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)

Frequency and distribution of teeth treated by single- and multiple- visit root canal treatment in a Nigerian population by differently skilled operators.

BACKGROUND: Single visit root canal treatment (RCT) is being advocated around the world. This study profiles RCT in a Nigerian population and compares pattern of single versus multiple visit RCT to tooth type and skill level of the doctors. METHOD: A retrospective study was carried out on RCT performed in one year by fresh graduates and postgraduate dentists. Records retrieved included patients' sex and age, tooth type, location in the jaw and whether single- or multiple-visit RCT was done. RESULTS: Records of 705 teeth were reviewed, 54.6% belonged to females. Age range was 18-87 years, mean of 31.76 (± 12.31) years. Majority (70.1%) belonged to 20-39 years' age group. Most teeth were located in the maxilla (60.8%) and in posterior regions (73.6%). The most frequently root filled tooth was the mandibular first molar (20.7%) followed by maxillary central incisor (18.4%) then maxillary premolar (12.8%). However, all molars accounted for 47.3%, premolars 26.3% and incisors 25.0%. Canines (1.45%) were least frequently root-filled. Incisors (54.8%) were the teeth most frequently treated in single-visit followed by premolars (28.8%). Most frequently treated by multiple-visit were molars (51.0%). All doctors performed multiple-visit RCT in an approximately equal proportion but a significant percentage of single-visit RCT was carried out by senior doctors (71.2%). CONCLUSION: The most frequently root filled teeth were mandibular first molars. Teeth most likely to be treated by single-visit RCT were incisors. Appropriate operator skill and experience is important in the decision to perform single-visit RCT. Single-visit RCT is advocated in the developing environment.

What is the role of the oral and maxillofacial department in the preoperative management of patients awaiting cardiac operations?

There is limited evidence and guidance on best practice regarding preoperative dental assessments of patients awaiting cardiac operations. To analyse current practice in oral and maxillofacial units across the United Kingdom, we did a telephone survey to find out how these patients are managed. All maxillofacial departments in the United Kingdom were contacted, with a response rate of 77%. Those attached to dental schools were excluded. Most departments did extractions only, and in many, patients were assessed and treated within 7 days of being referred, although this varied. Most units did not offer antibiotic prophylaxis to patients at high risk of infective endocarditis, but some did after advice had been sought from a cardiologist. Respondents in 76% thought that preoperative dental assessments for cardiac patients were an appropriate use of resources. We propose a more integrated pathway for the management of these patients (particularly considering the pressure on time for treatment) that focuses primary and secondary resources accordingly.

Occupational exposure to sharp injuries among medical and dental house officers in Nigeria.

OBJECTIVE: Sharp injuries constitute important occupational exposure in hospital environment, and perhaps the newly graduated medical and dental students, known as House Officers, in the first twelve months of their practice, are the most vulnerable of all health workers. This study was designed to examine the nature and prevalence of occupational injuries among medical and dental house officers and factors associated with reporting these injuries. MATERIALS AND METHODS: A self-administered questionnaire was used to obtain information on demography, types of exposure, and barriers to official reporting of occupational injuries. One hundred and forty-four medical and dental house officers in 3 government owned hospitals in Edo State, Nigeria participated in the study, between April and May, 2010. Descriptive and multivariable analyses were performed. RESULTS: The overall response rate was 96%. Out of all participants, 69.4% were male; 82.6% were medical house officers. Prevalence of percutaneous injury was 56.9%; where needlestick injury constituted one-third of all injuries. Mean frequency of injury was 1.86±2.24, with medicals having more injuries (p = 0.043). The ward was the most common location for the injury and 14.8% of exposures occurred as a result of lapse in concentration. At least 77.0% did not formally report their injury and perceived low injury risk was the most common reason given (51.67%). CONCLUSION: This study shows that a substantial number of House Officers are exposed to occupational injuries and that the majority of them does not formally report these. Safer work environment may be achieved by implementing adequate educational programs tailored specifically to house officers, and policies encouraging exposure reporting should be developed.

