Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 160
Filtrar
1.
Braz Oral Res ; 34: e041, 2020 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-32401931

RESUMO

The expansion of coronavirus disease 2019 (COVID-19) throughout the world has alarmed all health professionals. Especially in dentistry, there is a growing concern due to it's high virulence and routes of transmission through saliva aerosols. The virus keeps viable on air for at least 3 hours and on plastic and stainless-steel surfaces up to 72 hours. In this sense, dental offices, both in the public and private sectors, are high-risk settings of cross infection among patients, dentists and health professionals in the clinical environment (including hospital's intensive dental care facilities). This manuscript aims to compile current available evidence on prevention strategies for dental professionals. Besides, we briefly describe promising treatment strategies recognized until this moment. The purpose is to clarify dental practitioners about the virus history and microbiology, besides guiding on how to proceed during emergency consultations based on international documents. Dentists should consider that a substantial number of individuals (including children) who do not show any signs and symptoms of COVID-19 may be infected and can disseminate the virus. Currently, there is no effective treatment and fast diagnosis is still a challenge. All elective dental treatments and non-essential procedures should be postponed, keeping only urgent and emergency visits to the dental office. The use of teledentistry (phone calls, text messages) is a very promising tool to keep contact with the patient without being at risk of infection.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Assistência Odontológica/normas , Saúde Bucal/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Padrões de Prática Odontológica/normas , Betacoronavirus/patogenicidade , Infecções por Coronavirus/transmissão , Odontólogos/normas , Humanos , Pneumonia Viral/transmissão , Guias de Prática Clínica como Assunto , Fatores de Risco
3.
Artigo em Inglês | LILACS | ID: biblio-1095345

RESUMO

As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted mainly through droplets, sneezes and aerosols, there is a high risk of transmission during dental procedures. This report describes measures that can be adopted by oral healthcare personnel to minimize the risk of cross-contamination in clinical practice during the current SARS-CoV-2 pandemic. (AU)


Dado que el SARS-CoV-2, causante de síndrome respiratorio agudo severo, se transmite principalmente por medio de gotitas, estornudos y aerosoles, existe un alto riesgo de transmisión durante los procedimientos dentales. En este informe se describen las medidas que puede adoptar el personal de salud bucodental para reducir al mínimo el riesgo de contaminación cruzada en la práctica clínica durante la actual pandemia por SARS-CoV-2.(AU)


Como o SARS-CoV-2, que causa síndrome respiratória aguda grave, é transmitido principalmente por gotícu-las, espirros e aerossóis, há um alto risco de transmissão durante os procedimentos odontológicos. Este relatório descreve os passos que podem ser tomados pelo pessoal de saúde oral para minimizar o risco de contaminação cruzada na prática clínica durante a actual pandemia do SARS-CoV-2.(AU)


Assuntos
Humanos , Pneumonia Viral/prevenção & controle , Assistência Odontológica/normas , Infecções por Coronavirus/prevenção & controle , Padrões de Prática Odontológica/normas , Pandemias
4.
Dent Clin North Am ; 63(1): 1-16, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30447786

RESUMO

Constructing an evidence-based dental practice requires leadership, commitment, technology support, and time, as well as skill practice in searching, appraising, and organizing evidence. In mastering the skills of evidence-based dentistry, clinicians can implement high-quality science into practice through a variety of opportunities including the development of clinical care guidelines, procedural technique protocols, and electronic dental record auto-note templates, as well as treatment planning, care prioritization, and case presentation. The benefits of building an evidence-based dental practice are many, including improvements in patient care and satisfaction, increased treatment predictability and confidence in care approaches, as well as potential cost savings.


