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2.
Pediatr Dent ; 42(5): 380-386, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-33087223

RESUMO

Purpose: To evaluate dentists' perspectives on the Medicaid program and explore hypothetical changes that could lead to increased participation. Methods: A 26-item questionnaire assessing demographics, practice profile, attitudes towards the Medicaid program and hypothetical scenarios to increase participation was administered to general and pediatric dentists. Results: A total of 165 surveys were completed; 50.6 percent of respondents indicated they were not Medicaid participating providers. Pediatric dentists were more likely than general dentists to be participating in Medicaid and willing to participate in the future, 35.5 percent vs. 23.2 percent respectively. A 68 percent increase in fees would yield the highest level of participation with 58.4 percent of participants responding they would treat at least 16 additional children per week. Pediatric versus general dentists would be more likely to participate in Medicaid with more modest raises, i.e. 30-44 percent range. Low compensation by Medicaid (weighted average of 4.77) was the greatest barrier indicated by all participants. Hispanic dentists had greater odds of participating in Medicaid than non-Hispanic dentists. Dentists who were 'employees' had a greater odds of participating in Medicaid than a 'solo owner of a practice'. Conclusion: Increased participation in Medicaid would require a combination of meaningful increases in reimbursement rates, loan forgiveness programs and tax credits.


Assuntos
Odontólogos , Medicaid , Criança , Honorários e Preços , Florida , Humanos , Inquéritos e Questionários , Estados Unidos
3.
ScientificWorldJournal ; 2020: 7945309, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029109

RESUMO

As early as December 2019 in the province of Hubei, China, contamination of patients with pneumonia of an unknown etiology occurred. These patients presented with symptoms such as coughing, sore throat, malaise, diarrhea, high fever, and dyspnea. This emerging disease was named COVID-19 due to being part of the group of coronaviruses (CoVs) belonging to the subfamily Orthocoronavirinae, in the Coronaviridae family and in the Nidovirales order. COVID-19 is most commonly transmitted through speech, coughing, sneezing, and salivary sputum. Because dental professionals work closely with the oral cavity, it is imperative that infection prevention controls are strictly adhered to. It is important that the dental profession treats patients while also limiting the possible contamination through the production of aerosol in the dental environment. Furthermore, the dental professional also has a key role in raising awareness and guidance amongst the population concerning COVID-19 related biosafety measures. This literature review aims to inform dental professionals about the COVID-19 pandemic and to present the implications of the virus to the dentist. Dental professionals are considered to be at high risk for contracting SARS-CoV-2.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Odontólogos , Procedimentos Cirúrgicos Bucais , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Papel Profissional , Segurança , Infecções por Coronavirus/epidemiologia , Humanos , Segurança do Paciente , Pneumonia Viral/epidemiologia , Medição de Risco
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(10): 729-736, 2020 Oct 09.
Artigo em Chinês | MEDLINE | ID: mdl-33045783

RESUMO

Objective: To explore and evaluate a three-dimensional (3D) digital simulated design and implementation technique in esthetic rehabilitation. Methods: Thirty patients with esthetic deficiency, who came to the Department of Prosthodontics, Peking University School and Hospital of Stomatology from December 2017 to July 2019, were recruited and randomly assigned into 2 groups. Four males and 11 females which were (36.0±10.5) years old in the experimental group, 6 males and 9 females which were (32.0±6.7) years old in the control group, were enrolled. In the experimental group, 3D digital simulated design was used to predict the post-treatment effect; and the final restorations were designed duplicating from the pre-treatment digital design confirmed by the patient and milled. In the control group, the final restorations were manufactured by the dental technician according to the design of two-dimensional (2D) digital smile design. The simulation degree of digital design and the similarity between preoperative design and postoperative rehabilitation were scored by the patients with visual analogue scales (VAS) in both groups; and the satisfaction rate to the restorations was evaluated by the patients. The quality of the restorations was accessed by a prosthodontist who did not know the grouping of patients according to the modified criteria of United States Public Health Service (USPHS). Results: Three-dimensional digital simulated design and implementation technique was successfully established. The VAS score on the simulation degree of digital design in the experimental group (8.5±0.5) was higher than that in the control group (7.2±0.7) (P<0.01); the VAS score on the similarity between preoperative design and postoperative rehabilitation in the experimental group (9.6±0.3) was higher than that in the control group (7.0±0.9) (P<0.01). The satisfaction rate of the patients to the restorations was significantly higher in the experimental group than in the control group (P<0.05). There was no significant difference of the quality of the restorations between the two groups on the anatomic form, the marginal adaption and the surface quality (P>0.05). Conclusions: Three-dimensional digital simulated design and implementation technique can help achieving 3D digital simulated design before treatment and duplication to the final restorations, and can improve the patients' satisfaction in esthetic rehabilitation.