Saúde bucal de pacientes internados em hospital de emergência / Oral health status in patients admitted to an emergency hospital

Objetivo: O objetivo deste estudo foi avaliar as condições de saúde bucal, acesso a serviços odontológicos e autopercepção em saúde bucal, bem como relacionar a necessidade de tratamento odontológico em pacientes internados em um hospital de emergência, em Fortaleza - Ceará, no ano de 2011. Materiais e Métodos: Pesquisa exploratória do tipo transversal em que foram examinados 301 pacientes internados em duas enfermarias de um hospital de referência terciária em trauma, de abrangência regional e estadual. Asvariáveis exploratórias foram avaliação socioeconômica, acesso e autopercepção em saúde bucal e Índice de Necessidade de Tratamento Odontológico (INTO). A coleta de dados foi realizada por um único examinador,os dados foram processados no SPSS (Statistical Package for Social Science), versão 17.0. A comparação entreas variáveis foi feita através do teste t de Student, com nível de significância de 5,0%. Resultados: A maioria dos pacientes era do sexo masculino, com média de idade de 39,38 anos, com ensino fundamental completo, com período mínimo de internamento de 2 dias e máximo de 4,83 meses (DP ±1,31). Ao serem indagados sobre busca de atendimento odontológico, o serviço público foi o principal meio de acesso e o principal motivo relatado da procura do serviço foi a presença de cavidades de cárie. Grande parte dos pacientes foi classificada, segundo modificação do INTO, nos perfis 3 e 4 (76,4%), ou seja, apresentava cálculo dentário, cavidade pequena de cárie e indicação de exodontia. Houve associação estatisticamente significante entre as variáveis ôpercepção de necessidade de tratamento odontológicoõ e ôclassificação da saúde bucalõ (p<0,001), bem como entre ôperfilõ e ôautopercepção de saúde bucalõ (p<0,001). Conclusão: A partir de tal análise, conclui-se queas condições de saúde bucal desses pacientes são preocupantes, com a necessidade inconteste de cuidados desaúde bucal para a população institucionalizada.

Provision of oral medicine in departments of oral and maxillofacial surgery in the UK: national postal questionnaire survey 2009.

We investigated the current provision of oral medicine in oral and maxillofacial (OMF) departments in the UK. We examined the number of specialists in oral medicine in OMF departments, the training given to OMF consultants in oral medicine, and the estimated time dedicated to treating patients with oral medical conditions in outpatient clinics. We also examined the pattern and reasons for onward referrals to departments of oral medicine. A postal questionnaire was sent to 300 OMF consultants and was returned by 183 (61%). Sixteen (9%) of the responding consultants had a registered specialist qualification in oral medicine with the General Dental Council (GDC), 15 (8%) had a degree in oral medicine, and 4 (2%) had a diploma. One hundred and eighteen (64%) consultants had been given formal training in oral medicine during their training as registrars. Time dedicated to oral medicine in outpatient clinics varied between less than 20% and more than 40% of total outpatient time. Sixteen surgeons (9%) referred 1-2 patients/week to departments of oral medicine, and 19 (10%) referred 2-4/month. Reasons for referral included need for specialist expertise, failure of treatment, and lack of time in outpatients. The proposal for a dentally qualified consultant-led oral medicine service was supported by 70 responding surgeons (38%).

Work experiences, professional development and career prospects of New Zealand dental house surgeons.

OBJECTIVE: New dental graduates compete for house surgeon positions every year, despite little being known about the work experience gained from such posts. The main objectives of this study were to identify the nature of house surgeons' work experiences, their continued professional development (CPD) opportunities and the impact of hospital experience on their future career pathways. METHOD: A questionnaire was mailed to all 31 New Zealand dental house surgeons (response rate 100%). RESULTS: The majority of house surgeons (77.4%) found hospital work enjoyable, with nearly all (93.5%) perceiving themselves as better clinicians from their experience. Oral surgery, restorative dentistry, special needs dentistry and removable prosthodontics were the most commonly practised areas. The average weekly number of working hours was 42.3 hours for a normal week and 61.8 hours for an on-call week. Stress levels during on-call work were significantly higher than during day-to-day hospital work (p < 0.05). Departmental seminars were reported to be the most common form of CPD available at hospitals (74.2%), followed by hands-on clinical training (61.3%). More than half of the house surgeons (58.1%) planned to pursue a specialist career, with nearly 13% wishing to return to a New Zealand hospital in the future. CONCLUSIONS: A dental house surgeon position remains an attractive choice and offers an enjoyable experience for young graduates. Hospitals provide ample CPD opportunities and appear to play an influential role in a house surgeon's career pathway.

Prevalence of ocular injury and the use of protective eye wear among the dental personnel in a teaching hospital.

