Intensidad lumínica de las lámparas de fotocurado LED en los consultorios odontológicos de Piura, Perú / Output intensity of LED light curing units in dental offices of Piura, Peru

Introducción: La lámpara de fotocurado, que utiliza diodos emisores de luz (LED), se emplea en odontología para la conversión polimérica de los materiales de restauración dental. Se ha comunicado que una intensidad lumínica inadecuada de la lámpara no aseguraría la correcta polimerización del material de restauración. Objetivo: Determinar la intensidad lumínica de las lámparas de fotocurado LED en consultorios odontológicos de la ciudad de Piura, Perú, 2020. Métodos: Estudio observacional, descriptivo. Se midió la intensidad lumínica en 70 lámparas de fotocurado LED, usando un radiómetro con una longitud de onda de 400-500 nm, con capacidad de medida de la intensidad lumínica de hasta 3500 mw/cm2. Por debajo de los 400 mw/cm2 indica intensidad baja, de 400 a 800 mw/cm2 intensidad media, de 800 a 1200 mw/cm2 intensidad alta y por encima de los 1200 mw/cm2 indica intensidad muy alta. Resultados: El 48,5 por ciento de las lámparas analizadas presentaban intensidad media, el 22,86 por ciento intensidad alta, mientras que el 15,71 por ciento intensidad baja y finalmente el 12,86 por ciento de las lámparas presentaban intensidad muy alta. Se reportó menor frecuencia de lámparas con mayor uso clínico. Conclusiones: Las lámparas de fotocurado LED, utilizadas en los consultorios dentales de la provincia de Piura durante el 2020, emiten una intensidad lumínica promedio de 778,14 mW/cm2, equivalente a la intensidad media(AU)

Introduction: Light curing lamps that use light-emitting diodes (LED) are used in dentistry for the polymeric conversion of dental restorative materials. It has been reported that inadequate light intensity in the lamp would not ensure the appropriate polymerization of restorative materials. Objective: Determine the output intensity of LED light curing units used in dental offices of the city of Piura, Peru, in the year 2020. Methods: An observational descriptive study was conducted. Measurements were taken of the light output of 70 LED light curing lamps using a radiometer with a wavelength of 400-500 nm and a light intensity measurement capacity of up to 3 500 mw/cm2. Intensity below 400 mw/cm2 was recorded as low, from 400 to 800 mw/cm2 as medium, from 800 a 1 200 mw/cm2 as high and above 1 200 mw/cm2 as very high. Results: Intensity was medium in 48.5 percent of the lamps analyzed, high in 22.86 percent, low in 15.71 percent and very high in 12.86 percent. A lower frequency of lamps with greater clinical use was reported. Conclusions: The LED light curing lamps used in dental offices of the province of Piura during the year 2020 emit an average output intensity of 778.14 mW/cm2, which corresponds to medium intensity(AU)

Stopping the COVID-19 pandemic in dental offices: A review of SARS-CoV-2 transmission and cross-infection prevention.

Due to the essential role of dentists in stopping the COVID-19 pandemic, the purpose of this review is to help dentists to detect any weaknesses in their disinfection and cross-contamination prevention protocols, and to triage dental treatments to meet the needs of patients during the pandemic. We used PRISMA to identify peer-reviewed publications which supplemented guidance from the center for disease control about infection control and guidelines for dentists. Dentists must triage dental treatments to meet the needs of patients during the pandemic. The ongoing pandemic has changed the practice of dentistry forever, the changes make it more cumbersome, time-consuming, and costly due to the possible pathways of transmission and mitigation steps needed to prevent the spread of COVID-19. Dental chairside rapid tests for SARS-CoV-2 are urgently needed. Until then, dentists need to screen patients for COVID-19 even though 75% of people with COVID-19 have no symptoms. Despite the widespread anxiety and fear of the devastating health effects of COVID-19, only 61% of dentists have implemented a change to their treatment protocols. As an urgent matter of public health, all dentists must identify the additional steps they can take to prevent the spread of COVID-19. The most effective steps to stop the pandemic in dental offices are to; vaccinate all dentists, staff, and patients; triage dental treatments for patients, separate vulnerable patients, separate COVID-19 patients, prevent cross-contamination, disinfect areas touched by patients, maintain social distancing, and change personal protective equipment between patients.

Alternative Methods of Sterilization in Dental Practices Against COVID-19.