Assuntos
Estética Dentária , Sorriso , Adulto , Odontólogos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Prostodontia , Estados Unidos
5.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(5): 948-951, 2020 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-33047735

RESUMO

OBJECTIVE: To assess the effects of loupes and microscope on the posture of prosthodontists when preparing the laminate veneer, and to assess the clinical value of loupes and microscope from the ergonomic aspects. METHODS: Twenty young prosthodontists from Department of Prosthodontics, Peking University School and Hospital of Stomatology were recruited into this study, which was a prospective, single blind, self-control trials. The research hypothesis was concealed and the participants were deceived about the precise purpose of the study to counterbalance the lack of direct blinding. The prosthodontists prepared laminate veneers of open window type in the artificial dental model, under routine visual field (control group), 2.5× headwear loupes (loupes group), and 8× operating microscope (microscopic group) by turning. The participants were photographed from profile view and front view. Thereafter, the subjective assessment was performed by themselves using the visual analogue score (VAS). The expert assessment was performed by two professors using modified-dental operator posture assessment instrument on the basis of photographs of the profile view and front view. RESULTS: The subjective assessment scores for the control group, loupes group and microscopic group were 4.55±1.96, 7.90±1.12, and 9.00±0.92, respectively. There was significant difference between the three groups' subjective scores (P < 0.05). The expert assessment scores for the control group, loupes group and microscopic group were 16.38±1.52, 15.15±1.30, and 13.60±0.88, respectively. There was significant difference between the three groups' expert assessment scores (P < 0.05). Specifically, the three groups' expert assessment scores were significantly different (P < 0.05) in trunk position (front to back) (1.33±0.41, 1.03±0.11, 1.00±0.00), head and neck position (front to back) (2.75±0.38, 2.13±0.36, 1.23±0.38), elbows level (1.38±0.43, 1.40±0.45, 1.13±0.22), and shoulders level (1.43±0.41, 1.23±0.34, 1.13±0.28). Thereinto, the microscopic group was better than loupes group in head and neck position (front to back) and elbows level (P < 0.05). CONCLUSION: Loupes and microscope improve the posture of the prosthodontist when preparing the laminate veneer, in which the microscope is better than loupes. Therefore, the magnification devices have clinical value from the ergonomic aspects.


Assuntos
Ergonomia , Postura , Odontólogos , Humanos , Estudos Prospectivos , Método Simples-Cego
6.
BMC Oral Health ; 20(1): 281, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33050914

RESUMO

BACKGROUND: Coronavirus Disease (COVID-19) epidemic is a public health emergency of international concern. Dentists are exposed to the enormous risk of COVID-19 infection during this epidemic. This study aims to assess the knowledge and practice of dentists toward the COVID-19 epidemic in Lebanon. METHODS: We conducted an online survey using the snowball-sampling technique. Information on socio-demographic data, knowledge, practice, and additional information required concerning COVID-19 were collected. RESULTS: Our results showed that the majority of the Lebanese dentists had good knowledge (91.3%), and nearly half of the respondents had a good practice (58.7%) regarding COVID-19. The most common information source was the World Health Organization (73.7%). Multiple linear regression showed that specialist dentists who completed training on COVID-19 with a high level of knowledge had better practice. CONCLUSIONS: Lebanese dentists revealed good knowledge regarding COVID-19. However, dentists had limited comprehension of the extra precautionary measures that protect the dental staff and patients from this virus. Our findings have important implications for the development of strategies suitable for improving the level of practice among dentists and enhance prevention programs.