OBJECTIVE: To determine the prevalence of ocular injury and the frequency of use of protective eye wear among the dental personnel of Lagos University teaching hospital. METHODOLOGY: A structured questionnaire was distributed to dental personnel of Lagos University Teaching Hospital working in the dental clinic and laboratory within a period of one month (November 2006). RESULTS: Ninety questionnaires out of 105 questionnaires were returned filled giving a response rate of 90.5%. 36.7% of the dental personnel are regular wearers of protective eye wear. 28.9% of males and 42.3% of females are regular wearers. Among the dental personnel the dental therapists showed the highest frequency of regular eye protection (100%) while the technologists showed the lowest frequency of regular eye protection (20%). There was significant difference in the prevalence of ocular injury among the dental personnel with the technologist having the highest prevalence of 40% and the dental students having the lowest prevalence of 15.4% (p < 0.05). CONCLUSION: The frequency of using protective eye wear among the dental personnel of Lagos University Teaching hospital was low. The use of protective eye wear should be emphasized for all dental personnel and patients to prevent the occurrence of ocular injuries in the clinic and laboratory.

Preventing percutaneous injuries among dental health care personnel.

BACKGROUND: The Occupational Safety and Health Administration and the Centers for Disease Control and Prevention (CDC) recommend that health care personnel (HCP) adopt safer work practices and consider using medical devices with safety features. This article describes the circumstances of percutaneous injuries among a sample of hospital-based dental HCP and estimates the preventability of a subset of these injuries: needlesticks. METHODS: The authors analyzed percutaneous injuries reported by dental HCP in the CDC's National Surveillance System for Health Care Workers (NaSH) from December 1995 through August 2004 to describe the circumstances. RESULTS: Of 360 percutaneous injuries, 36 percent were reported by dentists, 34 percent by oral surgeons, 22 percent by dental assistants, and 4 percent each by hygienists and students. Almost 25 percent involved anesthetic syringe needles. Of 87 needlestick injuries, 53 percent occurred after needle use and during activities in which a safety feature could have been activated (such as during passing and handling) or a safer work practice used. CONCLUSIONS: NaSH data show that needlestick injuries still occur and that a majority occur at a point in the workflow at which safety syringes--in addition to safe work practices and recapping systems--could contribute to injury prevention. CLINICAL IMPLICATIONS: All dental practices should have a comprehensive written program for preventing needlestick injuries that describes procedures for identifying, screening and, when appropriate, adopting safety devices; mechanisms for reporting and providing medical follow-up for percutaneous injuries; and a system for training staff members in safe work practices and the proper use of safety devices.

Continuity of care and the European working time directive: a maxillofacial perspective.

The European Working Time Directive (EWTD) was introduced in 1993 and was heralded as both a challenge and an opportunity for the NHS to modernize its services Continuity of care is usually viewed as the ongoing relationship between a patient and a single practitioner. Fragmentation of this continuity by many doctors being involved in a patient's management may weaken this relationship. The effect of the EWTD on junior doctors training in various specialities is well studied, we however were interested to assess the effect of the EWTD on the patient-doctor relationship in a maxillofacial setting and aimed for this paper to serve as an indicator of current practice and facilitate future research in this area. Seventy-five consecutive patients were studied with 72 patient proformas analysed. Our findings show greater same consultant patient contact than that of the specialist registrars and senior house officers. We feel that this is largely due to new work patterns introduced through the advent of the EWTD.

Preparing for a career in oral and maxillofacial surgery: a survey of dentists at medical schools.

A questionnaire was sent to the 112 dental graduates who were doing a second degree in medicine in the United Kingdom (UK) in the academic year 2002-2003. Seventy-four students replied. The most common time from graduating from dental school to returning to medical school was 36 months. Of the 74 respondents 50 (68%) wrote that they intended to return to oral and maxillofacial surgery.

Trainees' perceptions of UK maxillofacial training.

Training is a central component of the work of many units around the UK. Many changes to the way that junior doctors are trained have taken place over the past few years and maxillofacial surgery, of all the surgical specialities, has perhaps undergone the most far-reaching. A postal survey of 93 maxillofacial specialist registrars (SpRs) in all regions of the UK was carried out, of whom 81 (87%) responded. The aim was to seek their views on subjects directly related to the quality of, and access to, training. Information was gathered on age of trainees, entitlement to annual and study leave, certification for Advanced Trauma Life Support (ATLS) and office and research facilities.

Self-reported needlestick injuries in dental health care workers at Armed Forces Hospital Riyadh, Saudi Arabia.