Assuntos
Registros Odontológicos/normas , Odontologia Baseada em Evidências , Padrões de Prática Odontológica/normas , Redução de Custos , Assistência Odontológica/normas , Consultórios Odontológicos , Recursos Humanos em Odontologia , Educação em Odontologia , Implementação de Plano de Saúde , Humanos , Internet , Planejamento de Assistência ao Paciente , Satisfação do Paciente , Guias de Prática Clínica como Assunto , Administração da Prática Odontológica , Garantia da Qualidade dos Cuidados de Saúde/normas , Sociedades Odontológicas
5.
Dent Clin North Am ; 63(1): 83-95, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30447794

RESUMO

Oral medicine is "the discipline of dentistry concerned with the oral health care of medically complex patients, including the diagnosis and primarily nonsurgical treatment and/or management of medically related conditions affecting the oral and maxillofacial region." In each of these areas, evidence-based medicine has shaped theoretic understanding and clinical practice. The available evidence allows for improved patient management. Further evidence, as it becomes available, should be reviewed on a regular basis to guide our clinical practice.


Assuntos
Odontologia Baseada em Evidências/normas , Medicina Baseada em Evidências/normas , Medicina Bucal/normas , Padrões de Prática Odontológica/normas , Antibioticoprofilaxia , Assistência Odontológica , Consultórios Odontológicos , Dor Facial , Humanos , Boca , Doenças da Boca , Saúde Bucal , Doenças das Glândulas Salivares
7.
Wiad Lek ; 71(3 pt 2): 738-745, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29783259

RESUMO

OBJECTIVE: Introduction:The problem of temporomandibular disorders (TMD) is relevant in today's world and is considered one of the most common pathologies causing nonodontogenic pain syndromes of maxillofacial region. The morbidity of temporomandibular disorders is 27 to 76% among patients who seek dental care. There is now a significant number of classifications of TMD, however, clinically convenient, morphologically and pathogenetically substantiated classification of temporomandibular joint's (TMJ) conditions has not yet been developed. Therefore, the patient's examination protocols differ substantially. The aim: To analyze and assess the quality of classifications and examination protocols for the patients with suspected TMD. PATIENTS AND METHODS: Materials and methods: A comparative analysis of 5 TMD classifications and 3 protocols for the examination of patients with suspected TMDs were performed. RESULTS: Review: A comparative analysis of following TMD classifications was conducted: American Academy of Orofacial Pain, Research Diagnostic Criteria for TMD, by B.W.Neville, D.D.Damm, C.M.Allen, J.E.Bouquot, by Christian Köneke, international classification of diseases ICD-10. The analysis of the following protocols for the examination of patients with suspected TMDs was conducted: M. Helkimo index, Hamburg protocol, M. Kleinrok protocol. CONCLUSION: Conclusions: Difficulties in interpreting diagnoses by dentists are caused by ambiguities in classifications, a considerable number of clinical entities and their construction principles. Organ principle of structure has proved to be the most convenient for clinical application. The evaluation protocols are cumbersome and duplicate each other. Owing to the lack of a common opinion about the origin and development of TMD, use of the evaluation protocols is based on the experience of dental practitioners.


Assuntos
Exame Físico/classificação , Padrões de Prática Odontológica/normas , Transtornos da Articulação Temporomandibular/classificação , Transtornos da Articulação Temporomandibular/diagnóstico , Diagnóstico Diferencial , Dor Facial/diagnóstico , Feminino , Cefaleia/diagnóstico , Humanos , Luxações Articulares/diagnóstico , Masculino , Mialgia/diagnóstico , Terminologia como Assunto
8.
J Dent ; 67: 102-106, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29031996

RESUMO

OBJECTIVES: The primary aim of this study was to evaluate the quality of published dental clinical guidelines using the AGREE II instrument. METHODS: Online searching of a wide range of organisations (national and International) was undertaken to identify dental clinical practice guidelines published between 2000 and 2014. The quality of each included guideline was assessed in relation to the AGREE II instrument by four assessors independently. Inter-rater agreement was assessed. Descriptive statistics and both univariate and multivariate analyses were conducted. RESULTS: 162 guidelines were identified. The overall mean quality score was 51.9% (SD 13.3). There was variation in the reporting quality of individual domains with both Applicability (20.4%) and Editorial Independence (34.25%) poorly reported. Variation between the overall quality scores for guidelines produced by different dental specialities was evident. The quality of guidelines improved per publication year (ß=0.76, 95% CI: 0.26, 1.26, p=0.003). Guidelines based on formal evidence (ß=19.94, 95% CI: 15.25, 24.64, p=0.001) achieved higher quality scores. CONCLUSION: Overall, the quality of clinical dental practice guidelines is suboptimal. There is variation in the overall quality, reporting of individual items and domains of the AGREE II instrument between different dental speciality clinical practice guidelines. Guidelines based on formal evidence achieved higher quality scores. CLINICAL SIGNIFICANCE: Clinicians should be aware of the variation in the quality of dental clinical guidelines in particular related to methodological rigour. The use of formal evidence may be a useful indicator of their quality prior to their implementation.


