Prevalence of Oral Lesions Diagnosed at a Pathology Institute: A Four-year Analysis

Abstract Objective: To identify the most prevalent oral lesions based on reports from a pathology institute's reports and associations between malignant and oral potentially malignant disorders with patient's demographic variables and the anatomical location. Material and Methods: All 1,298 histopathological reports of oral lesions recorded in the database were reviewed. Demographic variables, anatomical location of the lesion, histopathological diagnosis of the lesions, and their biological behavior were analyzed. Results: Regarding the biological behavior of the identified lesions, benign lesions were predominant (70%), followed by lesions of undetermined behavior (14.3%), malignant lesions (14.2%), absence of histological alteration (1.2%), and finally, oral potentially malignant disorders (0.5%). The anatomical locations of the most prevalent oral lesions potentially malignant disorders and malignant were in the following structures of the oral cavity: gums, buccal mucosa, floor of the mouth and hard palate (p=49.2%), and tongue (p=48.7%). Conclusion: The probability of malignant and premalignant lesions was higher among males (PR= 4.21; 95% CI 2.08-6.22), the increase in age (PR = 1.06; 95% CI 1.05-1.08), and in the tongue region (PR = 5.48; 95% CI 1.67; 17.92). Identification of malignant and potentially malignant oral conditions is higher in older men and in tongue specimens.

Untreated caries and serum vitamin D levels in children and youth of the United States: NHANES 2013-2014

Abstract This study aimed to investigate the association between serum vitamin D levels and untreated caries and determining factors in children and youth. Methodology: This cross-sectional study used data from the National Health and Nutrition Examination Survey (2013-2014). In total, 3,072 participants with ages ranging from 1 to 19 years were included in our sample. The main dependent variable, untreated caries, was defined as having at least one untreated carious surface in any tooth. Serum concentration of 25-hydroxyvitamin D [25(OH)D] was categorized into four groups: ≥75 nmol/ml, 50-74.9 nmol/ml, 25-49.9 nmol/ml, and <25 nmol/ml. Data were analyzed using a binary logistic regression. Results: For children aged 1-5 years, age (OR = 1.68, 95% confidence intervals (95% CI) 1.38-2.04) and low levels of vitamin D (25-49.9 nmol/ml, and <25 nmol/ml: OR = 2.55, 95% CI 1.06-6.13) were associated with untreated caries. For children aged 6-11 years, low levels of vitamin D (50-74.9 nmol/ml: OR=1.45, 95% CI 1.16-1.82) remained associated with untreated caries. No associations were found in those between 12 and 19 years of age. Conclusion: Our findings show an association between low levels of 25(OH)D and untreated caries in children between 1 and 11 years of age, suggesting that this nutrient might interfere in the caries process.

Resumo Este estudo teve como objetivo investigar a associação entre os níveis séricos de vitamina D e cárie dentária não-tratada e fatores determinantes em crianças e jovens. Metodologia: Este estudo transversal utilizou dados da Pesquisa Nacional de Saúde e Nutrição (2013-2014). No total, 3.072 participantes com idades entre 1 e 19 anos foram incluídos em nossa amostra. A principal variável dependente, cárie não-tratada, foi definida como pelo menos uma superfície de cárie não-tratada em qualquer dente. A concentração sérica de 25-hidroxivitamina D [25(OH)D] foi categorizada em quatro grupos: ≥75 nmol/ml, 50-74,9 nmol/ml, 25-49,9 nmol/ml e <25 nmol/ml. Os dados foram analisados ​​por meio de regressão logística binária. Resultados: Para crianças de 1 a 5 anos, idade (OR = 1,68, intervalo de confiança de 95% (IC 95%) 1,38 a 2,04) e baixos níveis de vitamina D (25 a 49,9 nmol/ml e <25 nmol/ml: OR = 2,55, IC 95% 1,06-6,13) foram associados a cárie não-tratada. Para crianças de 6 a 11 anos, baixos níveis de vitamina D (50 a 74,9 nmol/ml: OR = 1,45, IC 95% 1,16 a 1,82) permaneceram associados à cárie não-tratada. Não foram encontradas associações naqueles entre 12 e 19 anos de idade. Conclusão: Nossos achados mostram uma associação entre baixos níveis de 25(OH)D e cárie não-tratada em crianças de 1 a 11 anos, sugerindo que este nutriente pode interferir no processo da cárie dentária .

Impact of xerostomia and the use of dental prosthesis on the quality of life of elderly: a cross-sectional study

Aim: To evaluate the impact of xerostomia, edentulism, use of dental prosthesis, and presence of chronic diseases on quality of life in relation to oral health in institutionalized elderly individuals. Methods: This is a cross-sectional study. A questionnaire was administered containing the following instruments: Oral Health Impact Profile (OHIP-14), which measures the quality of life related to oral health; the Summated Xerostomia Inventory questionnaire (SXI-PL) for evaluation of xerostomia, sociodemographic data, clinical description, and patient-reported factors was assessed (edentulism, use of dental prostheses, and chronic diseases). Results: Most elderly individuals did not have any teeth in their mouths and used dental prosthesis. The impact on quality of life, considering the mean of the OHIP-14 scores, was positive in 58.3% of the elderly. Those who used a dental prosthesis were three times more likely to have their oral health negatively impacted (OR=3.09; 95%CI =1.17 8.11), compared to those who did not use, and individuals with xerostomia were more likely to have their oral health negatively impacted (OR=1.57; 95%CI=1.25-1.98) compared to those without xerostomia. There was no difference in the quality of life of individuals with and without chronic diseases. Conclusions: The feeling of dry mouth and use of dental prostheses negatively impacted the quality of life in relation to oral health of the elderly

Affect and cognition as antecedents of patients' trust in the dentist: cross-sectional study

Aim: to evaluate the association of the patients' perception about dentist's affect and cognition on trust and, consequently, on intention to return and patient satisfaction with life. Methods: Analytical cross-sectional study conducted in patients' adults and elderly at of two dentistry clinics in the south of Brazil. Patients had to have a previous relationship with the dentist (at least one previous consult) and 18 years of age or older. The data were collected through self-administrated questionnaire using measures adapted from other research, using structural equation modeling. We test using a chi-square difference test (p-value<0,05). Results: The mean age of the 197 patients was 37.0 years (σ = 15.5). The affect perceived by the patient at the dentist had a positive effect (ß = .53) on the trust that the patient develops in relation to the dentist. The same is true for the effect of the rational or cognitive aspects perceived by the patient at the dentist (ß = .41). The trust positively influences the patient's intention to return to that dentist (ß = .82). In addition, the intention to return to the dentist positively influences the patient's satisfaction with life (ß = .49). Conclusions: Affective and cognitive aspects positively influenced the patient's trust in the dentist. The greater the patient's trust in the dentist, the greater the intention to return to that dentist. Furthermore, a good relationship with the dentist improve the patient's satisfaction with life

Factors associated with decision-making for replacing the temporary coronal restoration after endodontic treatment

Aim: This study aimed to evaluate the decision-making by patients to replace temporary restorations with permanent restorations after endodontic treatment and to verify the associated factors and evaluate the quality/integrity of the temporary restorative material within one month. Methods: This is a cross-sectional study using non-probabilistic sampling which analyzed patients after one month of endodontic treatment. The self-administered questionnaire contained sociodemographic, treatment decision-making and endodontic treatment questions. The restoration present in the mouth was evaluated in the clinical oral examination. The Poisson Regression test was used to verify the prevalence ratio. Results: The prevalence failure to perform permanent restorations was 61.1% of patients, and 42.7% reported not having adhered. The reasons are lack of time and not knowing the importance of replacing the restoration with a definitive one. The glass ionomer temporary restorative frequency was higher among those who chose not to replace the temporary restoration with a permanent one (PR=5.19; 95%CI 2.10-12.33). In addition, there was an association between the quality of the restorative material and the type of material, and the best clinical quality of the restoration was statistically associated with glass ionomer and composite resin. Conclusions: The findings show the importance of guidance by the dental surgeon in helping patients decide to replace their temporary restoration

Periodontitis and its associated factors in patients at the faculty of southern Brazil: a cross - sectional study

To verify the presence of periodontitis, its severity, and their association with associated factors based on medical records of patients who attended the Dental Clinic of the Faculty of Southern Brazil over 4 years. This is a cross-sectional study, which included 422 medical records of patients aged ≥ 18 years. The clinically analyzed data were: plaque index (PI),bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL). Sociodemographic data, dental hygiene, harmful habits and chronic systemic diseases were described. Statistical analysis of binary logistic regression was used to verify the relationship between the severity of periodontitis and the exposure variables. The older adults [odds ratio (OR) = 2.36; 95% confidence interval (CI): 1.23-4.54 ­41 to 55 years and OR = 3.0; 95% CI: 1.49-6.09 ­56 to 87 years], and men (OR = 1.9; 95% CI: 1.18-3.14) showed higher chances of periodontitis severity. Smokers (OR = 3.54; 95% CI: 2.05-6.12), those with hypertension (OR = 2.11; 95% CI: 1.23-3.63) and with diabetes (OR = 2.10; 95% CI: 1.08-4.12) showed higher chances of developing advanced periodontitis. Advanced or severe periodontitis occurred in one-third of the patients. The findings showed that men, older adults, with systemic arterial hypertension, diabetes mellitus, and smokers are more susceptible to severe periodontitis.

Influence of Breastfeeding and Feeding on Children Dental Caries: a Cross-Sectional Study / Influência da Amamentação e da Alimentação na Cárie Dentária Infantil: um Estudo Transversal

Abstract The objective was to investigate the experience of dental caries and associated factors from the children's and adolescents' medical records who visited the Children's Dental Clinic of a College of southern Brazil. A cross-sectional study was carried out by analyzing 262 medical records. For data collection, information on demographic data, oral hygiene, food, breastfeeding and oral clinical data were used to investigate. A multivariate analysis was used to estimate the odds ratios (OR) and their 95% confidence intervals, by the exposure variables in a Binary Logistic Regression model (p-value< 0.05). Of the sample, 86.3% had some teeth with experience of dental caries, with only 13.7% free of caries. The average dental caries was 5.3 ± 3.1 in children between 6 and 8 years and 2.0 ± 1.9 between 9 and 12 years. There was a statistically significant association between age and dental caries, with the largest age group being a protective factor for dental caries (OR 0.30; 95%CI 0.17-0.53). Children who were breastfed naturally had a protective factor for caries (OR 0.29; 95%CI 0.10-0.88). The experience of dental caries in children was high, especially in primary teeth, with a higher average of decayed teeth. Breastfeeding and age were a protective factor for dental caries. (AU)