Assuntos
Coronavirus , Odontólogos/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Humanos , Líbano/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Inquéritos e Questionários
7.
BMC Psychol ; 8(1): 106, 2020 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-33054836

RESUMO

BACKGROUND: Depression, stress, and anxiety are common psychological conditions among dental students in many countries around the world. A number of researchers have found life coaching to be effective at reducing psychological distress. The aim of this study was to assess the effect of a life coaching program on dental students' psychological status. METHODS: A quasi-experiment study with two arms was conducted on 88 female dental students at Umm Al-Qura University (study group = 44; control group = 44). The psychological status was assessed by questionnaire before and after intervention. The questionnaire was composed of the Depression and Anxiety Stress Scale (DASS-21), Resilience Scale (RS-14), the Psychological Well-Being Scale-Short (PWB-S), and goal approach questions. The study group received a coaching program comprising one lecture for 1 h and five phone coaching sessions over 5 weeks, while the control group received no intervention. RESULTS: The study group showed a significant reduction in depression, anxiety, stress, resilience, and self-acceptance according to the PWB-S scale. Also, goal approach was significantly improved. On the other hand, the control group showed a significant reduction on the RS-14 only. The differences in the tested scales between the study group and the control group from pre-intervention (T1) to post-intervention (T2) showed significant differences in depression, stress, self-acceptance, and goal approach measurements per t-test. CONCLUSION: The study's findings showed that life coaching had the effect of reducing psychological distress, which encouraged the implementation of coaching practice in the daily life of dental students.


Assuntos
Odontólogos/psicologia , Relações Interprofissionais , Tutoria , Angústia Psicológica , Estudantes de Odontologia/psicologia , Adulto , Depressão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Psicológico , Ensino
8.
Wiad Lek ; 73(8): 1730-1734, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33055343

RESUMO

OBJECTIVE: The aim: Investigate the factors that influence the tendency of parents to follow the advice of a dentist on the way to improving the dental health of their children and build a prognostic model. PATIENTS AND METHODS: Materials and methods: Materials: we analyzed 406 questionnaires (specially created by the author), which contain the answers of parents of schoolchildren of Poltava. Methods: questionnaires, medical and statistical, modeling. RESULTS: Results: The statistical processing of the questionnaires revealed a number of factors those that affect parents' compliance with the advice of a dentist, increasing or decreasing the chances of it: low sanitary and hygienic awareness of parents; non-observance of hygiene rules by parents; parents do not teach the child to care for the oral cavity;opinion of the parents that only state must take care of children's health; the recommendations of the dentist wasn`t received; child had never visited a dentist for prevention. The operational characteristics of the obtained prognostic model: the area under the curve is 0,762, which indicates a good predictability of the model. Sensitivity is 82,2%, specificity - 79,8%. CONCLUSION: Conclusions: The data obtained as a result of our study and the constructed prognostic model: they indicate low sanitary and hygienic awareness of parents, paternalism of their thinking (shifting responsibility to someone, unwillingness to take responsibility), lack of medical and hygienic knowledge, as a result of which they do not apply them to themselves and, of course, to their children. The solution to this problem is possible only through informational and explanatory activities with the involvement of modern methods of communication and people who have passed appropriate training.


Assuntos
Saúde Bucal , Pais , Criança , Odontólogos , Humanos , Higiene Bucal , Cooperação do Paciente
9.
J Contemp Dent Pract ; 21(7): 718-722, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33020352

RESUMO

AIM: The present study was conducted to assess the perceived risk of COVID-19 transmission in dental professionals (DPs), that include dentists and dental auxiliary staffs, and whether rapid tests should be a recommended tool to constrain the transmission of the COVID-19, and who should be bearing their cost (governments, dentists, or patients) through an online survey. MATERIALS AND METHODS: A sample size of n = 700 was recruited in the study. The study included DPs from all over the world. A randomized selection of samples was done through dental groups present on social networks. An online survey was conducted in April 2020, using the Google Form software to provide questions and collect and elaborate answers. Data were analyzed using the statistical software STATA and presented in terms of percentages. RESULTS: About 78% of the study participants perceived a very high risk of COVID-19 contamination in dental settings. Nearly 80% of the study participants were willing to be subjected to rapid tests and the same could be performed on patients visiting their dental clinics, which could prevent the spread of the disease. About 55% of the participants had reported that additional costs for the rapid tests should be borne by the governments. CONCLUSION: The results of the present survey report that DPs do not feel safe and perceive a high risk of COVID-19 contagion and prevention of the disease could be done by performing rapid tests on dentists, dental staff, and patients visiting the dental clinics irrespective of age and gender of the participants. SIGNIFICANCE: Since all the dentists and allied staff have perceived increased risk for COVID-19 transmission, it is important that preventive measures are implemented through rapid test kits at the earliest.


