis was performed. Performance qualifiers from the ICF-CY component Activities and participation were used to calculate functional factors. RESULTS: Median referral age was 1.5 years and the majority were referred by their paediatrician. Almost all visited a dental hygienist regularly. Dental treatment under GA was common and was combined in 78% of sessions with medical treatment. Children with limitations in their interpersonal interactions and relationships were most likely to have dental GA. CONCLUSION: Children without caries experience had been referred for specialist dental care at an earlier age than children with caries experience. GA was a common treatment modality and dental and medical treatments were coordinated under the same GA for a majority of children. By using the ICF-CY, it was possible to identify functional limitations characterising children with disabilities that require dental treatment under GA. Implications for Rehabilitation Early referral to a specialist in paediatric dentistry is valuable for oral disease prevention in children with disabilities. Availability of dental treatment under general anaesthesia (GA) is also important. Combining dental and medical interventions during the same GA session optimises resources both for the individual and for the health organisation. Children with limitations in interpersonal interactions and relationships are more likely to need dental treatment under GA than other children.

Percepção de estudantes de graduação em Odontologia frente ao atendimento de pessoas com deficiência / Perception of Dental undergraduate students related to the attendance of special needs people or people with disabilities

O objetivo deste estudo foi identificar e analisar a percepção de estudantes frente ao atendimento de pessoas com deficiência no projeto de extensão "Conquistando saúde: atendimento odontológico de pessoas com deficiência" da Universidade Luterana do Brasil (ULBRA), em Canoas/RS. O delineamento do estudo foi qualitativo e envolveu 13 estudantes. Os dados foram obtidos por meio de entrevista semiestruturada realizada no ambulatório do curso de Odontologia por um pesquisador treinado e os dados foram analisados por análise de conteúdo. As questões versavam a respeito do conhecimento em relação a pessoas com deficiência, a motivação para participar do projeto e os sentimentos norteadores dos atendimentos. A maioria dos entrevistados modificou opiniões existentes sobre o que acreditavam ser uma pessoa com deficiência e seus sentimentos prévios aos atendimentos, acrescentando novos conceitos e sentimentos que fomentaram sua construção profissional. A oportunidade de vivenciar o atendimento odontológico de pessoas com deficiências ainda na graduação em Odontologia contribui para a formação de um profissional mais capacitado tanto técnica quanto emocionalmente. Com isto, há ampliação do atendimento, minimizando a dificuldade enfrentada por estes pacientes na busca pelo atendimento odontológico (AU).

This study aimed to identify and to analyze students' perceptions regarding the assistance of people with disabilities in the extension project "Conquering health: dental assistance of people with disabilities", of Universidade Luterana do Brasil (ULBRA) in Canoas/RS. It is a qualitative study developed with 13 students. Data were collected by a trained researcher using semistructured interviews in the Dental College Clinic and were analyzed with content analysis. The questions approached participants' knowledge regarding people with disabilities, their motivations to take part of the project, and feelings guiding their assistance. Most participants changed their opinions about what they believed to be a person with disabilities as well as their previous feelings towards assistance, adding new concepts and feelings that encourage professional performance. The opportunity to deeply experience dental assistance of people with disabilities while attending undergrad dentistry school contributes to the development of better professionals, both technically and emotionally. Therefore, there is an amplification of dental assistance, minimizing difficulties faced by patients with disabilities when looking for dental assistance (AU).

Oral health evaluation in special needs individuals / Avaliação da saúde bucal em pessoas com necessidades especiais

ABSTRACT Objective To identify the prevalence of the main oral problems present in special needs children and to relate the underlying conditions with the clinical and demographic variables. Methods The study was based on the physical examination of 47 students from the Associação de Pais e Amigos dos Excepcionais diagnosed as Down syndrome, cerebral palsy and intellectual deficit. For data collection, we used a self-administered questionnaire that included indices of dental caries and oral hygiene, Angle classification, malposition of dental groups and oral hygiene habits. Results The predominant age group was 12-25 years (46.8%) and most patients were male (55.3%). Regarding daily brushing, 63.8% reported brushing their teeth three times a day, and 85.1% did it by themselves. A total of 48.9% were rated as Angle class I, and 25.5% had no type of malocclusion. A high dental carries index (decayed, missing, filled >10) was observed in 44.7%, and 53.2% had inadequate oral hygiene (zero to 1.16). There was a statistically significant difference between cerebral palsy and the act of the participants brushing their teeth by themselves. Conclusion There was a high decayed-missing-filled teeth index and malocclusion class I, as well as inadequate oral hygiene. The type of underlying condition of the participants influenced the act of brushing teeth by themselves.