SARS-CoV-2, and several other microorganisms, may be present in nasopharyngeal and salivary secretions in patients treated in dental practices, so an appropriate clinical behavior is required in order to avoid the dangerous spread of infections. COVID-19 could also be spread when patients touches a contaminated surface with infected droplets and then touch their nose, mouth, or eyes. It is time to consider a dental practice quite similar to a hospital surgery room, where particular attention should be addressed to problems related to the spreading of infections due to air and surface contamination. The effectiveness of conventional cleaning and disinfection procedures may be limited by several factors; first of all, human operator dependence seems to be the weak aspect of all procedures. The improvement of these conventional methods requires the modification of human behavior, which is difficult to achieve and sustain. As alternative sterilization methods, there are some that do not depend on the operator, because they are based on devices that perform the entire procedure on their own, with minimal human intervention. In conclusion, continued efforts to improve the traditional manual disinfection of surfaces are needed, so dentists should consider combining the use of proper disinfectants and no-touch decontamination technologies to improve sterilization procedures.

Willingness of Adults in the United States to Receive HIV Testing in Dental Care Settings: Cross-Sectional Web-Based Study.

BACKGROUND: The Centers for Disease Control and Prevention estimates that 1.1 million people in the United States are living with HIV and 1 in 8 are estimated to be unaware of their serostatus. Little is known about whether individuals would consider being tested for HIV in nontraditional health care settings such as a dentist's office. Studies in selected US cities have indicated high acceptability of receiving an HIV test among people attending dental clinics. However, we are not aware of studies that have assessed willingness to receive HIV testing in dental care settings at a national level. OBJECTIVE: Using a web-based sample of adult residents of the United States, we sought to assess the self-reported willingness to receive any type of HIV testing (ie, oral fluid rapid testing, finger-stick blood rapid testing, or venipuncture blood testing) in a dental care setting and evaluate independent associations of willingness with the extent to which dental care providers were perceived as knowledgeable about HIV and how comfortable participants felt discussing HIV with their dental care providers. METHODS: Participants were recruited using banner advertisements featured on social networking platforms (Facebook and Instagram) from December 2018 to February 2019. Demographic and behavioral data including information on sexual behaviors in the past 6 months, HIV testing history, and dental/health care-seeking history were collected using an anonymous web-based survey. Willingness to receive any type of HIV testing in a dental care setting was assessed on 4-point scale from very willing to very unwilling. Factors independently associated with participants' willingness were identified using a multivariable logistic regression model. RESULTS: Of the 421 participants in our study aged 18 to 73 years, 271 (64.4%) reported having oral sex, 197 (46.8%) reported having vaginal sex, and 136 (32.3%) reported having anal sex in the past 6 months. Approximately one-third had never been tested for HIV (137/421, 32.5%), and the same proportion had not been tested in the past year (137/421, 32.5%). Most participants had dental insurance coverage (356/421, 84.6%), and more than three-fourths reported being very or somewhat willing (326/421, 77.4%) to receive any type of HIV testing in a dental care setting. Higher levels of willingness were associated with being 18 to 24 years versus ≥35 years (aOR 3.22, 95% CI 1.48-6.98), 25 to 34 years versus ≥35 years (aOR 5.26, 95% CI 2.52-10.98), believing that one's dental care provider is knowledgeable about HIV (aOR 2.04, 95% CI 1.06-3.92), and feeling comfortable discussing HIV with one's dental care provider (aOR 9.84, 95% CI 3.99-24.27). CONCLUSIONS: Our data indicate high acceptability of receiving HIV testing in a dental care setting, especially among those who report having a positive patient-provider relationship. Future research should focus on assessing dental care providers' attitudes, self-efficacy, and beliefs about whether HIV testing fits into the scope of dentistry.

Dental treatment for the pregnant patient / Atendimento odontológico à paciente gestante

Dental treatment of pregnant women should be accomplished with safety. Consequently, the dental professional should evaluate its real need and risks for the mother and child. This paper reports through a literature review, the caution with the clinical dental procedures commonly performed and possible risks of the therapeutic agents used, allowing the dentist to evaluate the treatment and the drug to be administered to the pregnant women

O tratamento odontológico da gestante deve ser realizado com segurança, e para isto deve-se avaliar a real necessidade de sua execução e os riscos que o mesmo poderá trazer para a mãe e para o bebê. Este artigo relata, com base em uma revisão de literatura, os cuidados com os procedimentos clínicos comumente realizados no consultório odontológico e os possíveis riscos dos agentes terapêuticos utilizados, permitindo ao clínico avaliar o tratamento e a droga a serem administrados às gestantes.

[Assessment of decontamination processes: cleaning, disinfection and sterilization in dental practice in Poland in the years 2011-2012]. / Ocena procesów dekontaminacji: mycia, dezynfekcji i sterylizacji w praktyce stomatologicznej w Polsce w latach 2011-2012.

OBJECTIVE: Effective decontamination of instruments is a key element of infection control and the provision of high quality in dental care. The aim of the study was to evaluate the efficiency of decontamination procedures including cleaning, disinfection and sterilization of re-usable instruments in dental practices in Poland. MATERIAL AND METHODS: The efficiency of disinfection and sterilization processes have been evaluated on the results of the questionnaires. The following information were taken into account: setting where disinfection and sterilization had been performed, preparation of dental equipment for sterilization (disinfection, washing and cleaning, packaging), the types of autoclaves and used types of sterilization cycles, routine monitoring and documentation of sterilization processes, treatment of handpieces and the frequency of surface decontamination. RESULTS: Data were collected from 43 dental practices (35 dental offices and 8 clinics). Disinfection and cleaning processes were performed manually in 63% of dental offices and ultrasonic baths were used in 53% of settings. Washer disinfectors were used in 23% of dental practices: in every researched clinic and in a few dental offices. All sterilization processes were performed in steam autoclaves, mainly in small steam sterilizers (81%). Dental handpieces were sterilized in 72% of practices, but only 33% of them performed sterilization in recommended cycle B. Sterilization processes were monitored with chemical indicators in 33% of practices. Biological monitoring of the processes was carried out at different intervals. Incorrect documentation of instruments and surfaces decontamination was recorded in several settings. CONCLUSIONS: There is still a need for improvement of decontamination processes in dental practice in Poland. Areas for improvement include: replacement of manual cleaning and disinfection processes with automatic processes, sterilization of dental handpieces after each patient, monitoring of a sterilization process with chemical and biological indicators. Reported incorrect procedures in decontamination of medical devices performed by questioned dentists and lack or inadequate response to asked questions indicate the lack of adequate knowledge about decontamination. Personnel who performs decontamination processes should be continuously trained.

Endotoxin level as a potential marker of concentration of Gram-negative bacteria in water effluent from dental units and in dental aerosols.

Gram-negative bacteria concentration in water effluent from a dental unit, and in dental aerosol forming during the work of a dental handpiece, was assessed. The study was conducted on 25 dental units before and after a 2-week period of using a disinfecntant for water in dental units waterlines (DUWL). The contamination of water with Gram-negative bacteria before disinfection was 18-398 x 10(3) cfu/ml, and after disinfection, bacteria were not found. The concentration of Gram-negative bacteria in the air before disinfection was 0-23 x 10(1) cfu/m(3), and after disinfection - 0-8 x 10(1) cfu/m(3). Simultaneously, the water and air were sampled to determine bacterial endotoxin. The statistical analysis did not show correlation between endotoxin concentration and Gram-negative bacteria concentration for the water before disinfection, and for the air before and after disinfection of DUWL water. Because the number of bacteria in the water after disinfection dropped to zero, statistical methods could not be used. The performed analysis suggests that bacterial endotoxin concentration is not indicative of Gram-negative bacteria contamination. Thus, bacterial endotoxin determination is not recommended as a method of monitoring the microbiological quality of DUWL water and dental aerosols.

Uso y verificación con indicadores biológicos en esterilización de cirujanos dentistas de San Luis Potosí, México / Verification and utilization of sterilizing equipment by dentists in San Luis Potosi, Mexico

Objetivo. Conocer el uso y verificar los ciclos de esterilización con indicadores biológicos en los equipos utilizados por cirujanos dentistas de la Facultad de Estomatología de la Universidad Autónoma de San Luis Potosí (UASLP) y del Colegio Dental Potosino. Material y métodos. Estudio transversal hecho en 1999-2000. El 65 por ciento (n=130) de los odontólogos participaron con un esterilizador, la verificación se realizó por indicadores que contenían esporas de Bacillus subtilis y de Bacillus stearothermophilus. Resultados. Participaron 30 autoclaves y 100 esterilizadores de calor seco, 23 de ellos (17.7 por ciento) presentaron crecimiento bacteriano; el 16.1 por ciento (n=21) de los participantes utilizan los indicadores biológicos como verificador. Los dos métodos de esterilización presentaron crecimiento bacteriano con frecuencias similares (p=>0.66). Conclusiones. Pocos cirujanos dentistas verifican su esterilizador con indicadores biológicos en los equipos que presentaron crecimiento bacteriano, sus fallas se encontraron en el proceso de esterilización. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html

Avaliação clínica da contaminação ambiental no campo de trabalho do cirurgião-dentista: efeito do emprego da alta velocidade e bochecho / Clinical evaluation of the enveronmental contamination in the dentist activity: effect of the use of high speed and rinsing of the month

Foram analisados em testes clínicos a ação antibacteriana de anti-séptico bucal antes e após o emprego de alta velocidade. Conclui-se que o uso dessa solução diminui o número de colônias bacterianas na saliva, mesmo com o emprego e o uso da alta velocidade contaminam o ambiente de trabalho