Assuntos
Técnicas de Laboratório Clínico , Infecções por Coronavirus , Odontólogos , Pandemias , Pneumonia Viral , Betacoronavirus , Infecções por Coronavirus/diagnóstico , Odontologia , Humanos , Risco , Inquéritos e Questionários
10.
J Contemp Dent Pract ; 21(6): 599-603, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33025925

RESUMO

AIM: The aim of the present study was to take a survey on Italian practitioners concerning the perceived risks of aerosol contamination in COVID-19 times and their attitude toward modifications of treatment protocols to reduce this risk. MATERIALS AND METHODS: Power analysis calculated a minimum sample size of 150 participants at 99% confidence level with a 5% margin of error. To homogenize responses elicited by different preventive measures by various national governments, only Italian dentists were included in the survey: overall 500 responses were collected. RESULTS: Of the 500 analyzed respondents, there were 266 females and 234 males; 379 practitioners were allocated in the more experienced groups, and the remaining 121 in the less experienced group based on less or more than 5 years of practice. The 70% of the dentists consider the dental practice more dangerous for the diffusion of COVID-19 than other social activities. The 5% consider dental practice more dangerous only for the patients. Aerosol contamination was perceived as a risk from the most dentist (70%), but there was agreement on the most dangerous way of cross infection in dental settings. Most of the dentists (55%) believed implementations in their protocols were needed to reduce the risk of COVID-19 infections. No significant differences were found within the groups: both women and men, as well as practitioners with different experience levels (younger or older than 35 years) perceived very similarly the problems related to COVID-19 in dentistry (p > 0.05). CONCLUSION: The survey demonstrated that COVID-19 had a great impact on dental practitioners; it increased not only fear of aerosol contamination during dental treatments but also influenced the fear of close contacts. SIGNIFICANCE: Airborne and waterborne infections are related with dental treatments and considered the preferred ways of diffusion for COVID-19. The risk of aerosol-related infections could interfere with the clinical practice of the dentist, during the COVID-19 pandemic; the limitations that provided changes to everyday behavior could affect the perception of the safety of the operators, staff, and patient and this could also affect economically the dental office.


Assuntos
Infecções por Coronavirus , Odontólogos , Pandemias , Pneumonia Viral , Aerossóis , Betacoronavirus , Feminino , Humanos , Itália , Masculino , Papel Profissional , Inquéritos e Questionários
11.
Ned Tijdschr Tandheelkd ; 127(9): 487-491, 2020 Sep.
Artigo em Holandês | MEDLINE | ID: mdl-33011754

RESUMO

The character of a consent for treatment is not a mere hobby for lawyers; it also has consequences in daily practicein the Netherlands, particularly if it concerns questions of who should prove what in proceedings. In general, consent agreements can be divided into an obligation to achieve results and an obligation to use reasonable endeavours. In oral healthcare, there is usually a question of an obligation to use reasonable endeavours, in which professional standards must play a leading role in the behaviour of the dentist; and here there have been a number of recent developments, such as an increase in the number of (clinical) guidelines and the acceptance of wish fulfilling medicine, under strict conditions. It is concluded that recent developments in the dentist's requirement to provide evidence in proceedings have definitely not made things simpler.


Assuntos
Medicina , Odontólogos , Humanos , Consentimento Livre e Esclarecido , Países Baixos
12.
Evid Based Dent ; 21(3): 96-97, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32978539

