ABSTRACT
RESUMO Objetivo: No Brasil, não há escala que avalie a catastrofização dos pais sobre a dor das crianças. O objetivo deste estudo foi traduzir e adaptar transculturalmente o Pain Catastrophizing Scale-Parents para a língua portuguesa do Brasil e avaliar preliminarmente as propriedades psicométricas de pais/outros parentes de crianças com e sem dor de dente. Métodos: Foi realizado um estudo transversal com 237 pais/outros parentes de 237 crianças. A adaptação transcultural da escala para o português brasileiro foi feita conforme a abordagem universalista. Para avaliar a confiabilidade e a validade da escala, os pais/outros parentes fizeram um relato sobre a dor de dente da criança e preencheram as versões brasileiras da Escala de Catastrofização da Dor-Pais e o Questionário de Desconforto Dentário. Resultados: Houve equivalência semântica com a versão original após pequenas modificações. O alfa de Cronbach para os 13 itens da escala foi 0,83 e os respectivos coeficientes de correlação intraclasse do teste-reteste variaram de 0,63 a 0,97. Os escores obtidos na Escala de Catastrofização da Dor-Pais e no Questionário de Desconforto Dentário apresentaram baixa correlação (rho=0,25; p<0,001). O escore total da Escala de Catastrofização da Dor-Pais diferiu significativamente (p<0,001) em crianças com dor de dente à noite (mediana: 30,0; percentil 25-75: 25,0-35,5) quando comparado com o daquelas sem dor de dente (25,5; 20,0-31,0). Conclusões: A versão brasileira da Escala de Catastrofização da Dor-Pais apresentou características aceitáveis nesta avaliação preliminar e pode ser utilizada no Brasil tanto na prática clínica quanto em pesquisas.
ABSTRACT Objective: In Brazil, there is no scale to assess parental catastrophizing about their child's pain. This study aimed to translate and cross-culturally adapt the Pain Catastrophizing Scale-Parents to the Brazilian Portuguese language, as well as to preliminarily evaluate its psychometric properties among parents/guardians of children with and without a toothache. Methods: A cross-sectional study was conducted with 237 parents/other relatives of 237 children. Across-cultural adaptation of the scale into Brazilian Portuguese was carried out according to the universalistic approach. To assess the reliability and validity of the scale, parents/other relatives reported on the child's toothache and filled out the Brazilian versions of the Pain Catastrophizing Scale-Parents and the Dental Discomfort Questionnaire. Results: There was semantic equivalence with the original version after minor modifications. TheCronbach's alpha for the 13 items of the scale was 0.83, and the respective test-retest intraclass correlation coefficients ranged from 0.63 to 0.97. The scores obtained from the Pain Catastrophizing Scale-Parents and the Dental Discomfort Questionnaire had a low correlation (rho=0.25; p<0.001). Thetotal score of the Pain Catastrophizing Scale-Parents differed significantly (p<0.001) in children with a toothache at night (median: 3.0, 25-75 percentile: 25.0-35.5) compared to those who did not have a toothache at night (25.5; 20.0-31.0). Conclusions: The Brazilian version of the Pain Catastrophizing Scale-Parents was acceptable in this preliminary evaluation and can be used in Brazilian clinical and research practice.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Pain , Parents/psychology , Self Report , Catastrophization/diagnosis , Psychometrics , Toothache , Translations , Brazil , Cross-Sectional Studies , Cultural CharacteristicsABSTRACT
Abstract There is little evidence on the long-term effects of pharmacological management in children undergoing dental treatment. This study aimed to assess children's behavior in consecutive dental sessions following oral rehabilitation using different pharmacological regimens for behavioral control. Participants were preschoolers who were previously treated for caries under one of the following: no sedative, oral sedation with midazolam, oral sedation with midazolam/ketamine, or general anesthesia. The children's behavior in the follow-up sessions was assessed using the Ohio State University Behavioral Rating Scale (OSUBRS); higher scores represented less cooperative behavior (range 5-20). Follow-up assessments were conducted on 50 children under four years old for up to 29 months. Data were analyzed by the Friedman/Wilcoxon tests and Cox regression model. OSUBRS mean (standard deviation) scores for the whole sample decreased from 11.9 (5.4) before treatment to 6.8 (3.2) at the final recall session (p < 0.001). Moderate sedation with midazolam (OR 2.9, 95%CI 1.2-6.9) or midazolam/ketamine (OR 4.3, 95%CI 1.6-11.4) improved children's future behavior. The general anesthesia group (n = 4) had a small sample size and the results should be considered with caution. Although invasive dental treatment negatively affected the child's behavior in the dental chair, they became more cooperative over time. Moderately sedated children showed better prospective behavior than those in the non-sedation group.