Resumo O objetivo foi investigar a experiência de cárie dentária e fatores associados em prontuários de crianças e adolescentes que procuraram o Ambulatório de Odontologia Infantil de uma Faculdade do Sul do Brasil. Realizou-se um estudo transversal por meio da análise de 262 prontuários. Para a coleta de dados, foram utilizadas informações sobre dados demográficos, higiene bucal, alimentação, aleitamento materno e dados clínicos bucais para investigação. Uma análise multivariada foi utilizada para estimar os odds ratios (OR) e seus intervalos de confiança de 95%, pelas variáveis de exposição em um modelo de Regressão Logística Binária (p-valor <0,05). Da amostra, 86,3% tinham alguns dentes com histórico de cárie dentária, e apenas 13,7% livre de cárie. A média de cárie dentária foi de 5,3 ± 3,1 em crianças entre 6 e 8 anos e 2,0 ± 1,9 entre 9 e 12 anos. Houve associação estatisticamente significativa entre idade e cárie dentária, sendo a maior faixa etária fator de proteção para cárie dentária (OR 0,30; IC95% 0,17-0,53). Crianças amamentadas naturalmente apresentaram fator de proteção para cárie (OR 0,29; IC95% 0,10-0,88). O histórico de cárie dentária em crianças foi elevado, principalmente nos dentes decíduos, com maior média de dentes cariados. O aleitamento materno e a idade foram fatores de proteção para cárie dentária. (AU)

Prevalence of xerostomia and its association with systemic diseases and medications in the elderly: a cross-sectional study

ABSTRACT BACKGROUND: Dry mouth syndrome or xerostomia is defined as decreased salivary flow or hypofunction of salivary glands. Its origins are multicausal and might be the result of a change in the salivary glands or a systemic imbalance. OBJECTIVE: To ascertain the prevalence of self-reported xerostomia and to identify associated factors. DESIGN AND SETTING: Cross-sectional study on the entire population of 293 elderly people over 60 years of age living in a Brazilian municipality. METHODS: Data were gathered from a questionnaire that asked about demographic data, chronic diseases and use of continuous medications, and which used the Xerostomia Inventory (XI) to evaluate dry mouth sensation. Our analysis consisted of multivariate regression and estimation of odds ratios (OR) and their respective 95% confidence intervals (CI) in binary logistic regression models. RESULTS: The prevalence of self-reported xerostomia was 19.1%. Elderly people with diabetes had higher odds of having self-reported xerostomia (OR: 3.59; 95% CI: 1.48-8.68; P < 0.001) as did those who had chronic diseases and used continuous medication (OR: 2.3; 95% CI: 1.19-4.67; P = 0.009). Elderly people who used continuous medication for the gastrointestinal tract were more likely to have xerostomia (OR: 2.14; 95% CI: 1.03-1.44; P = 0.030). CONCLUSIONS: Elderly people with diabetes and chronic diseases who were using continuous medication were more likely to have dry mouth. Use of continuous medications for the gastrointestinal tract led to a greater chance of having self-reported xerostomia.

Condições periodontais e fatores associados a profundidade de sondagem em pacientes de uma faculdade do sul do Brasil / Periodontal conditions and factors associated with the probing depth in patients from a faculty in southern Brazil

RESUMO Objetivos: Verificar os sinais clínicos periodontais e investigar a os níveis de profundidade de sondagem (PS) e fatores associados em pacientes atendidos nas Clínicas da Faculdade IMED, localizada em um município do sul do Brasil. Metodologia: Os dados foram coletados em 193 prontuários de pacientes que buscaram atendimento odontológico, no período de 2017-2018, agrupados em sociodemográficos, hábitos de higiene bucal, hábitos nocivos e doenças crônicas. Os dados clínicos foram índice de placa dental visível (IPV), índice de sangramento gengival (ISG) e PS. Após realizadas análises descritivas foi construído um modelo de Regressão linear simples e múltiplo para verificar relações entre as variáveis ao p-valor<0,05. Resultados: A maioria dos pacientes são do sexo feminino (63,2%) com média de 40,8 anos (±14,58). Os resultados descritivos de IPV, ISG e PS foram 39,11±32,28%, 21,81 ±22,43% e 2,91 ±1,09mm, respectivamente. Após os ajustes no modelo de regressão múltiplo, os portadores de diabetes e a a quantidade de cigarros fumados por dia influenciaram no nível de PS. Conclusões: Os achados desta investigação mostram um alto IPV e de SG. Apesar da média da PS ter sido baixa, portadores de diabetes e fumo foram fatores preditivos de maiores níveis de PS.

ABSTRACT: Objectives: To evaluate periodontal clinical signs and investigate the probing depth levels (PD) and associated factors in patients attending the Dental Clinics of the Faculty IMED, located in a municipality in southern Brazil. Material and Methods: The data were collected of 193 records of patients who demand dental care in the Dental Clinics for periodontal treatment, in the period 2017- 2018: sociodemographic data, oral hygiene habits, tobacco use and chronic diseases. The clinical data were: gingival bleeding index (GBI), visible plaque index (VPI) and PD. The statistical analyzed the relationship between probing depth and exposure variables, using a linear regression linear model (p-value<0.05). Results: The majority of the patients attended were female (63.2%) and 40.8 years old on average (± 14.58). The descriptive results of VPI, GBI e PD were: 39.11 ± 32.28%, 21.81 ± 22.43%, and 2.91 ± 1.09mm, respectively. After adjustments in the multiple regression model, it was observed that diabetes and quantity of cigarettes smoked had an influence on PD. Conclusions: The results obtained in this research allowed to verify a high index of VPI and GBI in the patients. The mean PD of the individuals was low, however, it was possible to verify that having diabetes and smoking a large amount of cigarettes daily were predictive factors of higher levels of PD.

Effect of Recreational Intervention on the Approach of Pediatric Patients in Dental Treatment: Analysis of Salivary Cortisol

Abstract Objective: To verify whether recreational interaction with pediatric patient before dental care influences cortisol levels and anxiety. Material and Methods: Twelve children were selected and divided into two groups: 6 children who had not previously received recreational intervention (Group I) and 6 children who received recreational intervention before dental care (Group II). Saliva was collected with Salivettes™ kits before and soon after dental care for the measurement of cortisol. Wilcoxon test was applied to verify the difference in salivary cortisol levels before and after the dental visit in the whole sample, and the Mann-Whitney U test was used to analyze the difference between groups I and II. A significance level of 0.05 was considered. Results: Among patients from Group I, 3 had their cortisol levels increased after dental care, 2 had their cortisol levels decreased, and the other 1 patient remained constant. All participants from Group II had no significant difference in cortisol levels pre- and post-procedure. Mean salivary cortisol level was higher in Group I, pre- and post-procedure, compared to Group II. Conclusion: Pediatric patients who participated in an interactive activity prior to dental care have a lower level of anxiety according to the salivary cortisol levels obtained, compared to patients who did not participate in recreation. The techniques for the dentist to approach the child control the anxiety of the patient and make the procedure calmer and less stressful for both of them.

Influence of Maternal Satisfaction with the Dentist in Children's Oral Care: Cross-Sectional Study / Influencia de la Satisfacción Materna con el Dentista en la Salud Oral del Niño: Estudio Transversal

ABSTRACT: Childhood is a period of life when the human being is constantly going through progressive steps of psychosocial, physical, and mental development. The quality of hygiene habits of family members will be reflected on the characteristics and attitudes of children, which significantly increases the responsibility of the family in oral hygiene education. The present study aimed to observe the influence of maternal satisfaction with the dentist in children's oral care. This is a cross-sectional design, which sample included 100 mothers from a city in Southern Brazil. From a questionnaire prepared for this purpose and adapted from previous research, the mothers were interviewed from January to July 2015. The results presented showed that most mothers work outside the home (46.4 %) but monitor their children during toothbrushing (50.7 %). For most mothers, the dentist represents satisfaction (37.1 %) and the main reason for seeking the dentist is oral health (44.3 %). It was found that mothers who encourage their children to use dental floss and monitor them during toothbrushing are the mothers who feel satisfied with the dentist (P < 0.05). In addition, mothers know that caries is a disease and its occurrence is related to diet habits, however, they add chocolate milk and sugar to their children's bottle. Thus, it was concluded that satisfaction with the dentist influences mothers on oral hygiene habits adopted by their children regarding the use of dental floss and toothbrushing monitoring.

RESUMEN: La infancia es un período de la vida en que el ser humano está en constante y progresivo desarrollo psicológico, físico y mental. La calidad de la higiene oral de otros miembros de la familia se va a reflejar directamente en las características y actitudes de los niños, aumentando significativamente la responsabilidad de la familia en la educación sobre higiene oral. El presente trabajo tuvo como objetivo observar la influencia que tiene la satisfacción de la madre con el cirujano dentista respecto a las acciones de la salud oral de los niños. Se trató de un estudio de tipo transversal, cuya muestra no probabilística contó con 100 madres de una ciudad del Sur de Brasil. A partir de un cuestionario elaborado para este fin y adaptado de investigaciones anteriores, las madres fueron entrevistadas en el período de enero a julio de 2015. Los resultados mostraron que la mayoría de las madres trabajaban fuera de la casa (46,4 %), pero acompañaban a su hijo durante el cepillado (50,7 %). La mayoría de ellas estaba conforme con la atención del cirujano dentista (37,1 %) y el mayor motivo de su búsqueda fue la salud oral (44,3 %). Se verificó que las madres que incentivaban el uso del hilo dental por parte de los hijos y que realizaban el acompañamiento durante el cepillado eran las madres que se sentían conformes con la atención del cirujano dentista (p<0,05). Además de esto, las madres saben que la caries es una enfermedad y que su surgimiento tiene relación con la alimentación, pero igualmente le incorporaban cacao en polvo y azúcar a la mamadera de sus hijos. De esta manera, fue posible concluir que, la satisfacción con la atención del cirujano dentista influye a las madres en los hábitos de higiene oral adoptados por sus hijos, en lo relativo al uso del hilo dental y el cepillado dental.

Oral complications in hospitalized children during antineoplastic treatment / Complicações bucais em crianças e adolescentes hospitalizadas durante o tratamento antineoplasico

INTRODUCTION: Normal cells are also affected during antineoplastic treatment, including oral mucosa cells, which potentially causes oral complications. OBJECTIVE: This study aimed to assess the prevalence of the main oral complications and the oral hygiene index in children and adolescents aged 5 to 12 years, who received chemotherapy and/or radiotherapy. METHODS: It is an observational prevalence study performed in a hospital in Southern Brazil. Data were collected from 21 hospitalized patients with a self-application questionnaire for the responsible persons of children and with an intraoral clinical examination. The indicators used were DMFT (decayed, missing, and filled teeth) for dental caries, SOHI (simplified oral hygiene index) for oral hygiene, and the presence of mucositis, xerostomia, and candidiasis. RESULTS: Most of the sample was male (57.1%) with average age of 8 years (sd 2.92), diagnosed with leukemia (47.6%). All patients received chemotherapy as treatment of choice and 38.1% received radiotherapy as part of the treatment. The results showed the presence of 61.9% of mucositis in patients and 28.6% of xerostomia. No patient presented candidiasis during clinical examination. As for dental caries, 66.7% of patients showed a DMFT from 4 to 16, which is considered high, and 38.1% of patients showed the presence of bacterial plaque and dental calculus. CONCLUSION: It is concluded that the main oral complications in children during antineoplastic treatment were mucositis and xerostomia. It was observed a high rate of dental caries as a consequence of an inadequated oral hygiene.

INTRODUÇÃO: Durante o tratamento antineoplásico, células normais também são afetadas, incluindo assim, as células da mucosa oral, o que potencialmente causa complicações orais. OBJETIVO: O presente trabalho teve por objetivo avaliar a prevalência das principais complicações bucais e índice de higiene oral em crianças e adolescentes submetidas à quimioterapia e/ou radioterapia. MÉTODO: O delineamento é do tipo observacional de prevalência realizado em um Hospital do Sul do Brasil. Foram coletados dados de 21 pacientes de 5 a 12 anos de idade em tratamento, a partir de um questionário auto aplicativo para os responsáveis pelos pacientes e um exame clínico intraoral. Os indicadores utilizados foram o índice CPOD (dentes cariados, perdidos e obturados) para cárie dentária, o índice IHOS (higiene oral simplificada) para Higiene Oral e a presença de mucosite, xerostomia e candidíase. RESULTADOS: A maior parte da amostra era do sexo masculino (57,1%) média de 8 anos de idade (dp 2,92), diagnosticados com leucemia (47,6%). Todos os participantes receberam quimioterapia como tratamento de escolha e 38,1% receberam radioterapia como parte do tratamento. Os resultados evidenciariam presença de mucosite em 61,9% e xerostomia em 28,6% dos pacientes. Nenhum paciente apresentou candidíase durante o exame clínico. Quanto a cárie dentária, 66,7% tem um CPOD de 4 e 16, considerado alto e 38,1% dos pacientes apresentaram presença de placa bacteriana e cálculo dentário. CONCLUSÃO: As principais complicações bucais evidenciadas durante o tratamento antineoplásico foram mucosite e xerostomia. Foi observado também um alto índice de cárie dentária, consequência de uma inadequada higiene oral.

Evaluation of anxiety levels and their characteristics in dental care: Cross-sectional study

Context: Anxiety is defined as an emotion produced by a set of feelings and physical changes. Many patients are afraid of some procedures involved in dental therapy. Aim: The objective of this study was to verify the anxiety of patients regarding the visits to dental clinics of a higher education institution, as well as to observe the moment of greatest anxiety. Settings and Design: It is a cross-sectional observational study including 94 patients from the dental clinics of an educational institution in a city of southern Brazil. Materials and Methods: The Corah Dental Anxiety Scale, composed of four questions, was used to evaluate the dental anxiety levels of all patients. The sample universe included registered patients under treatment in the clinics of the studied institution, from August to November of 2016. We included only healthy patients over 18-year old who were subjected to surgical and nonsurgical procedures. Statistical Analysis: The data were analyzed through descriptive statistic to verify the frequency distribution of all variables. Pearson's Chi-square test, at 5% significance level and 95% confidence interval, was used to evaluate the association between the dependent variable (dental treatment anxiety) and the independent variables (demographics), aided by the SPSS software 20.0. Results: It was found that most of the participants were not anxious (69.1%) and the moment of greatest anxiety reported was before local anesthesia. In addition, statistics showed no correlation among gender, age group, and type of procedure performed. It was possible to conclude that the level of anxiety of the patients regarding the dental care performed in the clinics of the studied institution was low for both surgical and nonsurgical procedures. Conclusion: This survey revealed that the moment of greatest anxiety for the patients was before the anesthetic procedure, and gender, age, and type of procedure did not influence the level of anxiety felt by the patient.

Qualidade do Pré-Natal no Brasil: Pesquisa Nacional de Saúde 2013 / Quality of Prenatal Care in Brazil: National Health Research 2013

Resumo O objetivo deste estudo foi avaliar a adequação do cuidado pré-natal no Brasil associado a determinantes sociodemográficos. A pesquisa consistiu em uma análise dos dados da Pesquisa Nacional de Saúde realizada no Brasil em 2013. Foram avaliados dois desfechos sobre a adequação do pré-natal, o índice de Kessner modificado por Takeda que, além de levar em consideração esse índice, avaliou se houve aferição da pressão arterial e do peso em todas as consultas, realização de algum exame de sangue e urina e ultrassom. Ambos indicadores de qualidade foram avaliados para o Brasil e também pelas macrorregiões do país. De acordo com o desfecho 1, 80,6% das mulheres realizaram o pré-natal adequado. Ao adicionarmos a realização de exames (Desfecho 2) o percentual foi 71,4%. O pré-natal adequado foi mais frequente entre as mulheres de cor branca e que realizaram o pré-natal na rede privada. A região norte apresentou as menores frequências de pré-natal adequado, enquanto a região sudeste as maiores. Apesar da ampla cobertura, o pré-natal no Brasil ainda apresenta iniquidades e baixa qualidade no atendimento, especialmente entre mulheres das regiões mais pobre do país.

Abstract This study aimed to assess the adequacy of prenatal care in Brazil associated with sociodemographic determinants. The study included a data analysis from the National Health Research performed in Brazil in 2013. Two outcomes on the adequacy of prenatal care were assessed: the Kessner index modified by Takeda index that, in addition to the former, assessed whether blood pressure and weight were measured in all appointments, as well as the performance of blood and urine tests and ultrasound. Both quality indicators were assessed for Brazil and for its macro-regions. According to Outcome 1, 80.6% of women received adequate prenatal care. When adding the performance of tests (Outcome 2), the rate dropped to 71.4%. Adequate prenatal care was more frequent among white women who performed prenatal care in the private health sector. The northern region had the lowest rate of adequate prenatal care, while the southeast region showed the highest rates. Despite the extensive coverage, prenatal care in Brazil still presents inequities and low service quality, especially for women from the poorest regions of the country.

Presence of Candida spp. and candidiasis in liver transplant patients

Abstract: BACKGROUND: Candidiasis is the most common opportunistic fungal infection of the oral cavity caused by fungi of the genus Candida and usually associated with immunosuppressed individuals. OBJECTIVES: To evaluate the presence of oral candidiasis and identify the presence of Candida spp. in liver transplant recipients and assess the association between the presence of the fungus and sociodemographic variables, dietary habits and environmental exposure. METHODS: A cross-sectional study was performed with 49 patients who had undergone liver transplants at Hospital São Vicente de Paulo in Passo Fundo - RS. Patient information was collected to obtain sociodemographic data, eating habits and environmental exposure. Fungal infections were screened by oral clinical examination and the presence of Candida spp by the collection of oral samples with a sterile swab, seeded in Sabouraud Dextrose Agar, incubated at 25°C and observed at 48 hours. To identify Candida albicans, the germ tube test was performed. RESULTS: In 49 patient samples, 39% had the yeast of the genus Candida isolated and, of these patients, 12% had candidiasis, 66% of atrophic type and 34% pseudomembranous. Eleven yeast species were (58%) Candida non-albicans and eight (42%) Candida albicans. STUDY LIMITATIONS: The present study presents as a limitation the inclusion of patients in different stages of immunosuppression. CONCLUSION: The high incidence of Candida non-albicans in the oral cavity of transplant patients with a long period of transplantation is warning to a more effective control of the health of these individuals, especially those with older age.

Impact of untreated dental caries on oral health of adolescents from cities in the countryside of Rio Grande do Sul / Impacto da cárie dentária não tratada na saúde de adolescentes de municípios do interior do Rio Grande do Sul

INTRODUCTION: Dental caries is a major public health problem around the world, because it can cause pain and suffering to individuals. Even with a decline in childhood disease in recent years, it is observed in many countries OBJECTIVE: The objective of this research is to analyze the mean of dental caries and the prevalence of untreated caries and associated factors in students from the southern region of Brazil METHODS: The approach of this study is quantitative, with a cross-sectional design. The research sample was composed of 77 adolescents from the state schools of the urban area of the municipalities of Ciríaco and David Canabarro, Rio Grande do Sul, Brazil. For the data collection, clinical exams were performed, using the DMFT index, and the application of two semistructured questionnaires to adolescents and their parents. The data were analyzed by descriptive statistics and inferential statistics to the Pearson chi-square test and ANOVA at a significance level of 5% RESULTS: The prevalence of untreated dental caries in the final sample was 40.3% and the DMFT index (decayed, missing and filled teeth) 2.32, there was no statistical difference between cities. There was a statistically significant relationship between the variable toothache in the last six months and the outcome of untreated caries (p = 0.012) with 76% of those who had pain. There was also an association between the variable perception of the treatment at the last visit and untreated caries (p = 0.021), with 84.6% of adolescents considering poor / regular treatment CONCLUSION: Although the average dental caries has been low, many adolescents have decayed and untreated teeth, with toothache and lack of quality in dental treatment being the factors that most impacted

INTRODUÇÃO: A cárie dentária é um grande problema de saúde pública em todo o mundo, pois pode causar dor e sofrimento aos indivíduos. Mesmo com um declínio da doença em crianças nos últimos anos, é observado em muitos países OBJETIVO: O objetivo desta pesquisa é analisar a média de cárie dentária e a prevalência de cárie não tratada e fatores associados em escolares da região Sul do Brasil MÉTODO: A abordagem do estudo é quantitativa, cujo delineamento é de corte transversal. A amostra foi composta por 77 adolescentes das escolas estaduais da zona urbana dos municípios de Ciríaco e David Canabarro, RS. Para a coleta de dados, foram realizados exames clínicos, utilizando o índice CPOD, e a aplicação de dois questionários semiestruturados dirigidos aos adolescentes e a seus pais. Os dados foram analisados individualmente, primeiramente por estatística descritiva e, posteriormente, por estatística inferencial ao teste do qui-quadrado de Pearson e de ANOVA, ao nível de significância de 5% RESULTADOS: A prevalência de cárie dentária não tratada na amostra final foi de 40,3% e a média de dentes com experiência de cárie, medida pelo índice CPOD (média de dentes cariado, perdidos e obturados) foi 2,32, não havendo diferença estatística entre os municípios. Houve relação estatisticamente significativa entre a variável dor de dente nos últimos seis meses e o desfecho cárie não tratada (p=0,012) com 76% dos que tiveram dor. Também houve associação entre a variável percepção do tratamento na última consulta e cárie não tratada (p=0,021) com 84,6% adolescentes que consideraram o tratamento ruim/regular CONCLUSÃO: A média de cárie dentária foi baixa, porém, muitos adolescentes possuem dentes cariados sem tratamento, sendo a dor de dente e a ausência de qualidade no tratamento odontológico os fatores que mais impactaram

Unhas das mãos como biomarcador para fluorose dentária / Fingernails as a biomarker for dental fluorosis

INTRODUCTION: Biomarkers indicate levels of a particular chemical agent in the environment studied, which may be useful for monitoring health status, and nails may be major indicators of fluoride. OBJECTIVE: To evaluate fluoride concentration in the fingernails of children as a biomarker for fluoride exposure. METHODS: Twenty students were selected, aged 4-5 years old. Their nails were cut at 15 and 45 days (two collections), and the fluoride concentration in the nails was analyzed with the ion-specific electrode (Orion 9409) after rapid diffusion with HDMS. RESULTS: The total fluoride mean of the samples was 3.68 μg F/g (sd 1.44), ranging from 1.39 μg F/g to 7.81 μg F/g. Eleven children (55%) brush their teeth three times a day, but only three children (15%) swallow toothpaste. CONCLUSION: There is a high prevalence of fluoride exposure in the fingernails of the children studied, presenting risk of developing dental fluorosis in permanent teeth.

INTRODUÇÃO: Os biomarcadores indicam níveis de determinado agente químico no meio estudado, os quais podem ser úteis ao monitoramento do estado de saúde, podendo as unhas serem importantes indicadores de flúor. OBJETIVO: Avaliar a concentração de flúor nas unhas das mãos de crianças como biomarcador de exposição ao flúo.r MÉTODO: Foram selecionadas 20 escolares, com idade entre 4 e 5 anos. As unhas foram cortadas aos 15 e 45 dias (duas coletas) e a concentração de flúor nas unhas foi analisada com o eletrodo íon específica (Orion 9409), após difusão facilitada por HDMS RESULTADOS: A média total de flúor das amostras foi de 3,68 µg F/g (dp 1,44), variando de 1,39 µg F/g a 7,81 µg F/g. Onze crianças (55%) escovam os dentes três vezes por dia, porém, somente três crianças (15%), engolem dentifrício. CONCLUSÃO: Há uma alta prevalência de exposição ao flúor nas unhas das mãos das crianças investigada com risco de desenvolver fluorose dentária nos dentes permanentes.

Clinical decision making for diagnosis and treatment of dental enamel injuries / Tomada de decisão clínica frente ao diagnóstico e tratamento de lesões em esmalte dentário

INTRODUCTION: In general, there are difficulties in the decision making regarding the differential diagnosis and the most appropriate treatment in the lesions that affect the dental tissues by dentists, due to the fact that lesions in enamel have similar clinical characteristics OBJECTIVE: To evaluate the correct decision making for the diagnosis and treatment of dental enamel lesions by professors and students of the Dentistry course METHODS: Descriptive quantitative study, whose sample was composed by 98 students enrolled in the disciplines of Dental Clinics from IV to VIII level and by 23 professors. The instrument of data collection was a questionnaire composed of photographs of four clinical cases, whose teeth presented different lesions in dental enamel: dental enamel hypoplasia, dental fluorosis, amelogenesis imperfecta and dental caries RESULTS: Of the 98 students, the predominant success was dental fluorosis, where 93.9% answered the diagnosis. While the predominant treatment success was that of caries lesions, where 86.7% opted for direct restoration. Of the 23 professors, the predominant diagnosis was caries lesion, 100% correct the diagnosis, while the treatment was the direct restoration in the case of dental enamel hypoplasia, where 95.7% chose this treatment option CONCLUSION: Professors and students of the Dentistry course had difficulty in making treatment decisions on teeth with amelogenesis imperfecta, with mild dental fluorosis and ease on teeth with hypoplasia and dental caries. In addition, the students reported having difficulties in the differential diagnosis of dental enamel lesions presented in the cases because they had still little knowledge for such