RESUMO

Design A single-blinded, randomised controlled trial. The experimental group received 24 personalised text messages each week, disseminating tailored preventive advice using the multifactorial model for individual caries risk assessment: Cariogram. The same frequency of text messaging was delivered to the control group; however, these were non-personalised messages and did not factor the Cariogram.Sample selection One hundred and ninety-one participants were assessed for eligibility by eight calibrated, volunteer dental practitioners in County Cork, Ireland. Six different inclusion criteria were detailed, including the requirement for medical card holders, serving as an indicator for economically underprivileged status. Other criteria included: aged between 19-70 years; competent with text messaging services; have a minimum of 20 teeth present; not pregnant; and prepared to give consent. Failure to return a baseline food diary or possess a mobile phone saw the exclusion of 20 participants. Following stratified and blocked randomisation, 85 and 86 participants were allocated in the test and control group, respectively. The study received ethical approval by the Clinical Research Ethics Committee of the Cork Teaching Hospitals.Data analysis One hundred and eleven participants attended the follow-up examination, 26 weeks after randomisation, where the 'chance of avoiding new cavities' was determined as a numerical index for caries risk. The secondary aim was to measure individual changes to seven Cariogram risk factors between the baseline assessment and the re-examination. The ANCOVA intention-to-threat (ITT) protocol and the per-protocol method were adhered to for analyses of outcome measures. Statistical analysis was performed using SAS 9.4, in adherence to a pre-defined significance level of 5% (two-sided).Results Both analytic techniques confirmed no statistically significant difference (p >0.05) between the groups regarding the 'chance of avoiding new cavities'. Of the risk parameters assessed, only saliva secretion demonstrated a positive effect in the intervention group (p = 0.036, OR = 0.3, 95% CI = 0.1, 0.9). Predictive modelling techniques were not reliable due to the limited sample size of per-protocol analysis.Conclusions The failure to conclude statistical significance between the groups validates the null hypothesis. Accordingly, no difference can be established between the personalised nor non-personalised mobile text messaging intervention on the caries risk of underprivileged adults in Ireland. The authors address the value of further studies exploring the potential for caries risk reduction through mobile phone communications.


Assuntos
Telefone Celular , Cárie Dentária , Envio de Mensagens de Texto , Adulto , Idoso , Cárie Dentária/prevenção & controle , Odontólogos , Feminino , Humanos , Irlanda , Pessoa de Meia-Idade , Gravidez , Papel Profissional , Método Simples-Cego , Adulto Jovem
13.
Int J Prosthodont ; 33(5): 493-502, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32956430

RESUMO

PURPOSE: To describe and analyze the restorative complications of long-span (> three units) implant-supported dental prostheses (LIDPs) in 27 private practices in the state of Victoria, Australia, during the period from January 1, 2005, to December 31, 2009. MATERIALS AND METHODS: Private dental practitioners providing implant treatment were invited to enroll in this study, which was conducted through a dental practice-based research network. Clinical records of the implant treatments, which were provided during the specified period, were accessed for data collection. LIDPs included implant-supported prostheses of fixed or removable design; namely, fixed partial dentures (IFPDs), fixed complete dentures (IFCDs), removable partial dentures (IRPDs), and complete overdentures (IODs). Descriptive statistics and generalized linear mixed modeling were used for data analysis. RESULTS: The range of observation time for 627 LIDPs was 3 to 72 months (mean ± SD: 3.22 ± 1.49 years). For fixed prostheses, the complication with the highest annual rate was veneer fracture (acrylic: 21%; ceramic: 2.9%), followed by loss of retention for cement-retained IFPDs (14.7%). For mandibular IODs, the highest annual complication rate was for retention complications, whereas for maxillary IODs, it was for acrylic veneer fracture (11.5% and 6.4%, respectively). The peak incidence of complications was during the first year of function in fixed protheses and in IODs. Acrylic veneer fracture in IFCDs and IOD base fracture were more common in patients with preoperative clinician-reported attrition (estimated odds ratios [ORs] = 4.5 and 11.3, respectively; P < .05). Ceramic veneer fracture in fixed protheses and acrylic veneer fracture in IODs were reported more commonly for maxillary compared to mandibular prostheses (ORs = 5 and 22, respectively; P < .05). Mandibular IODs had more frequent retention complications when supported by two compared to four implants (OR = 5.9, P < .05). CONCLUSION: Restorative complications were observed in all categories of LIDPs at various annual rates. Clusters of these complications occurred during the first year of prosthesis function. Patient- and prosthesis-related variables influenced the incidence rate of some of these complications.


Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Odontólogos , Seguimentos , Humanos , Prática Privada , Papel Profissional , Estudos Retrospectivos
14.
Braz Oral Res ; 34: e112, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32876114

RESUMO

Coronavirus disease-2019 (COVID-19) is the most recent infectious disease that is spreading rapidly throughout the world. This study aimed to evaluate the knowledge and awareness levels of dentists on COVID-19. This survey study, consisting of 37 questions, was sent to dentists via an online link in the first two weeks of April 2020. The questionnaire consisted of questions related to the knowledge level of dentists on COVID-19 during the pandemic period. The knowledge level of dentists was assessed with a 24-point scoring, consisting of correct answers. A Chi-square test was used to compare qualitative data (p < 0.05). A total of 267 dentists participated in this study, of which 51.7% were aged under 30 years, and 67% were women. The participants' knowledge level means score was 19.03 ± 3.15. According to these results, 231 were determined (86.5%) as high knowledgeable. Positive associations between increased knowledge level and factors such as being a woman, working in a university hospital, and being informed outside the institution were determined. The knowledge level of the dentists working in Istanbul about the COVID-19 pandemic is quite high.


Assuntos
Infecções por Coronavirus , Odontólogos , Conhecimentos, Atitudes e Prática em Saúde , Pandemias , Pneumonia Viral , Adulto , Betacoronavirus , Feminino , Humanos , Masculino , Inquéritos e Questionários
15.
Quintessence Int ; 51(9): 763-774, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32901237

RESUMO

When dental trauma occurs, initial management on the day of injury has a determining influence on healing and thus on the prognosis of the affected teeth. Improper, delayed, and/or inconsistent treatment often has far-reaching consequences that cannot be reversed later, even with great effort, especially in children and adolescents. In most cases, it is unrealistic or impossible for the patient to get to a specialized dental trauma facility in time. Therefore, it is every dental practitioner's duty to provide adequate initial diagnosis and treatment of dental trauma at their dental practice, even if they do not have routine experience in this area. This article serves as a guide to the initial management of dental trauma. It utilizes a three-tiered approach to illustrate which initial management measures are absolutely essential (MUSTS), which should ideally be performed (SHOULDS), and which are not top priorities but can be performed (CANS) if the necessary time, training and experience, and equipment and facilities are available. For further treatment, dental practitioners should realistically assess the limits of their ability to treat complex dental trauma cases and, if necessary, they should refer the patient to a specialist or specialized treatment center. (Quintessence Int 2020;51:763-774; doi: 10.3290/j.qi.a45103; modified from a previously published article (in German) Quintessenz 2019;70(9):990-1002).


Assuntos
Avulsão Dentária , Traumatismos Dentários , Adolescente , Criança , Odontólogos , Humanos , Papel Profissional , Prognóstico
16.
Quintessence Int ; 51(9): 732-740, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32901235

RESUMO

OBJECTIVE: The present study compared the efficacy of preoperative administration of paracetamol and placebo in reducing postoperative pain after routine dental treatment in children. The primary objective was to compare postoperative pain level between the groups. The secondary objective was to identify other factors that can influence postoperative pain. METHOD AND MATERIALS: A prospective, placebo-controlled parallel-group trial was conducted on two groups of children aged 5 to 12 years. One hundred and two children participated in the study, 51 in each group, 58 boys (56.9%) and 44 girls (43.1%). The average age was 7 ± 1.72 years, with no difference in age and sex between the groups. The study group received paracetamol (15 mg/kg) and the control group received placebo 15 minutes before dental treatment. Pretreatment baseline anxiety was recorded. Postoperative data were collected immediately at the end of the treatment, and by phone 2.5 hours after taking the remedy. RESULTS: The groups showed no difference in postoperative pain immediately after the treatment and 1.5 hours after treatment. The pain score was higher among children who received stainless steel crowns and combinations of crowns, pulpectomy, and extractions. CONCLUSION: Preoperative use of paracetamol has the same preemptive analgesic effect as placebo in pediatric patients who receive routine dental treatment. CLINICAL RELEVANCE: Postoperative pain can influence the willingness of children to receive consecutive treatments. Dental practitioners should prevent postoperative pain and recommend analgesia when necessary. Pain is expected after performing stainless steel crowns, pulpectomies, and extractions. The current study confirms that preoperative paracetamol has no beneficial effect.


Assuntos
Acetaminofen , Odontólogos , Manejo da Dor , Criança , Pré-Escolar , Método Duplo-Cego , Feminino , Humanos , Masculino , Papel Profissional , Estudos Prospectivos
17.
J Am Dent Assoc ; 151(10): 770-781.e6, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32979956