RESUMO Objetivo Conhecer a prevalência dos principais problemas bucais em crianças com necessidades especiais, e relacionar as doenças de base com variáveis clínicas e demográficas. Métodos O estudo foi realizado a partir de exame clínico em 47 alunos da Associação de Pais e Amigos dos Excepcionais com diagnóstico médico de síndrome de Down, paralisia cerebral e deficit intelectual. Para a coleta de dados, foi utilizado um questionário autoaplicativo com índices de cárie dentária e higiene oral, classificação de Angle, malposição de grupos dentários e hábitos de higiene oral. Resultados A faixa etária predominante foi de 12 a 25 anos (46,8%) e a maioria era do sexo masculino (55,3%). Em relação à escovação dentária, 63,8% relataram escovar os dentes três vezes ao dia, sendo que 85,1% realizavam-na sozinhos. Constatou-se que 48,9% dos examinados apresentavam uma classificação de Angle tipo I e 25,5% não apresentavam qualquer tipo de maloclusão. Os avaliados (44,7%) apresentaram alto índice de cárie dentária (cariados, perdidos e obturados >10) e 53,2% apresentaram higiene oral inadequada (zero a 1,16). Houve diferença estatisticamente significativa entre a paralisia cerebral e o ato de escovar os dentes sozinho. Conclusão Constataram-se altos índices de cárie e de maloclusão classe I, além de inadequada higiene oral. Houve influência do tipo de patologia de base na realização do ato de escovar os dentes sozinhos.

An Exploration of Dental Students' Assumptions About Community-Based Clinical Experiences.

The aim of this study was to ascertain which assumptions dental students recalled feeling prior to beginning community-based clinical experiences and whether those assumptions were fulfilled or challenged. All fourth-year students at the University of Iowa College of Dentistry & Dental Clinics participate in community-based clinical experiences. At the completion of their rotations, they write a guided reflection paper detailing the assumptions they had prior to beginning their rotations and assessing the accuracy of their assumptions. For this qualitative descriptive study, the 218 papers from three classes (2011-13) were analyzed for common themes. The results showed that the students had a variety of assumptions about their rotations. They were apprehensive about working with challenging patients, performing procedures for which they had minimal experience, and working too slowly. In contrast, they looked forward to improving their clinical and patient management skills and knowledge. Other assumptions involved the site (e.g., the equipment/facility would be outdated; protocols/procedures would be similar to the dental school's). Upon reflection, students reported experiences that both fulfilled and challenged their assumptions. Some continued to feel apprehensive about treating certain patient populations, while others found it easier than anticipated. Students were able to treat multiple patients per day, which led to increased speed and patient management skills. However, some reported challenges with time management. Similarly, students were surprised to discover some clinics were new/updated although some had limited instruments and materials. Based on this study's findings about students' recalled assumptions and reflective experiences, educators should consider assessing and addressing their students' assumptions prior to beginning community-based dental education experiences.

Dental Students' Clinical Expectations and Experiences Treating Persons with Disabilities.

Persons with disabilities (PWDs) have a disproportionate level of dental disease relative to the general population. Access to care is a cause along with dentists' willingness to treat PWDs. The aim of this study was to investigate the expectations and experiences of dental students in providing treatment to these patients in a hospital-based dental clinic for PWDs. Senior dental students at the Faculty of Dentistry, University of Toronto (n=92) were surveyed prior to (Phase I) and at the end of (Phase II) mandatory clinical rotations at the Mount Sinai Hospital's Dentistry Clinic for Persons with Special Needs. Response rates were 88% for Phase I and 58% for Phase II. Before the rotations, 70% of the respondents reported little or no experience with PWDs, and 46% said they did not feel comfortable providing basic dental treatment to PWDs. However, in Phase II, significantly more students reported being comfortable than in Phase I (p=0.001). Overall, the majority of respondents (Phase I 95%; Phase II 98%) indicated they would at least attempt to provide basic dental care to PWDs after graduation. The majority also identified the opportunity to provide care and interact with PWDs as the most enjoyable aspect of their experience at the clinic. They reported that the experience helped reduce their concerns about treating PWDs including being more realistic about the time required and ideal quality of the treatment they could provide. These results suggest that their experience in the clinic significantly increased students' comfort in treating PWDs. The respondents expressed a willingness to treat PWDs once graduated and generally identified their experience as being more positive than their expectations.

Oral health evaluation in special needs individuals.

OBJECTIVE: To identify the prevalence of the main oral problems present in special needs children and to relate the underlying conditions with the clinical and demographic variables. METHODS: The study was based on the physical examination of 47 students from the Associação de Pais e Amigos dos Excepcionais diagnosed as Down syndrome, cerebral palsy and intellectual deficit. For data collection, we used a self-administered questionnaire that included indices of dental caries and oral hygiene, Angle classification, malposition of dental groups and oral hygiene habits. RESULTS: The predominant age group was 12-25 years (46.8%) and most patients were male (55.3%). Regarding daily brushing, 63.8% reported brushing their teeth three times a day, and 85.1% did it by themselves. A total of 48.9% were rated as Angle class I, and 25.5% had no type of malocclusion. A high dental carries index (decayed, missing, filled >10) was observed in 44.7%, and 53.2% had inadequate oral hygiene (zero to 1.16). There was a statistically significant difference between cerebral palsy and the act of the participants brushing their teeth by themselves. CONCLUSION: There was a high decayed-missing-filled teeth index and malocclusion class I, as well as inadequate oral hygiene. The type of underlying condition of the participants influenced the act of brushing teeth by themselves. OBJETIVO: Conhecer a prevalência dos principais problemas bucais em crianças com necessidades especiais, e relacionar as doenças de base com variáveis clínicas e demográficas. MÉTODOS: O estudo foi realizado a partir de exame clínico em 47 alunos da Associação de Pais e Amigos dos Excepcionais com diagnóstico médico de síndrome de Down, paralisia cerebral e deficit intelectual. Para a coleta de dados, foi utilizado um questionário autoaplicativo com índices de cárie dentária e higiene oral, classificação de Angle, malposição de grupos dentários e hábitos de higiene oral. RESULTADOS: A faixa etária predominante foi de 12 a 25 anos (46,8%) e a maioria era do sexo masculino (55,3%). Em relação à escovação dentária, 63,8% relataram escovar os dentes três vezes ao dia, sendo que 85,1% realizavam-na sozinhos. Constatou-se que 48,9% dos examinados apresentavam uma classificação de Angle tipo I e 25,5% não apresentavam qualquer tipo de maloclusão. Os avaliados (44,7%) apresentaram alto índice de cárie dentária (cariados, perdidos e obturados >10) e 53,2% apresentaram higiene oral inadequada (zero a 1,16). Houve diferença estatisticamente significativa entre a paralisia cerebral e o ato de escovar os dentes sozinho. CONCLUSÃO: Constataram-se altos índices de cárie e de maloclusão classe I, além de inadequada higiene oral. Houve influência do tipo de patologia de base na realização do ato de escovar os dentes sozinhos.

The Effect of Full-Mouth Rehabilitation on Oral Health-Related Quality of Life for Children with Special Health Care Needs.

OBJECTIVES: Changes in oral health-related quality of life (OHRQoL) among 40 children with special health care needs (CSHCN) aged 5-14 years before and 12 months after full-mouth rehabilitation (FMR) under general anesthesia (GA) in two hospitals in Jeddah city were assessed. STUDY DESIGN: The questionnaire was delivered to the parents/caregivers at baseline (pre-operative) and at the 12-month post-operative follow-up visit. Medical and dental histories and clinical findings were correlated accordingly. RESULTS: The follow-up response rate was 87.5% with 35 children completing a 12-month follow-up visit. The age range was from 5 to 12 years with a mean of 7.3 ± 2.4 years. More than half of the study sample was boys (63%) in the 5-8 year age-group (69%). The impact on OHRQoL was reportedly negative before FMR under GA, with overall scores ranging from 12 to 68 and a mean of 43.34 ± 14.83. OHRQoL improved significantly in all aspects evaluated (P<0.05) following FMR under GA with overall scores ranging from 4 to 41 and a mean of 18.86 ± 8.54. CONCLUSIONS: Treating CSHCN under GA, with 3-month recall visits for the patients, had a significant long-term effect on their OHRQoL extending up to 12 months postoperatively.