Subject(s)
Humans , Male , Female , Child, Preschool , Child Behavior/drug effects , Conscious Sedation/methods , Dental Care for Children/methods , Midazolam/therapeutic use , Proportional Hazards Models , Prospective Studies , Reproducibility of Results , Analysis of Variance , Age Factors , Treatment Outcome , Dental Anxiety/prevention & control , Statistics, Nonparametric , Dental Caries/therapy , Hypnotics and Sedatives/therapeutic use , Anesthesia, General/methods , Ketamine/therapeutic use , Anesthetics, Dissociative/therapeutic useABSTRACT
To investigate the two-year survival rate of primary molars treated with non-instrumentation endodontic treatment with mixed antibiotic paste containing chloramphenicol, tetracycline, zinc oxide and eugenol (CTZ pulpotomy), and compare it to the conventional root canal treatment with calcium hydroxide paste. Material and Methods:Thirty-six children, mean age 6.2 years old (standard deviation, SD=1.5), presenting at least one primary molar with irreversible pulpitis or necrotic pulp, were included in this prospective clinical study. Teeth were assigned to CTZ pulpotomy (Group I) or calcium hydroxide pulpectomy (Group II) and assessed clinically and radiographically for up to 26 months. Data were analyzed using descriptive statistics, Chi-square test, Kaplan-Meier survival analysis and Log-rank test. Results:Fifty-three primary molars were treated in Group I (n=37) or Group II (n=16). Children were followed up for 1 to 26 months (mean=12.0; SD=7.1). Treatment failure rates were 73.0% in Group I and 31.3% in Group II. Overall, mean survival time was 15.2 months (95% confidence interval, CI 12.6û17.9); Group I (mean 13.2; 95% CI 10.2-16.3) had a lower survival rate than Group II (mean 18.9; 95% CI 14.5-23.2) (p=0.02). Necrotic pulp treatments had significantly lower survival rates (p=0.01) than pulpitis treatments. Conclusion:Non-instrumentation endodontic treatment of primary molars with CTZ paste resulted in a low survival rate in a two-year follow-up; its radiographic ineffectiveness discourages its use instead of conventional root canal endodontic treatment...
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Dental Pulp Cavity , Molar , Endodontics/methods , Calcium Hydroxide/chemistry , Pulpotomy/methods , Survival Analysis , Brazil , Chi-Square Distribution , Radiography, Dental/instrumentationABSTRACT
Objetivo: Identificar hábitos alimentares, de sucção não nutritiva e de higiene bucal nos primeiros três anos de vida de crianças nascidas prematuras. Materiais e Métodos: Estudo descritivo retrospectivo baseado em dados secundários obtidos de prontuários odontológicos das 109 crianças com história de nascimento prematuro, acompanhadas no Ambulatório Odontológico de Prematuridade do Hospital das Clínicas da Universidade Federal de Goiás, de fevereiro de 2011 a julho de 2012. Consideraram-se informações da primeira consulta odontológica: idade atual, sexo, idade gestacional, hábitos alimentares (tipo de aleitamento, ingestão de açúcar extrínseco), hábitos bucais não nutritivos (sucção de chupeta e sucção digital) e hábitos de higiene bucal. Os dados foram analisados por estatística descritiva com auxílio do software IBM SPSS versão 20.0. Resultados: No primeiro exame odontológico, as crianças nascidas prematuras tinham de 1 a 33 meses de idade (média de 8,6±7,2), sendo 49 (45,0%) meninas e 60 (55,0%) meninos. A ocorrência de aleitamento natural em menores de 6 meses foi de 22,8%, com predominância de aleitamento artificial (45,6%). Do total de nascidos prematuros, 79,8% utilizavam mamadeira e 58,7% realizavam sucção de chupeta. Em relação à higiene bucal, 73,4% da amostra realizava higiene bucal e 44,4% utilizava a fralda como instrumento. Conclusão: Os percentuais de aleitamento materno exclusivo foram baixos. A maioria das crianças apresentou algum hábito de sucção não nutritiva. A prática de higiene bucal mostrou-se insatisfatória. Assim, o estabelecimento de programas educativo-preventivos é essencial no apoio às famílias para os cuidados bucais a essas crianças, visando à promoção de saúde e prevenção de alterações no sistema estomatognático.(AU)
Aim: This study aimed to identify dietary habits, non-nutritive sucking habits, and oral hygiene habits in the first three years of pre-term children. Materials and Methods: This work consists of an observational, retrospective, descriptive study in which secondary data were collected from the clinical records of 109 children attended to at the Dental Clinic for Pre-term Children at the University Hospital of the Federal University of Goias (UFG), from February 2011 to July 2012. This study considered information regarding the child's first dental visit: the child's current age, gender, gestational age, dietary habits (natural breast-feeding, bottle feeding, extrinsic sugar consumption), non-nutritive sucking habits (sucking a pacifier and finger sucking), and oral hygiene habits. Data were analyzed by descriptive statistics using the IBM Statistical Package for the Social Sciences (SPSS®), version 20.0. Results: In the first dental visit, the pre-term children were from 1 to 33 months old (8.6±7,2), with 49 (45.0%) girls and 60 (55.0%) boys. The occurrence of natural breastfeeding in children under 6 months of age was 22.8%, with a predominance of mixed bottle-breastfeeding (45.6%). Of the total number of pre-term children, 79.8% were bottle-fed and 58.7% used pacifiers. Mothers of 73.4% of these children performed their oral hygiene, while 44.4% used only a soft cloth diaper to perform oral hygiene. Conclusions: The percentage of exclusive breastfeeding was low. The majority of children presented some type of non-nutritive sucking habit. Most of the children received unsatisfactory oral hygiene. Thus, the establishment of educationalpreventive programs are essential in an attempt to provide support to the family regarding their babies' oral hygiene, geared toward the promotion of oral healthcare and the prevention of changes in the child's stomatognathic system.(AU)