Assuntos
Odontologia/normas , Guias de Prática Clínica como Assunto/normas , Padrões de Prática Odontológica/normas , Bases de Dados Factuais , Odontologia Baseada em Evidências/normas , Medicina Baseada em Evidências/normas , Humanos , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Publicações , Análise de Regressão
9.
Aust Dent J ; 62(4): 426-432, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28423461

RESUMO

BACKGROUND: Adherence to the Dental Board of Australia Guidelines on dental records is not universal and remediation of deficient practise requires clarity in the practical application of standards. The aim of this research is to clarify practical requirements of dental record keeping in New South Wales. METHODS: Seventeen experts were invited to participate in an electronically administered series of Delphi questionnaires. Concepts were refined until consensus was reached. RESULTS: Two rounds were required to achieve a satisfactory level of consensus (>80%). A high level of consensus was obtained across the two rounds, with 72% and 86% agreement on propositions in the first and second rounds, respectively. Consensus criteria were established in 14 domains to establish attributes of the complete dental record (ACDR). CONCLUSIONS: The ACDR may supplement existing national guidelines and are likely to be useful in a remediation context in which clear, unambiguous expectations for conduct are paramount.


Assuntos
Técnica Delfos , Registros Odontológicos/normas , Padrões de Prática Odontológica/normas , Consenso , Humanos , New South Wales , Guias de Prática Clínica como Assunto/normas , Inquéritos e Questionários
11.
J Am Pharm Assoc (2003) ; 57(2S): S78-S82, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28215574

RESUMO

OBJECTIVES: To compare rates of dental opioid prescribing between periods of full and partial integration of pharmacy services and periods of no integration. METHODS: This observational study used a retrospective chart review of opioid prescriptions written by dental providers practicing in a free dental clinic for the medically underserved over a period of 74 months. Pharmacy services were fully integrated into the practice model for 48 of the 74 months under study. During this time frame, all dental opioid orders required review by the pharmacy department before prescribing. Outcomes related to prescribing rates and errors were compared between groups, which were defined by the level of integrated pharmacy services. Demographic and prescription-specific data (drug name, dose, quantity, directions, professional designation of individual entering order) and clinic appointment data were collected and analyzed with the use of descriptive and inferential statistics. RESULTS: A total of 102 opioids were prescribed to 89 patients; hydrocodone-acetaminophen combination products were the most frequently used. Opioid prescribing rates were 5 times greater when pharmacy services were not integrated (P <0.001); and dentists were 81% less likely to prescribe opioids when pharmacy was fully integrated (odds ratio 0.19, 95% confidence interval 0.124-0.293; P <0.001). Frequency of hydrocodone use compared with other opioids did not decrease after the rescheduling of hydrocodone to a Schedule II controlled substance. The frequency of prescribing errors was not statistically different between groups, although there were numerically fewer errors with integrated pharmacy services. CONCLUSION: The literature reports that dentists are the third most frequent prescribers of opioids. The findings from this study suggest that collaboration between pharmacists and dentists has the potential to decrease opioid utilization in primary dental practice.