INTRODUÇÃO: O tecido que recobre a coroa dos dentes é o esmalte dentário, que promove proteção e revestimento. Trata-se de tecido mineralizado e sensível às variações do ambiente em sua formação, sendo que não sofre remodelação ao longo de seu ciclo de vida OBJETIVO: Avaliar a escolha mais adequada do diagnóstico e opções de tratamento de lesões de esmalte dentário pelos docentes e discentes do curso de Odontologia MÉTODO: Estudo quantitativo descritivo, cuja amostra foi composta por 98 discentes matriculados nas disciplinas de Clínicas Odontológicas do IV ao VIII nível e por 23 docentes. O instrumento de coleta dos dados foi um questionário composto por fotografias de quatro casos clínicos, cujos dentes apresentavam diferentes lesões em esmalte dentário: hipoplasia do esmalte dentário, fluorose dentária, amelogênese imperfeita e cárie dentária RESULTADOS: Dos 98 discentes, o acerto predominante foi o da fluorose dentária, onde 93,9% acertaram o diagnóstico. Enquanto o acerto predominante em relação ao tratamento foi o das lesões de cárie, onde 86,7% optaram por restauração direta. Dos 23 docentes, o acerto predominante frente ao diagnóstico foi de lesão de cárie, 100% acertaram o diagnóstico, enquanto o tratamento foi o de restauração direta no caso de hipoplasia, onde 95,7% fizeram essa opção de tratamento CONCLUSÃO: Ambos os grupos apesentaram dificuldade na tomada de decisão de tratamento nos dentes com amelogênese imperfeita e com fluorose dentária leve. Os discentes relataram possuir dificuldade no diagnóstico diferencial na prática clínica frente às diferentes lesões que acometem os tecidos dentários, além de terem pouco conhecimento sobre o diagnóstico das lesões abordadas

Implementation of dental specialty centers: a descriptive analysis of the current status in the Brazilian territory

ABSTRACT This study aimed to assess the current implementation status of Dental Specialty Centers (Centros de Especialidades Odontológicas - CEO) in Brazil. The sample included CEOs implemented up to November 2015 in the 27 Brazilian federative units. Data were obtained directly from the database of the Informatics Department of the Brazilian Unified Health System, according to the National Registry of Health Facilities (NRHF) of Dental Specialty Centers of all Brazilian regions. Primary care data were also collected from the cities with implemented CEOs, including coverage status of the Family Health Strategy (FHS) and number of Oral Health Teams (OHT) I and II, at 2 collection periods (January 2006 and November 2015). There were 1019 CEOs implemented in Brazil, which were unequally distributed among the Brazilian states, with prevalence of implementation of CEOs type II (n=503, 49.4%). The statistical analysis showed significant difference between the three types of CEO (I, II, and III) and the variables of coverage rate (FHS) and number of teams (OHT I, OHT II) at both data collection periods. Although presenting an evolutionary aspect in the implementation of CEOs, the implementation of medium-complexity care in Brazil is disorganized.

Self-perceived quality of health and satisfaction by elderly seen by the Family Health Strategy team / Autopercepção da qualidade de saúde e satisfação de idosos acompanhados por equipe Estratégia Saúde da Família

ABSTRACT Objective: To verify the profile of elderly followed up by Family Health Strategy teams and the influence of self-reported chronic diseases on demographic variables, describing self-perception and satisfaction with quality of health. Methods: This is a cross-sectional population- based study carried out with 301 elderly residents in two areas of a city in southern Brazil. Data were collected through a questionnaire based on the Health, Well-Being, and Aging Study adapted by researchers, and a playful scale to assess satisfaction with health. For the statistical analysis, the χ2 test was used (p<0.05). Results: Regarding cognitive assessment, the majority was classified as independent (86.4%), not requiring caregiver assistance to answer the questionnaire. The population was predominantly female (55.8%), White (64.8%), married (51.2%), and catholic (82.1%). A total of 47.5% considered their current health status as regular. Regarding satisfaction with health, 72.4% were happy, even reporting having at least one chronic health problem (58.5%). Conclusion: The presence of chronic diseases was reported by most respondents, and the practice of self-medication is significantly more frequent among the aged. Nevertheless, the degree of satisfaction with their health status was predominantly positive, both related to the previous year and compared to others of the same age.

RESUMO Objetivo: Verificar o perfil de idosos acompanhados por equipes Estratégia Saúde da Família e a influência de doenças crônicas autorreferidas nas variáveis sociodemográficas, descrevendo a autopercepção e a satisfação com a qualidade de sua saúde. Métodos: Pesquisa transversal, de base populacional, realizada com 301 idosos residentes em duas áreas de um município do sul do Brasil. Os dados foram coletados por um questionário baseado no questionário do estudo Saúde, Bem-Estar e Envelhecimento, adaptado pelos pesquisadores, e um escala lúdica, para avaliar a satisfação com a saúde. Para a análise estatística, foi utilizado o teste χ2 (p<0,05). Resultados: Com relação à avaliação cognitiva, a maioria da população foi classificada como independente (86,4%), não necessitando de auxílio de cuidador para responder o questionário. A população foi predominantemente feminina (55,8%), branca (64,8%), casada (51,2%) e católica (82,1%). Ainda, 47,5% consideraram seu estado de saúde atual como regular. Com relação à satisfação com a saúde, 72,4% sentiam-se felizes, mesmo tendo relatado possuir, no mínimo, um problema de saúde crônico (58,5%). Conclusão: A presença de doenças crônicas foi relatada pela maioria dos entrevistados, com a prática de automedicação significativamente mais frequente nestes idosos. Apesar disto, o grau de satisfação com suas condições de saúde foi referido de forma predominantemente positiva, tanto em relação ao ano anterior quanto quando comparado a outras pessoas da mesma idade.