Leadership through a gender lens: Disparities in Dental Research

Abstract This study aimed to analyze the 100 most-cited papers in Dentistry, with a focus on female leadership in dental research. Papers were retrieved from the Web of Science Core Collection (WoS- CC) in the category 'Dentistry, Oral Surgery & Medicine'. Gender was assessed through WoS-CC, Scopus, ResearchGate, social media, institutional websites, and software that assigns gender according to first names (https://genderapi.io). Characteristics of authors in leadership roles were retrieved, such as affiliation, publication history, citations, H factor, and i500. The 100 most-cited papers in Dentistry were authored by 394 researchers, 326 (82.7%) men, and 68 (17.3%) women - there were 4.8 male authors for each female. Among the lead authors, there were 11.3 males for each female. Among female senior authors, there were 7 males for each female. Among lead/senior authors of the 100 most-cited papers (first and last authors, respectively), 18 were women. There was an increase in the participation of women in the top cited papers regardless of authorship role across the six decades, with a peak of two female authors in the first decade of the 21st century. For female authors in leadership roles, their publication history shows the time between their first and last papers in WoS-CC ranged from 4 to 42 years for lead authors and 1 to 39 years for senior authors. Women were found to be largely underrepresented as leaders of the 100 most-cited papers, highlighting pervasive gender inequalities in dental research publications.

Resumo Objetivou-se analisar os 100 artigos mais citados em Odontologia, com foco na liderança feminina na pesquisa odontológica. Os artigos foram identificados utilizando-se a base de dados Web of Science Core Collection (WoS-CC) na categoria 'Dentistry, Oral Surgery & Medicine'. O gênero dos autores foi avaliado por meio do WoS-CC, Scopus, ResearchGate, mídias sociais, sites institucionais e um software que atribui gênero de acordo com o primeiro nome (https://genderapi.io). As características dos autores em papéis de liderança foram identificadas, como afiliação, histórico de publicação, número de citações, fator H e i500. Os 100 trabalhos mais citados em Odontologia foram de autoria de 394 pesquisadores, sendo 326 (82,7%) homens e 68 (17,3%) mulheres - foram 4,8 autores homens para cada mulher. Entre os primeiros autores, havia 11,3 homens para cada mulher. Entre os últimos autores, havia 7 homens para cada mulher. Entre os primeiros/últimos autores dos 100 artigos mais citados, 18 eram mulheres. Houve um aumento na participação de mulheres nos artigos mais citados, independentemente do papel da autoria ao longo das seis décadas, com um pico de duas autoras na primeira década do século XXI. Para autoras em papéis de liderança, seu histórico de publicação mostra que o tempo entre o primeiro e o último artigo no WoS-CC variou de 4 a 42 anos para primeiro autor principais e de 1 a 39 anos para último autor. Verificou-se que as mulheres estão sub-representadas como líderes dos 100 artigos mais citados, destacando-se desigualdades de gênero generalizadas nas publicações em pesquisa odontológica.

A scoping review about LGBTQIAP+ people in oral health research

Abstract Oral health personnel must acknowledge the health needs of sexual and gender minorities. They should consult scientific literature to deepen their knowledge about sexuality, gender identity, general and oral health status, and treatment disparities among LGBTQIA+ people. The aim of this scoping review was to portray the development and current stage of internationally indexed literature approaching the oral health of this population. In this study, the search strategy used consisted of combinations of subject descriptors (MeSH terms), in two concept blocks: LGBTQIAP+ people and oral health. Global literature was searched through Medline (PUBMED), Web of Science, Embase, Lilacs, and Scopus electronic databases, with no language or date restrictions. Records were selected and evaluated by two independent reviewers, under the supervision of three senior reviewers and the inclusion criteria resulted in 189 eligible papers. Since the first study was published in 1974, numbers increased over the decades, reaching 67 (35.4%) in 2010-2019. The most frequently studied populations were North American (42.9%) and European (19.0%) and the most frequent language of publication was English (99.0%). There were 38 open access papers (20.1%). Medical (57.7%) and dental journals (20.1%) predominated. Cross-sectional studies were found more frequently (65.1%), followed by the cohort type (11.1%). Oral manifestation of STI (58.7%) was the topic most frequently addressed. The search for literature approaching the oral health of LGBTQIAP+ people showed evidence of the need to encourage research reported in papers made easily available, with more robust scientific evidence, and on a broader scope of topics, including oral health needs and treatment, and planning of oral health services.

Factors associated with the use of a public information system of dentist-prescribed antibiotics in Minas Gerais, Brazil / Fatores associados ao uso de um sistema de informação público de antibióticos prescritos por cirurgiões-dentistas em Minas Gerais, Brasil

Abstract This article aims to investigate the association between socioeconomic factors, health care organizations, and the use of a management and monitoring system for the dispensing of antibiotics prescribed by dentists in public health services in Minas Gerais, Brazil. This is an ecological-epidemiological study that analyzed secondary data from the Integrated Pharmaceutical Care Management System (SIGAF) of the Department of Health of the state of MG, Brazil, in 2017. Thirteen independent variables were analyzed to assess their influence on municipal adherence to SIGAF system considering dental prescriptions of antibiotics. Descriptive statistical analyses were performed, and the Classification and Regression Tree technique was used to identify the municipal variables associated with the outcome. A total of 57,279 antibiotic courses prescribed by dentists and recorded in SIGAF were examined. Socioeconomic factors were not associated with the use of SIGAF to record these prescriptions. Oral healthcare coverage was positively associated with the use of SIGAF for the dispensing of antibiotics prescribed by dentists. Dental Specialties Center were negatively associated with the outcome. Municipalities with high oral healthcare coverage and those without a Dental Specialties Center were more likely to use SIGAF.

Resumo O objetivo deste artigo é avaliar a associação entre fatores socioeconômicos, organização dos serviços de saúde e a utilização de um sistema de gestão e monitoramento da dispensação de antibióticos prescritos por cirurgiões-dentistas em Minas Gerais, Brasil. Estudo epidemiológico ecológico que analisou dados secundários do Sistema Integrado de Gestão da Assistência Farmacêutica (SIGAF) da Secretaria de Estado de Saúde de MG, Brasil, em 2017. Treze variáveis independentes foram analisadas para testar a influência destas com a adesão dos municípios ao SIGAF das prescrições odontológicas de antibióticos. Foram realizadas análises estatísticas descritivas, e a técnica de Árvore de Classificação e Regressão foi utilizada. Foram examinadas 57.279 prescrições de antibióticos prescritos por dentistas e registradas no SIGAF. Fatores socioeconômicos não foram associados ao uso do SIGAF para registro dessas prescrições. A cobertura de saúde bucal esteve positivamente associada à utilização do SIGAF para as dispensações de antibióticos prescritos por cirurgiões-dentistas. A presença de Centro De Especialidade Odontológica, esteve negativamente associado ao desfecho. Municípios com maior cobertura de saúde bucal e sem Centro de Especialidade Odontológica foram mais propensos a utilizar o SIGAF.

Mother's education and family relations protect children from dental caries experience: a salutogenic approach

Abstract The objective of this study was to identify dental caries-protective factors among 5-year-old children using the salutogenic theory. A cross-sectional study was conducted in a small-sized municipality in the Southeast region of Brazil, with a representative sample of 247 children registered in preschool and their respective mothers. The data were collected through questionnaires administered to the mothers about the socioeconomic, behavioral, and biological aspects of the mother and children. Additionally, the collections included validated instruments concerning psychosocial aspects, such as a sense of coherence, resilience, family cohesion and religiosity, and intraoral examinations of the children through the decayed-missing-filled primary teeth (dmft) index. All examinations were performed by a trained and calibrated examiner. The non-adjusted and adjusted odds ratios (OR) and their respective confidence intervals (CI) were estimated using multiple logistic regression with a hierarchical model. Among the examined children, 41.7% were caries-free. In the final model, the chances of the absence of dental caries experience (dmft = 0) were greater in children with mothers who had higher education levels (> 8 years of study) (OR = 2.55 [95%CIi:1.42-4.59]) and those who lived in an environment of high family cohesion (OR = 3.66 [95%CI: 1.19-11.29]). The results indicated that mothers' level of education and family relationships are protective factors against dental caries in 5-year-old children, which overlapped with behavioral and biological factors.

Prevalence of recognition and reporting of child physical abuse by dental surgeons and associated factors / Prevalência de identificação e notificação de abuso físico infantil por dentistas e fatores associados

Abstract Studies evaluating the factors associated with under reporting and with the recognition and reporting of child physical abuse are scarce and highly necessary. This study aimed to assess the prevalence of recognition and reporting of child physical abuse (CPA) by Brazilian dentistsin primary care and associated factors. A cross-sectional study was carried out with a representative sample of dentistsfrom the Family Health Strategy in Belo Horizonte. A self-administered questionnaire validated to Brazilian Portuguesewas used for data collection. Statistical analysis included univariate and multiple analyses through Poisson regression. A total of 181dentists participated in the study. Among them, 73 (40.3%) had already recognized some cases of CPA, but only 11 (6.1%) ended up reporting. Dentists with six to 19 years of experience as a municipal worker presented 2.38 times [PR = 2.38 (95%CI: 1.29-4.41)] more probability to recognize cases of CPA than the ones with less than six years. Having a graduate degree with a major in childcare [PR = 4.50 (95%CI: 1.08-18.68)] was associated with a larger number of reports. The employment duration as municipal worker was positively associated with the recognition of CPA cases and the prevalence of reporting was low.

Resumo Estudos que avaliem os fatores associados à subnotificação e às dificuldades dos dentistas para identificar e notificar abuso físico infantil são escassos e necessários. Este estudo teve como objetivo investigar a prevalência de identificação e de notificação de abuso físico infantil (AFI) e fatores associados por dentistas da atenção primária. Trata-se de um estudo transversal com amostra representativa dos dentistas da Estratégia Saúde da Família de Belo Horizonte. Para a coleta de dados foi utilizado um questionário autoaplicável, validado para uso no Brasil. A análise estatística incluiu análise univariada e múltipla pela regressão de Poisson. Um total de 181 profissionais participaram do estudo. Destes, 73 (40,3%) já identificaram algum caso de AFI, mas apenas 11 (6,1%) realizaram a notificação. Dentistas com seis a 19 anos de trabalho no município apresentaram probabilidade 2,38 vezes [RP = 2,38 (CI 95%: 1,29-4,41)] maior de identificar casos de AFI do que aqueles com menos de seis anos de atuação. Possuir pós-graduação com foco em crianças [PR = 4,50(CI 95%: 1,08-18,68)] esteve positivamente associado a um maior número de notificações. O tempo de trabalho no município esteve associado à identificação de casos de AFI. A prevalência de notificação encontrada foi baixa.

Oral health-related quality of life of pre-school children: review and perspectives for new instruments

Abstract This study aimed to describe different approaches for the evaluation of the Oral health-related quality of life (OHRQoL) of preschool children and to discuss perspectives for future instruments. The OHRQoL is a concept that surpasses an exclusively clinical perception and includes functional, social, emotional, and environmental issues. The measure of OHRQoL represents a holistic approach for researchers and clinicians extending their visions beyond the mouth and understanding the entire context of the patient. Negative impacts of oral conditions on OHRQoL in childhood can reflect on health development, especially in a life stage marked by social and cognitive maturation. Instruments have been developed and cross-culturally adapted to evaluate the impact of oral conditions on the OHRQoL of preschool children and their families. Some features distinguish these instruments and influence their selection, such as: self- or proxy-report; generic- or specific-condition; long- or short-form, and less or more established used in literature. Moreover, theoretical framework, construct validation and availability should also be considered. Nine OHRQoL instruments for preschool children were included in the present literature review. They were created between 2003 and 2017 by developed countries in most cases. The shorter instrument has five items, and the larger has 31 items. Most of them are proxy-reported, generic-condition, and have been relatively well established in the literature. The diversity of instruments indicates the evolution of OHRQoL studies, but there are methodological issues still in need to be improved in future developments or cross-cultural adaptations, according to current psychometric evidence.

Resumo Qualidade de Vida Relacionada à Saúde Bucal (QVRSB) é um conceito que extrapola uma percepção exclusivamente clínica ao incluir questões funcionais, sociais, emocionais e ambientais. A avaliação da QVRSB representa uma abordagem holística para a pesquisa e prática clínica. O impacto negativo das condições bucais na QVRSB durante a infância pode refletir no desenvolvimento saudável, especialmente em um estágio da vida marcado pela maturação social e cognitiva. Instrumentos vêm sendo desenvolvidos e adaptados transculturalmente para avaliar o impacto das condições bucais na QVRSB de pré-escolares e seus familiares. Algumas características distinguem esses instrumentos e influenciam na seleção, tais como: autorrelato ou relato proxy; condição genérica ou específica; formas longas ou curtas, mais ou menos estabelecidos na literatura. Além disso, a base teórica, a avaliação do construto e a disponibilidade do instrumento também devem ser consideradas. A diversidade de instrumentos indica a evolução dos estudos em QVRSB, mas ainda há questões metodológicas que precisam ser avançadas em futuros desenvolvimentos ou adaptações desses instrumentos, seguindo as atuais evidências psicométricas. O presente estudo objetiva descrever as diferentes abordagens para avaliar a QVRSB de pré-escolares e discutir as perspectivas para futuros instrumentos.

COVID-19: a new turning point for dental practice

Abstract Recent new zoonotic respiratory viruses have infected humans and led to severe acute respiratory syndrome: severe acute respiratory syndrome coronavirus (SARS-CoV), influenza A H5N1, influenza A H1N1 and Middle East respiratory syndrome coronavirus (MERS-CoV). The first SARS-CoV outbreak took place in 2003, in Guangdong, China. A decade later, another pathogenic coronavirus, MERS-CoV caused an endemic in Middle Eastern countries. The latest pandemic coronavirus infectious disease (COVID-19) has been related to the newly isolated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For the first time since the acquired immunodeficiency syndrome (AIDS) in the 1980s. Dentistry is facing a new turning point. This critical review aims to discuss the impact of COVID-19 infection on oral health care. In dental practice COVID-19 patients are the main source of infection and symptomatic patients are more contagious. Dentists can be first line of diagnosis of the disease, as they work in close contact with patients and are at the risk of being affected by COVID-19 and all respiratory infections. Several guidelines for dental practice environments have been published by dental associations and regulatory boards. It is already evident that biological, psychological and social effects of the COVID-19 pandemic have present and future impacts on dental practice. Dental schools, regulatory boards, scientific associations, government authorities, and public and private health care services must join efforts to design enduring answers for severe and long-standing viral challenges.