Assuntos
Analgésicos Opioides/administração & dosagem , Assistência Farmacêutica/organização & administração , Farmacêuticos/organização & administração , Padrões de Prática Odontológica/estatística & dados numéricos , Acetaminofen/administração & dosagem , Adulto , Idoso , Comportamento Cooperativo , Prestação Integrada de Cuidados de Saúde/organização & administração , Assistência Odontológica/organização & administração , Combinação de Medicamentos , Feminino , Humanos , Hidrocodona/administração & dosagem , Masculino , Área Carente de Assistência Médica , Erros de Medicação/prevenção & controle , Erros de Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Padrões de Prática Odontológica/normas , Estudos Retrospectivos , Adulto Jovem
12.
Ned Tijdschr Tandheelkd ; 124(2): 69-74, 2017 Feb.
Artigo em Holandês | MEDLINE | ID: mdl-28186510

RESUMO

The proper functioning of guidelines depends in part on correct validation. Validation requires an established norm. The professional and proto-pro-fessional paradigm uses different standards for validation based on different epistemological assumptions. Several different fundamental principles are also applied among healthcare professionals themselves. This leads to an insurmountable methodological difference whereby validation is not possible or meaningful at the moment. An important role seems reserved for the epistemology of the humanities to explain and interpret the guidelines. In addition, the operationalization of guidelines does not seem to be straightforward. The use of guidelines shows that unintended effects, such as the exclusion of patients from insurance and reimbursement, arise. In addition the number of guidelines is increasing to such an extent that implementation and enforcement are in danger of being compromised. Recommendations are made to monitor the significance and effect of guidelines.


Assuntos
Guias de Prática Clínica como Assunto/normas , Padrões de Prática Odontológica/normas , Odontologia Baseada em Evidências , Fidelidade a Diretrizes , Humanos , Qualidade da Assistência à Saúde
13.
Rev. esp. quimioter ; 30(1): 34-39, feb. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-159557

RESUMO

Objetivo. Valorar si existe una diferencia significativa en tasa de infección tras cirugía de extracción dentaria en dos hospitales de Noruega y España, donde se aplican protocolos de profilaxis quirúrgica diferentes. Material y Métodos. Se realizó un estudio observacional analítico, tipo cohortes retrospectivo, analizando pacientes sanos, sin factores de riesgo, operados de tercer molar incluido en los servicios de maxilofacial de dos hospitales diferentes: St. Olav de Trondheim (Noruega) y Clínico San Carlos de Madrid (España). Se recogieron las variables: edad, número de piezas extraídas, tipo de anestesia, y observaciones recogidas en la historia clínica sobre el curso de la operación. Para valorar el desarrollo infección postoperatoria se recogieron los datos de los pacientes que escogieron el hospital como lugar de retirada de los puntos en el Hospital St. Olav, y en el Hospital Clínico San Carlos se llevó a cabo una encuesta telefónica para conocer el curso de la operación meses después. Resultados. El 11,1% de los pacientes operados en el Hospital St. Olav recibió pauta antibiótica durante una semana tras la operación, mientras que en el Hospital Clínico San Carlos fue del 100%. La tasa de infección tras ésta fue del 15% en el Hospital de St. Olav y del 7,5% en el Hospital Clínico siendo estas diferencias no estadísticamente significativas. Conclusiones. La administración sistemática de antibiótico a pacientes sanos sin factores de riesgo sometidos a extracción quirúrgica del tercer molar retenido es una práctica rutinaria en clínica que no parece estar justificada (AU)


Objective. To assess whether there is a significant difference in infection rate after surgery tooth extraction in two different hospitals from Norway and Spain where different surgical antimicrobial prophylaxis protocols are applied. Methods. An analytical observational study was conducted, retrospective cohorts type, analyzing healthy patients with no risk factors, who were third molar tooth operated in maxillofacial services of two different hospitals: St. Olav in Trondheim (Norway) and Clínico San Carlos in Madrid (Spain). The collected variables were: age, number of tooth removed, anesthesia type, and observations about the course of the operation registered in the clinical history. To assess the development of postoperative infection, patient’s data of those who chose the hospital as the place to remove the suture thread were collected in Norway, whereas in Spain a telephone survey was conducted to determine the course of the operation months later. Results. In St. Olav Hospital 11.1% of patients operated received antibiotic regimen after surgery, while in Hospital San Carlos were 100%. The infection rate was 15% in St.Olav Hospital and 7.5% in Hospital San Carlos. These differences were no statistically significant. Conclusions. The routine administration of antibiotics to healthy patients with no risk factors undergoing impacted third molar surgical removal is a common clinical practice which it does not seem to be justified (AU)