RESUMO

BACKGROUND: Little is known about antibiotic prescribing practices of dentists. The objective of this study was to gain a better understanding of dentists' beliefs and behaviors regarding the use of antibiotic prophylaxis (AP) before invasive dental procedures. METHODS: A multidisciplinary team developed and disseminated a questionnaire to 3,584 dentist members of the National Dental Practice-Based Research Network. RESULTS: Overall, 2,169 network dentists (61%) responded. Respondents saw patients at risk of developing infective endocarditis (IE) and prosthetic joint infection (PJI) at least once per week (35% and 65%, respectively). Although 78% of dentists agreed that the 2007 American Heart Association guidelines for the prevention of IE are well-defined and clear, only 49% agreed concerning PJI guidelines. Differences for the IE and PJI patient populations also existed for questions regarding dentists' understanding of the specific patient groups at risk, the recommended antibiotic regimens, and the need to consult with a patient's cardiologist or orthopedic surgeon. CONCLUSIONS: The survey results indicate that decision making regarding the use of AP occurs frequently among dentists. Moreover, dentists reported uncertainty about the appropriate use of AP as defined by both IE and PJI guidelines, which may have resulted in a lack of concordance between dentists' beliefs and their practice behaviors. PRACTICAL IMPLICATIONS: The results reported by the authors highlight the need to develop better educational programs that address antimicrobial stewardship in AP for patients at risk of developing IE and PJI and target the dental profession.


Assuntos
Endocardite , Fidelidade a Diretrizes , Antibacterianos/uso terapêutico , Antibioticoprofilaxia , Odontólogos , Humanos , Padrões de Prática Odontológica , Inquéritos e Questionários
18.
J Evid Based Dent Pract ; 20(3): 101459, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32921379

RESUMO

OBJECTIVE: The dimensions of oral health-related quality of life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the major areas where patients are impacted by oral diseases and dental interventions. The aim of this study was to evaluate whether dental patients' reasons to visit the dentist fit the 4 OHRQoL dimensions. METHODS: Dentists (N = 1580) from 32 countries participated in a web-based survey. For their patients with current oral health problems, dentists were asked whether these problems were related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact or whether they do not fit the aforementioned 4 categories. Dentists were also asked about their patients who intended to prevent future oral health problems. For both patient groups, the proportions of oral health problems falling into the 4 OHRQoL dimensions were calculated. RESULTS: For every 100 dental patients with current oral health problems, 96 had problems related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact. For every 100 dental patients who wanted to prevent future oral health problems, 92 wanted to prevent problems related to these 4 OHRQoL dimensions. Both numbers increased to at least 98 of 100 patients when experts analyzed dentists' explanations of why some oral health problems would not fit the four dimension. For the remaining 2 of 100 patients, none of the dentist-provided explanations suggested evidence against the OHRQoL dimensions as the concepts that capture dental patients' suffering. CONCLUSION: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact capture dental patients' oral health problems worldwide. These 4 OHRQoL dimensions offer a psychometrically sound and practical framework for patient care and research, identifying what is important to dental patients.


Assuntos
Saúde Bucal , Qualidade de Vida , Odontólogos , Humanos , Inquéritos e Questionários , Organização Mundial da Saúde
19.
Br Dent J ; 229(6): 325, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32978554
20.
Evid Based Dent ; 21(3): 88, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32978534

RESUMO

Data sources The following electronic databases were searched: MEDLINE, EMBASE, PsycoINFO, Scopis, WoS, AMED, CENTRAL Open alongside the Open Grey database and Cochrane Library of systematic reviews. In addition, reference lists of included studies and systematic reviews were searched.Study selection Initial screening was undertaken by two independent reviewers against the PICO and inclusion/exclusion criteria. Discrepancies between reviewers were resolved by a third reviewer.Data extraction and synthesis Data was extracted from included studies using a standardised form. Three summary measures were calculated: prevented fraction (PF); standardised mean difference (SMD); and standardised effect size (ES). Where concerns about incomplete data were encountered, authors were contacted to provide clarification; if data was not able to be completed, the study was excluded.Results Following screening, 38 selected manuscripts explored the impact of sugar-free gum (SFG) across all aspects of oral health. From this, data was extracted from 12 studies with dental caries outcomes included; of these, eight explored xylitol gum as the intervention and were analysed separately. A significant reduction in caries incidence was found with the use of SFGs - PF of 28% (95%CI 7%-48%). In the eight trials that used xylitol-only gum as the basis of the intervention, the PF increased to 33% (95% CI 4%-61%). No adverse effects were recorded. There was a high level of heterogeneity among the trials included.Conclusions The use of SFG was shown to have a significant, but tentative, effect in reducing the incidence of caries, compared to those who do not or use other sugar-free alternatives. The authors comment that a considerable degree of variability was noted between the trials reviewed. Further research is required in this field to provide robust empirical evidence.


Assuntos
Goma de Mascar , Cárie Dentária , Odontólogos , Humanos , Saúde Bucal , Xilitol
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