Dental care of hospitalized pediatric patient with tetralogy of Fallot: a case report / Atendimento odontológico hospitalar de paciente pediátrico com tetralogia de Fallot: relato de caso

ABSTRACT Tetralogy of Fallot is the most prevalent cyanotic congenital heart disease and it has a high mortality rate. The aim of this article was to provide a clinical case, describing the dental treatment of an infant patient with tetralogy of Fallot done at a hospital. The patient was a 7-year-old male, lived in a rural area with no previous diagnosis of this cardiopathy when he was attended to by a multidisciplinary team at University Hospital Ana Bezerra, at Santa Cruz, Northern Rio Grande, Brazil. After his medical appointment, the patient received a visit from the dental resident in Mother-Infant Health in his hospital room. During the dental exam, multiple carious lesions were found and there was an urgent need to reduce the risk of dental infection before the patient underwent heart surgery. The treatment started with a preventive approach, including oral hygiene instruction and behavior management. The treatment was completed using the atraumatic restorative technique, and a root tip was extracted. Antibiotic prophylaxis was administered before the extraction to minimize the risk of infectious endocarditis. After the dental treatment, the multidisciplinary team referred the patient for surgery to address the tetralogy of Fallot. The integration between the multidisciplinary residency and the medical team was important to reduce the risks of infectious endocarditis during the dental treatment, aiming to provide integral care to this patient.

RESUMO A tetralogia de Fallot é a cardiopatia cianótica congênita mais prevalente, e apresenta alta mortalidade. O objetivo do presente artigo foi descrever um caso clínico de atendimento odontológico de paciente infantil com tetralogia de Fallot em ambiente hospitalar. O paciente de 7 anos de idade, sexo masculino, morador da zona rural, não possuía o diagnóstico da cardiopatia quando buscou o serviço e foi atendido pela equipe multidisciplinar do Hospital Universitário Ana Bezerra, em Santa Cruz, Rio Grande do Norte, Brasil. O paciente, após atendimento médico, recebeu no leito da enfermaria do hospital a visita do cirurgião-dentista residente na Residência Multiprofissional em Saúde Materno-Infantil. Após avaliação bucal, verificou-se múltiplas lesões de cárie, e necessidade de tratamento odontológico urgente para redução de risco do foco infeccioso, previamente ao procedimento cirúrgico da cardiopatia. O tratamento iniciou pela abordagem preventiva, com orientações de higiene oral e condicionamento psicológico, e em seguida foi feito tratamento restaurador, pela técnica restauradora atraumática e extração de um fragmento radicular. A profilaxia antibiótica foi realizada antes da extração, para minimizar o risco de endocardite bacteriana. Após o atendimento odontológico, o paciente foi encaminhado pela equipe multidisciplinar para a abordagem cirúrgica da tetralogia de Fallot. A integração da residência multiprofissional com a equipe médica foi importante para a redução de riscos de endocardite bacteriana durante os procedimentos odontológicos, visando uma atenção integral ao paciente.

The Role of an Individual's Perception of their Partner's Oral Health in Heterosexual Couples

Abstract Objective: To analyze the role of an individual's perception of their partner's oral health in heterosexual couples. Material and Methods: The exploratory study with a qualitative and quantitative approach and data were collected in households in 2015. The quantitative data were analyzed using simple and multivariate binary logistic regression (p<0.05), and the qualitative using Thematic Content Analysis. Results: Of 143 participants, 113 (79.0%) were in a relationship and made up the final sample of the present study. Both women and men reported a small percentage of discomfort in relation to their partners' oral health (23.1% vs. 14.8%; p=0.199), and only a few had received complaints about their own oral health (20.7% vs. 10.7%; p=0.179). However, almost half of the sample had been told by their partner to see the dentist (47.6% vs. 31.0%; p=0.156), and of these, most were men (48.3% vs. 25.0%; p=0.022). The men that were more likely to be told by their partners to see the dentist (OR=5.82; 95% CI: 1.71-19.80) were upper-class (OR=3.35; 95% CI: 1.05-10.67), workers (OR=7.45; 95% CI: 1.62-34.20) who were dissatisfied with their oral health (OR=3.45; 95% CI: 1.13-10.51). The participants' reasons for complaining of their partners' oral health or for telling them to see the dentist were related to physiopathological clinical aspects and healthcare habits. Conclusion: The women told their male partners to seek dental services more often, and future studies should explore whether women are predictors of care and the validity of this information as an indicator of the oral health condition of their male partners.

Intraoral findings in newborns: prevalence and associated factors

Aim: To investigate the prevalence of intraoral characteristics and associated factors with neonatal and parent variables in a group of Brazilian newborns. Methods: This cross-sectional study with a descriptive and inferential approach, whose data was obtained through clinical examination, interview and the collection of medical record information. The sample was selected from babies up to three days old, of both sexes, and born between January and December 2013 in the Ana Bezerra University Hospital, in the city of Santa Cruz-RN, Brazil. The exposure variables included neonatal (sex, weight, gestational age, type of delivery and Apgar score) and parent (presence of systemic disease(s), drug use and consanguinity between the parents) variables. Descriptive analysis and Poisson regression were performed to estimate the ratio of gross and adjusted prevalence of intraoral findings (Epstein pearls, Bohn's nodule, dental lamina cyst and ankyloglossia) with the neonatal and parent variables (p<0.05). Results: Of a total of 168 examined newborns, 56.5% (n=95) were male. The most prevalent intraoral feature was the fibrous cord of Magitot, 62.5% (n=105), and the most frequent alteration was Epstein pearls, 44.6% (n=75). Female gender was a factor for Bohn's nodule (OR=0.90; 95%CI:0.82-0.99), and no tobacco use by the father was a protective factor for Epstein pearls (OR=0.73;95%CI:0.55-0.97). Additionally, lower mother's age, between 20-34 years of age (OR=1.58;95%CI:1.07-2.35) and under 19 years of age (OR=1.61; 95%CI:1.03-2.52) increases the chance of having Epstein pearls. Conclusion: There was a high prevalence of alterations in the newborns' oral cavities and there were associations between neonatal and parent variables