Assuntos
Humanos , Masculino , Feminino , Padrões de Prática Odontológica/normas , Prescrições de Medicamentos/normas , Dente Impactado/tratamento farmacológico , Dente Impactado/prevenção & controle , Profilaxia Dentária/métodos , Dente Serotino , Dente Serotino/cirurgia , Estudos Retrospectivos , Estudos de Coortes
14.
J Eval Clin Pract ; 23(1): 96-101, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27491703

RESUMO

RATIONALE, AIMS AND OBJECTIVES: The objectives of this study were to: (1) examine differences in the use of dental clinical practice guidelines among Japanese dentists, and (2) identify characteristics associated with the number of guidelines used by participating dentists. METHODS: We conducted a cross-sectional study consisting of a questionnaire survey in Japan between July 2014 and May 2015. The study queried dentists working in outpatient dental practices who are affiliated with the Dental Practice-Based Research Network Japan (n = 148). They were asked whether they have used each of 15 Japanese dental clinical guidelines. Associations between the number of guidelines used by participants and specific characteristics were analysed via negative binomial regression analysis. RESULTS: The mean number of guidelines used by participating dentists was 2.5 ± 2.9 [standard deviation (SD)]. Rate of use of guidelines showed substantial variation, from 5% to 34% among dentists. The proportion of dentists that used guidelines was the highest among oral medicine specialists, who had the highest proportion for 10 of 15 guidelines. Negative binomial regression analysis identified three factors significantly associated with the number of guidelines used: 'years since graduation from dental school', 'specialty practice' and 'practice busyness'. CONCLUSIONS: These results suggest that the use of clinical practice guidelines by Japanese dentists may still be inadequate. Training in the use of the guidelines could be given to dental students as undergraduate education and to young clinicians as continuing education.


Assuntos
Fidelidade a Diretrizes/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Padrões de Prática Odontológica/estatística & dados numéricos , Padrões de Prática Odontológica/normas , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Fatores Socioeconômicos
15.
J Indian Soc Pedod Prev Dent ; 34(4): 348-53, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27681398

RESUMO

CONTEXT: To investigate the antibiotic prescribing training received by dental students, clinical experience in treating child patients, awareness of antibiotic prescribing guidelines, preparedness in antibiotic prescribing, and compliance with antibiotic prescribing guidelines for the management of dental infections in children. METHODS: This was a cross-sectional study involving final year dentals students from Malaysian and Asian dental schools. A self-administered questionnaire consisting of five clinical case scenarios was e-mailed to all final year students at selected dental schools. Students' responses were compared for each clinical case scenario with the prescribing guidelines of the American Academy of Pediatric Dentistry and the American Dental Association. Compliance in each scenario was tested for association with their preparedness in antibiotic prescribing, previous training on antibiotic prescribing and awareness of antibiotic prescribing guidelines using Chi-square test. Data collected were analyzed using SPSS statistics version 20. RESULTS: A total of 108 completed responses were received. About 74 (69%) students were from Malaysian dental schools. The compliance rate with prescribing guidelines ranged from 15.7% to 43.5%. Those attending Malaysian dental schools (47.3%) and those who had treated child patient more often (46.3%) were more likely (P < 0.05) to be aware of the guidelines. Those who had received antibiotic prescribing training (21.3%) were more likely to think they were well prepared in antibiotic prescribing (P < 0.05). CONCLUSIONS: Final year dental students had low awareness and compliance with antibiotic prescribing guidelines. Further research is needed to investigate how compliance with the guidelines may be enhanced.