The objective of the present study was to assess the incidence of sharps/needlestick injuries among dental health care workers (DHCWs) at Armed Forces Hospital Riyadh. A questionnaire was distributed among all dental staff, including dentists, hygienists, and dental surgery assistants. Results show that 65 individuals (58%) had sharps/needlestick injuries, and of these, more than half did not report these injuries to the appropriate department. At the time of injury, the majority of the DHCWs were vaccinated or immune, but a few of them were not vaccinated against hepatitis B virus. This study concludes that every DHCW should be immunized against hepatitis B virus to avoid cross-infection from sharps/needlestick injuries, which are quite common in a dental practice. The high frequency of these injuries could be reduced by simple interventions.

Medical and dental staffing prospects in the NHS in England and Wales 1993.

This article provides a brief update on current national policies affecting medical education and training, and information on the present medical and dental workforce. Although of general interest, senior medical students and doctors in the training grades may find it particularly helpful when considering choices of future career. As there may be marked local variations in career prospects for any one specialty, further information and advice is available from Regional Postgraduate Medical and Dental Deans, specialty advisors (through Royal College and specialty associations) and clinical tutors. The information in this article relates to the present situation only and a review of previous articles in this series may be useful to observe certain trends.

Removal of impacted third molars by oral/maxillofacial surgery and general dentistry residents.

The post-operative symptoms of patients who had undergone third molar extractions by Oral/Maxillofacial Surgery (OMS) residents were compared with those of patients whose extractions were performed by General Dentistry (GD) residents. The OMS group had more extractions per visit and were more likely to use intravenous sedation than the GD-treated group. No significant differences were found when the provider groups were compared by post-operative symptoms such as osteitis, infection, trismus, or paresthesia/dysthesia. The pain relief due to postoperative analgesics during the immediate 12-hour period was higher for patients treated by GD residents. Multiple regression analysis revealed that this difference was due to the number of teeth extracted and the complexity of the surgical procedure, independent of type of provider.

Medical and dental staffing prospects in the NHS in England and Wales 1992.

This annual article is intended to help young doctors and dentists make informed decisions about their career paths, in the light of the current prospects of obtaining a career post in any specialty. Regional details of the national figures presented here may be obtained through individual Regional postgraduate deans, Health Authorities and clinical tutors. This article summarises the most recent figures available, and comparison with previous articles in this series may help to identify employment trends.

Medical and dental staffing prospects in the NHS in England and Wales 1991.

This article offers some background information to help junior doctors, and those who advise them, to make decisions about their future careers. Further information can be obtained from the Regional tables, which the Department of Health circulate to Regional Postgraduate Deans, Health Authorities and clinical tutors. All the information presented here is retrospective. Comparing this with the previous annual articles in this series may help you to assess the likely future prospects in your particular specialty.

Human immunodeficiency virus testing experience and hepatitis B vaccination and testing status of healthcare workers in South Carolina: implications for compliance with US Public Health Service guidelines.

OBJECTIVE: To assess the previous human immunodeficiency virus (HIV) testing experience and the hepatitis B (HB) vaccination and testing status of healthcare workers potentially involved in invasive surgical procedures. DESIGN: Anonymous questionnaire survey. SETTING: Tertiary care and community-teaching medical center and affiliated healthcare facilities in Greenville County, South Carolina. PARTICIPANTS: Physicians (including residents in training), dentists, nurses and surgical technicians working in the operating room and labor/delivery areas. RESULTS: Of 506 responding physicians and dentists (65% of the sample), 60% previously had had a test for HIV, and 72% had received HB vaccine. Testing had occurred most often because of a requirement by an insurance company or because of blood donation. Eighty percent of tested respondents had their most recent test within 2 years of the time of the survey (August 1991). Of 145 responding nurses and surgical technicians (73% of the sample), 26% had had a test for HIV and 77% had received HB vaccine. CONCLUSIONS: The majority of surgeons and dentists in Greenville County, South Carolina, already have been tested for HIV for a variety of reasons and thus are aware of their HIV infection status, at least as of the time of the most recent test. The majority of local healthcare workers who are potentially involved with invasive surgical procedures have received HB vaccine. Programs developed in response to recent US Public Health Service guidelines should take HIV testing of healthcare workers for any reason into consideration and should emphasize HB vaccination and testing for vaccine-induced HB immunity.

Medical and dental staffing prospects in the NHS in England and Wales in 1988.

The Medical Manpower and Education Division of the Department of Health publishes information in this journal each year on the current state of medical and dental manpower in England and Wales, to assist medical and dental students and newly-qualified doctors and dentists in their career choices. Additional information can be obtained from the national and regional census tables which are usually published by the Department of Health each spring. These are circulated widely to all health authorities, postgraduate deans and clinical tutors.