Assuntos
Antibacterianos/uso terapêutico , Atitude do Pessoal de Saúde , Prescrições de Medicamentos/normas , Fidelidade a Diretrizes/normas , Estudantes de Odontologia/psicologia , Doenças Dentárias/tratamento farmacológico , American Dental Association , Distribuição de Qui-Quadrado , Estudos Transversais , Educação em Odontologia , Feminino , Humanos , Malásia , Masculino , Odontopediatria , Guias de Prática Clínica como Assunto , Padrões de Prática Odontológica/normas , Inquéritos e Questionários , Estados Unidos
16.
Trials ; 17(1): 201, 2016 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-27084667

RESUMO

BACKGROUND: White spot lesions (WSLs) occur as a side effect in over 25 % of patients who undergo orthodontic treatment, causing aesthetic problems and a risk of deeper enamel and dentine lesions. Dutch orthodontists show substantial variation in their application of WSL preventive measures, which include little incorporation of evidence from the literature. We recently developed an evidence-based clinical practice guideline (CPG) on this topic, which was further converted into a computerized clinical decision support system (CDSS) to facilitate its incorporation into clinical practice. The present study aimed to assess the effectiveness of this CPG-based CDSS, with regard to actually preventing WSL development during orthodontic treatment with fixed appliances compared to usual preventive measures. Our study also aimed to evaluate the effects of implementing the CPG-based CDSS into routine clinical practice using a multifaceted strategy. METHODS/DESIGN: We designed a hybrid effectiveness-implementation study assessing both clinical effectiveness of the CPG and its implementation into routine practice. A total of 840 patients nested in 14 orthodontic practices will be randomly assigned as clusters to the intervention or the control arm. Patients recruited by the orthodontist in the intervention group will be treated following the CPG, while the usual preventative measures will be followed in the control arm. The primary outcome measure is the proportion of patients with newly formed or enlarged WSLs after 6-9 months of treatment with fixed appliances, and at the end of treatment, using the CPG for WSL prevention compared with usual preventive measures. An additional aim is to obtain some preliminary outcomes regarding the implementation process. DISCUSSION: This study investigates the effectiveness of a newly developed guideline to improve oral health during orthodontic treatment, while simultaneously illuminating potential difficulties in adopting a guideline in general orthodontic practice. The innovative features of this study include the risk-based CDSS that discriminates between patients' oral health statuses with regard to preventive measure utilization in general orthodontic practices. Most studies focusing on WSL prevention apply the preventive intervention to each patient in an experimental setting, resulting in overtreatment and a disconnect from the real-world conditions in which the intervention is to be applied. Additionally, one of the overreaching goals of this initiative is to create a gold standard for WSL prevention during orthodontic treatment, against which future studies can compare new promising preventive measures and the readiness of clinicians to change and adopt new treatments. By doing so, we want to help bridge the gap between science and orthodontic clinical practice and improve the quality of oral health care. TRIAL REGISTRATION: This trial is registered with the Dutch Trial Registry of the Dutch Cochrane Center under number NTR5012 , registration date 2 March 2015.


Assuntos
Cárie Dentária/prevenção & controle , Saúde Bucal/normas , Aparelhos Ortodônticos/efeitos adversos , Ortodontia/normas , Guias de Prática Clínica como Assunto/normas , Padrões de Prática Odontológica/normas , Adolescente , Criança , Protocolos Clínicos , Sistemas de Apoio a Decisões Clínicas , Técnicas de Apoio para a Decisão , Cárie Dentária/etiologia , Feminino , Fidelidade a Diretrizes/normas , Humanos , Masculino , Países Baixos , Desenho de Aparelho Ortodôntico , Projetos de Pesquisa , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
17.
BMJ Open ; 5(12): e009779, 2015 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-26656026

RESUMO

OBJECTIVES: Use of a rubber dam during root canal treatment is considered the standard of care because it enhances patient safety and optimises the odds of successful treatment. Nonetheless, not all dentists use a rubber dam, creating disconnect between presumed standard of care and what is actually done in clinical practice. Little is known about dentists' attitudes towards use of the rubber dam in their practices. The objectives were to: (1) quantify these attitudes and (2) test the hypothesis that specific attitudes are significantly associated with rubber dam use. SETTING: National Dental Practice-Based Research Network (NationalDentalPBRN.org). PARTICIPANTS: 1490 network dentists. OUTCOME MEASURES: Dentists completed a questionnaire about their attitudes towards rubber dam use during root canal treatment. Three attitude scales comprised 33 items that used a 5-point ordinal scale to measure beliefs about effectiveness, inconvenience, ease of placement, comparison to other isolation techniques and patient factors. Factor analysis, cluster analysis and multivariable logistic regression analysed the relationship between attitudes and rubber dam use. RESULTS: All items had responses at each point on the 5-point scale, with an overall pattern of substantial variation across dentists. Five attitudinal factors (rubber dam effectiveness; inconvenient/time-consuming; ease of placement; effectiveness compared to Isolite; patient factors) and 4 clusters of practitioners were identified. Each factor and cluster was independently and strongly associated with rubber dam use. CONCLUSIONS: General dentists have substantial variation in attitudes about rubber dam use. Beliefs that rubber dam use is not effective, inconvenient, time-consuming, not easy to place or affected by patient factors, were independently and significantly associated with lower rubber dam use. These attitudes explain why there is substantial discordance between presumed standard of care and actual practice.


Assuntos
Atitude do Pessoal de Saúde , Odontólogos/psicologia , Padrões de Prática Odontológica/normas , Tratamento do Canal Radicular/métodos , Diques de Borracha/estatística & dados numéricos , Padrão de Cuidado , Feminino , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Autorrelato
18.
Rev. Asoc. Odontol. Argent ; 103(4): 151-153, dic.2015.
Artigo em Espanhol | LILACS | ID: lil-781813

RESUMO

En la odontología, el aislamiento absoluto del campo operatorio facilita y aumenta la eficacia de todos los procedimientos clínicos. Un campo operatorio seco y libre de contaminación protege al paciente, al profesional y al personal auxiliar. En general, el profesional, por incapacidad o impericia, recurre con frecuencia a excusas, sin comprender que su uso es lógico e insustituíble. La caída de instrumentos y la ingestión o la aspiración de cuerpos extraños que tienen origen dental constituyen la segunda causa médica más común de este tipo de accidentes. Teniendo en cuenta todos los cuidados y las precauciones que se toman para combatir y/o prevenir la infección microbiana durante un tratamiento endodóntico, resulta paradójico que muchas veces, en la reconstrucción posendodóntica, se trabaje sin efectuar la aislación absoluta...


Assuntos
Humanos , Instrumentos Odontológicos , Diques de Borracha , Preparo de Canal Radicular/instrumentação , Controle de Infecções Dentárias/métodos , Padrões de Prática Odontológica/normas
19.
Ned Tijdschr Tandheelkd ; 122(3): 148-55, 2015 Mar.
Artigo em Holandês | MEDLINE | ID: mdl-26181393

RESUMO

Adherence to clinical guidelines requires support in practice. However, systematic implementation of evidence-based guidelines is not common practice in oral healthcare. The Knowledge Institute Oral Care (KiMo) offers the opportunity to take into account potential barriers and facilitators during the development of evidence-based clinical practice guidelines. These factors which are relevant to the guideline and the oral healthcare practice provide the ingredients for a tailor-made programme of implementation that has a scientific basis. Elements of any implementation programme are the quality indicators derived from the oral healthcare guidelines. These indicators should fit, on the one hand, the specific goals of the guidelines (patient safety, effectiveness, efficiency, patient-centred, timeliness, accessibility) and, onthe other hand, the various perspectives of the different stakeholders, such as patients, caregivers, health insurers and inspectorate. These quality indicators provide information on adherence to the guidelines, the results of a certain treatment and the success of the implementation strategy, all with the aim to improve the quality of oral healthcare.


Assuntos
Odontologia Baseada em Evidências , Guias de Prática Clínica como Assunto/normas , Padrões de Prática Odontológica/normas , Qualidade da Assistência à Saúde , Fidelidade a Diretrizes , Conhecimentos, Atitudes e Prática em Saúde , Humanos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA