ABSTRACT
A doença renal crônica em estágio terminal pode levar a alterações sistêmicas que tornam o manejo clínico odontológico desses indivíduos desafiador, especialmente se os procedimentos forem invasivos. As preocupações incluem alteração do metabolismo de drogas, da resposta imunológica e do metabolismo ósseo, além do risco aumentado de sangramento e discussão sobre risco aumentado para endocardite infecciosa. O objetivo deste estudo retrospectivo foi conhecer a frequência e o tipo de complicações durante e após execução de procedimentos odontológicos em indivíduos com insuficiência renal crônica em diálise (IRC-D), atendidos no Centro de Atendimento a Pacientes Especiais (CAPE) da Faculdade de Odontologia da USP (FOUSP). Adicionalmente, comparamos a quantidade e o tipo de complicações entre os indivíduos que usaram antibiótico profilático e aqueles que não usaram, antes dos procedimentos odontológicos. Para tanto desenvolvemos um formulário específico para este estudo, no qual compilamos as informações relativas aos períodos trans e pós-operatórios de procedimentos odontológicos realizados nos pacientes com IRC em diálise. Nossa hipótese era a de que a prevalência de complicações durante e após os procedimentos odontológicos de indivíduos com IRC em diálise fosse baixa, e que ouso do antibiótico prescrito profilaticamente não interferiria na qualidade dareparação ou na incidência de complicações relacionadas aos procedimentos odontológicos. Analisamos retrospectivamente 225 prontuários de pacientes com IRC em diálise atendidos no CAPE-FOUSP desde 1990 até os dias atuais. Desse total, 130 eram pacientes do sexo masculino e do 95 do feminino. A idade média destes indivíduos foi de 48,4 anos. As principais doenças de base que levaram a ocorrência da IRC-HD foram a hipertensão arterial sistêmica (48 pacientes) e o diabetes mellitus (23 pacientes). Nos 225 pacientes, 1.390 procedimentos odontológicos foram realizados, dos quais 856 foram não invasivos, 443 invasivos e 91 tratamentos endodônticos. Dentre os procedimentos invasivos, houve 259 exodontias. Antes de 80 das 259 intervenções cirúrgicas (31%) houve a prescrição de antibiótico profilático em diferentes posologias; em 29 exodontias (11%) foram utilizados hemostáticos locais no momento da realização da sutura. Foram descritos nos prontuários 16 casos de sangramento transoperatório (6%), 5 casos de sangramento pós-operatório (2%) e 2 casos de complicação pós-operatória (0,8%), definidos como uma alveolite e uma infecção alveolar. Nossos resultados permitiram nos concluir que a incidência de complicações após exodontias é baixa e que o uso de antibiótico profilático (AP) não interferiu nessa incidência.
Subject(s)
Dental Care , Renal Dialysis , Dry Socket , Renal Insufficiency, Chronic , HemorrhageABSTRACT
Abstract Objective: To describe the challenges pediatric dentists face while caring for their patients during the pandemic. Material and Methods: A descriptive qualitative study was conducted with purposefully sampled pediatric dentists. Data were collected through in-depth, semi-structured interviews until the content of the collected data reached theoretical saturation. Data were transcribed verbatim, coded, and analyzed using content analyses. Results: Seven participants (four females and three males) between 29 and 50 years participated in the study. Three themes emerged from the analyses: Anxiety and fear; PPE (Personal Protective Equipment) and its impact on care delivery; and 3) Behavior management. Conclusion: Dental care delivery was challenging for pediatric dentists. They experienced high anxiety levels and modified their services according to the recommended guidelines while making accommodations to lessen patients' COVID-19-related anxiety. The additional mandated PPE use affected the communication between the dentists and their patients, affecting their dentist-patient bonding.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Dentists , COVID-19/psychology , Dental Care , Qualitative Research , India/epidemiologyABSTRACT
Aim: This present study aims to compare the data from the Brazilian Unified Health System on the number of clinical consultations of Oral Medicine from the first 6 months (March-August 2020) of the COVID-19 pandemic in Brazil with the last 6 months (September-February 2020/2021) to update the data, verify the measures' effectiveness to return clinical activities in the following months. Methods: perform a literature review of recent articles that report the impact of the COVID-19 pandemic on Oral Medicine. Results: There was an increase in the number of Oral Medicine clinical consultations in the second half of the pandemic throughout Brazil (+64.2%), representing over 9,235 appointments in this period. Conclusion: measures for the return of health assistance and the practice of Telemedicine proved to be effective after the second period of the pandemic. Even so, strengthening security measures against the coronavirus is essential to ward off a new wave since the Omicron variant emerged in the country and, consequently, possible new lockdowns that might affect healthcare in Brazil
Subject(s)
Security Measures , Unified Health System , Dental Care , Oral Medicine , COVID-19ABSTRACT
A imaturidade do sistema imunológico, associado a Determinantes Sociais de Saúde (DSS), promove doenças na infância. Especificamente, na cavidade oral, os DSS, representados pelo consumo elevado de açúcar, limitado acesso aos serviços de saúde e deficiência na higiene bucal, favorecem transtornos locais e sistêmicos. Assim, o estudo objetivou associar os DSS, no contexto das condições socioeconômicas, do acompanhamento pelo serviço de saúde e dos aspectos relacionados à saúde bucal de crianças atendidas em Unidades Básicas de Saúde (UBS) de um município cearense. Trata-se de estudo observacional, analítico, transversal e de abordagem quantitativa, conduzido com crianças e suas mães em Acarape - CE. Após consentimento, essas preencheram um questionário. Os dados foram analisados. Das 70 mães, 87,14% e 90,00% tinham idade inferior ou igual a 30 anos e renda de até um salário mínimo, respectivamente. Das 70 crianças, 87,14% tinham seus dentes/gengiva higienizados por seus pais ou responsável. Do total, 94,29% nunca se submeteram a atendimento odontológico. Observou-se associação significativa entre a mãe ter escolaridade superior ao ensino fundamental incompleto e higienizar os dentes/gengiva do filho com escova dental e dentifrício. Constatou-se associação significativa entre a criança ingerir bolacha doce/recheada, não consumir refrigerante e usar escova dental e dentifrício na higienização oral. Conclui-se que as crianças eram acompanhadas nas UBS regularmente; no entanto, esse serviço não esteve relacionado ao atendimento odontológico. Apesar da ausência desse tipo de acompanhamento e do consumo de alimentos cariogênicos, as mães se preocupavam com a saúde bucal das crianças, higienizando a cavidade oral diariamente, com meios adequados.
The immaturity of the immune system, associated with Social Determi- nants of Health (SDH), promotes diseases in childhood. Specifically, in the oral cavity, SDH, represented by high sugar consumption, limited access to health services, and poor oral hygiene, favors local and systemic disorders. Thus, the study aimed to associate the SDH, in the context of socioeconomic conditions, monitoring by the health service and aspects related to children's oral health assisted in Basic Health Units (BHU) of a muni- cipality in Ceará. This is an observational, analytical, cross-sectional study with a quan- titative approach conducted with children and their mothers in Acarape - CE. After con- sent, they filled out a questionnaire. Data were analyzed. Of the 70 mothers, 87.14% and 90.00% were aged less than or equal to 30 years and had income up to one minimum wage, respectively. Of the 70 children, 87.14% had their teeth/gums cleaned by their pa- rents or guardian. Of the total, 94.29% never underwent dental care. There was a signifi- cant association between the mother having higher education than incomplete elementary school and cleaning the child's teeth/gums with a toothbrush and toothpaste. A significant association was found between the child eating sweet/stuffed biscuits, not consuming soft drink, and using a toothbrush and dentifrice for oral hygiene. It is concluded that the chil- dren were regularly monitored at the BHU; however, this service was not related to dental care. Despite the absence of this type of follow-up and the consumption of cariogenic foods, the mothers were concerned about their children's oral health, cleaning the oral cavity daily with adequate means.
La inmadurez del sistema inmunológico, asociada a los Determinantes So- ciales de la Salud (DSS), promueve enfermedades en la infancia. Específicamente, en la cavidad bucal, los DSS, representados por el alto consumo de azúcar, el acceso limitado a los servicios de salud y la mala higiene bucal, favorecen los trastornos locales y sisté- micos. Así, el estudio tuvo como objetivo asociar el DSS, en el contexto de las condicio- nes socioeconómicas, el seguimiento por el servicio de salud y los aspectos relacionados con la salud bucal de los niños atendidos en las Unidades Básicas de Salud (UBS) de un municipio de Ceará. Se trata de un estudio observacional, analítico, transversal con enfo- que cuantitativo, realizado con niños y sus madres en Acarape CE. Después del consen- timiento, completaron un cuestionario. Los datos fueron analizados. De las 70 madres, 87,14% y 90,00% tenían edad menor o igual a 30 años e ingresos hasta un salario mínimo, respectivamente. De los 70 niños, al 87,14% se les limpió los dientes/encías por sus pa- dres o tutores. Del total, el 94,29% nunca realizó atención odontológica. Hubo una aso- ciación significativa entre la madre con educación superior a la primaria incompleta y la limpieza de los dientes/encías del niño con cepillo y pasta dental. Se encontró una asoci- ación significativa entre el niño que come galletas dulces/rellenas, no consume gaseosas y usa cepillo de dientes y dentífrico para la higiene bucal. Se concluyó que los niños eran monitoreados periódicamente en la UBS; sin embargo, este servicio no estaba relacionado con el cuidado dental. A pesar de la ausencia de este tipo de seguimiento y del consumo de alimentos cariogénicos, las madres se preocupan por la salud bucal de sus hijos, reali- zando la limpieza de la cavidad bucal diariamente, con medios adecuados.
Subject(s)
Humans , Male , Female , Adult , Oral Hygiene/instrumentation , Cariogenic Agents/analysis , Child Care/supply & distribution , Unified Health System , Candy , Cross-Sectional Studies/methods , Dental Care/instrumentation , Health Services Accessibility , MothersABSTRACT
O objetivo desse estudo foi descrever a produção dos atendimentos oferecidos aos pacientes com necessidades especiais nos Centros de Especialidades Odontológicas (CEO) da Paraíba (Brasil) e sua relação com o cumprimento das metas de produtividade, entre o período de 2019 e 2022. Trata-se de um estudo descritivo e ecológico em que foram coletados dados secundários do Sistema de Informações Ambulatoriais do SUS (SIA/SUS), através da captação da produção ambulatorial individualizada (BPA-I), por meio da ferramenta TabWin, dos 98 CEO operantes na Paraíba. Realizou-se análise descritiva e analítica, por meio dos testes Qui-Quadrado de Pearson e Exato de Fisher entre a variável dependente "alcance da meta" e a variável independente "adesão à Rede de Cuidados à Pessoa com Deficiência (RCPD)". Em todos os anos, a porcentagem de CEO cumpridores da meta (15,3% em 2019; 1% em 2020; 12,2% em 2021; e 11,2% em 2022) foi substancialmente menor que os números expressados por aqueles que não alcançaram a produção mínima. Os resultados também apontaram maior realização de procedimentos restauradores (29,6% em 2019; 28,6% em 2020; 32,7% em 2021; e 37,8% em 2022) em detrimento aos periodontais, cirúrgicos e preventivos. No que concerne a estar aderido à RCPD, no ano de 2022, 90,9% dos CEO que alcançaram a meta estavam aderidos à Rede (p<0,05). Concluiu-se que uma baixa frequência de CEO alcançou o cumprimento da meta de produtividade da especialidade de Odontologia para Pacientes com Necessidades Especiais nos CEO. No entanto, a adesão à RCPD manifestou-se como elemento influenciador para aqueles que cumpriram suas metas mensais e anuais.
The objective of this study was to describe the production of care provided to special needs patients in the Dental Specialties Centers (CEO) of Paraíba (Brazil) and its relationship with the achievement of productivity goals, between the period 2019 and 2022. This is a descriptive and ecological study in which secondary data were collected from the SUS Outpatient Information System (SIA/SUS), by capturing the individualized outpatient production (BPA-I), through the TabWin tool, of the 98 operating CEOs in Paraíba. We carried out descriptive and analytical analysis, using Pearson's Chi-square and Fisher's Exact tests between the dependent variable "goal attainment" and the independent variable "adherence to the Care Network for People with Disabilities (RCPD)". In all years, the percentage of CEOs meeting the goal (15.3% in 2019; 1% in 2020; 12.2% in 2021; and 11.2% in 2022) was substantially lower than the numbers expressed by those who did not meet the minimum output. The results also indicated greater performance of restorative procedures (29.6% in 2019; 28.6% in 2020; 32.7% in 2021; and 37.8% in 2022) to the detriment of periodontal, surgical, and preventive procedures. Regarding being adhered to the RCPD, in the year 2022, 90.9% of the CEOs who reached the goal were adhered to the Network (p<0.05). It was concluded that a low frequency of CEOs achieved compliance with the productivity target of the specialty of Dentistry for Special Needs Patients in CEOs. However, adherence to the RCPD manifested itself as an influential element for those who met their monthly and annual goals.
El objetivo de este estudio fue describir la producción de la atención prestada a pacientes con necesidades especiales en los Centros de Especialidades Odontológicas (CEO) de Paraíba (Brasil) y su relación con el alcance de las metas de productividad, entre el período de 2019 y 2022. Se trata de un estudio descriptivo y ecológico en el que se recogieron datos secundarios del Sistema de Información Ambulatoria del SUS (SIA/SUS), mediante la captura de la producción ambulatoria individualizada (BPA-I), a través de la herramienta TabWin, de los 98 CEOs en funcionamiento en Paraíba. Se realizaron análisis descriptivos y analíticos, utilizando las pruebas Chi-cuadrado de Pearson y Exacta de Fisher entre la variable dependiente "cumplimiento de metas" y la variable independiente "adhesión a la Red de Atención a Personas con Discapacidad (RCPD)". En todos los años, el porcentaje de directores generales que cumplieron el objetivo (15,3% en 2019; 1% en 2020; 12,2% en 2021; y 11,2% en 2022) fue sustancialmente inferior a las cifras expresadas por los que no alcanzaron el rendimiento mínimo. Los resultados también indicaron una mayor realización de procedimientos restauradores (29,6% en 2019; 28,6% en 2020; 32,7% en 2021; y 37,8% en 2022) en detrimento de los procedimientos periodontales, quirúrgicos y preventivos. Respecto a estar adherido a la RCPD, en el año 2022, el 90,9% de los CEOs que alcanzaron el objetivo estaban adheridos a la Red (p<0,05). Se concluyó que una baja frecuencia de CEOs alcanzó el cumplimiento de la meta de productividad de la especialidad de Odontología para Pacientes con Necesidades Especiales en CEOs. Sin embargo, la adhesión al RCPD se manifestó como un elemento influyente para aquellos que cumplieron sus objetivos mensuales y anuales.
Subject(s)
Humans , Male , Female , Dental Care/organization & administration , Disabled Persons/education , Dental Health Services/organization & administration , Unified Health System , Secondary Care/organization & administration , Dentistry/organization & administration , Ambulatory Care/organization & administrationABSTRACT
Resumen Los pacientes que se encuentran bajo tratamiento de anticoagulantes orales, presentan alteraciones en distintas etapas de la hemostasia, lo que conlleva a tener implicancias y consideraciones médico/quirúrgicas durante su atención. En la actualidad, no existe un consenso en relación con el manejo odontológico de estos pacientes que serán sometidos a procedimientos quirúrgicos, llevando a protocolos clínicos que siguen diversas posturas, como la de disminuir la ingesta farmacológica del anticoagulante, sustituir con heparina y la de mantener el tratamiento bajo control. Objetivo Establecer el manejo estomatológico del paciente que se encuentra en tratamiento de anticoagulante oral mediante una revisión profunda de la literatura Materiales y método Se realizó una búsqueda de revisión bibliográfica manualmente de artículos indexados a las bases de datos de PUBMED y EBSCO que correspondiesen a las palabras "cirugía bucal", "anticoagulantes", "atención dental" y "hemorragia oral". En cuanto a los criterios de inclusión, se consideraron revisiones bibliográficas, estudios observacionales, ensayos clínicos, guías, revisiones sistemáticas y metaanálisis publicados entre noviembre de 2005 y 2022, en idiomas inglés o español. Conclusiones Existen múltiples protocolos para la atención del paciente anticoagulado que será sometido bajo procedimiento de cirugía oral menor. Es importante considerar el anticoagulante utilizado, motivo, control de este, el procedimiento a realizar en el paciente y medidas hemostáticas tanto intra como postoperatorias por realizar, tras analizar lo anterior, se advierte que disminuir la ingesta del fármaco para realizar el procedimiento, puede ser más perjudicial al paciente como al clínico, por lo tanto se sugiere mantener el tratamiento antitrombótico y realizar un correcto manejo médico/quirúrgico.
Abstract Patients undertaking oral anticoagulant treatment may experience alterations in different stages of hemostasis, which lead to medical/surgical implications and considerations during their care. Currently, there is no consensus regarding the dental management of these patients, as they go through surgical procedures. This leads to clinical protocols that follow numerous approaches, such as reducing the pharmacological intake of the anticoagulant, replacing it with heparin, and maintaining the controlled treatment. Objective: To establish the stomatological management of the patient undergoing oral anticoagulant treatment through an in depth review of the literature. Materials and Method: A manual bibliographic review search of articles indexed to the PUBMED and EBSCO databases corresponding to the words "oral surgery", "oral bleeding", "anticoagulants" and "dental management" was performed. Regarding the inclusion criteria: bibliographic reviews, observational studies, clinical trials, guidelines, systematic reviews, and meta-analyses published between November 2005 and 2022, in English or Spanish, were considered. Conclusion: There are multiple protocols for the care of the anticoagulated patient who will undergo a minor oral surgery procedure. It is important to reflect on the anticoagulant used, the reason for it, its supervision, the surgical procedure that will be undertaken by the patient, and both intraoperative and postoperative hemostatic measures to be implemented. After analyzing the above, it is noted that reducing the intake of the drug to perform the surgical procedure may be harmful to the patient and to the clinician, therefore it is suggested to maintain the antithrombotic treatment and carry out a correct medical/surgical management.
Subject(s)
Humans , Surgery, Oral/methods , Anticoagulants/therapeutic use , Oral Hemorrhage/drug therapy , Dental CareABSTRACT
El caso de los espacios clínicos odontológicos en Chile, en una primera instancia, deben ser observados como organizaciones altamente complejas y multidimensionales -debido a que dentro de ellas operan y funcionan tres lógicas de funcionamiento, por un lado, la educación formativa de pregrado y posgrado en odontología, la perspectiva de salud producto de las prestaciones que realiza y oferta para el desarrollo de prácticas, aprendizajes y procedimientos odontológicos, por tanto, no tan solo serán espacios organizacionales tradicionales universitarios, sino que más bien serán campos sociales complejo de analizar.
The case of dental clinical spaces in Chile, in the first instance, should be observed as highly complex and multidimensional organizations - because within them operate and function three logics of operation, on the one hand, undergraduate and postgraduate training education in dentistry, the health perspective resulting from the services provided and the offer for the development of dental practices, learning and procedures, therefore, they will not only be traditional university organizational spaces, but rather complex social fields to analyze.
Subject(s)
Dental Care/organization & administration , Communication , Dental Care Team/organization & administration , ChileABSTRACT
The present study aimed to review the literature on the main complications of antineoplastic therapies and the degree of knowledge of dental surgeons about these complications. A bibliographic search was conducted in the main health databases PUBMED (www.pubmed.gov) and Scholar Google (www.scholar.google.com.br), in which studies published from 1987 to 2023 were collected. Laboratory studies, case reports, systematic and literature reviews, which were developed in living individuals, about the main neoplastic genes and their relationship with the cells of individuals affected by neoplasms in the head and neck region, and studies on the care with this group of patients, were included. Therefore, articles that did not deal with neoplasm and the main complications of antineoplastic therapies were excluded. Neoplasm is a clonal disorder, caused by mutations, resulting from changes in the genetic structure of cells. Each healthy cell has instructions on how to grow and divi de. In the presence of any error in these instructions (mutation), it can result in a diseased cell that, when proliferating, may cause a tumor. Countless knowledge has been accumulated over the years on the main characteristics of neoplasms, whether they are cancer cell biology, carcinogenesis mechanism, neoplasms of the maxillofacial system and sequels of antineoplastic treatments. In this context, methods have been developed that offer a better quality of life for patients diagnosed with this pathology, as well as preventive vaccine models that may, in the not too distant future, contribute to this goal to be successfully achieved.
El presente estudio tuvo como objetivo revisar la literatura sobre las principales complicaciones de las terapias antineoplásicas y el grado de conocimiento de los odontólogos sobre este abordaje. Se realizó una búsqueda bibliográfica en las principales bases de datos de salud PUBMED (www.pubmed.gov) y Scholar Google (www.scholar.google.com.br), en la que se recopilaron estudios publicados entre 1987 y 2023. Fueron incluidos estudios de laboratorio, relatos de casos, revisiones de la literatura y revisiones sistemáticas, desarrolladas en individuos vivos, que incluyeran los principales genes neoplásicos y su relación con las células de individuos afectados por neoplasias en la cabeza y el cuello. También, se tuvieron en cuenta estudios relacionados con la atención a este grupo de pacientes. La neoplasia es un trastorno clonal, causado por mutaciones, como resultado de cambios en la estructura genética de las células. Cada célula sana tiene instrucciones sobre cómo crecer y dividirse. En presencia de cualquier error en estas instrucciones (mutación), puede provocar una célula alterada que, al proliferar, puede causar un tumor. Se han acumulado innumerables conocimientos a lo largo de los años sobre las principales características de las neoplasias, ya sea sobre biología de células cancerosas, el mecanismo de la carcinogénesis, la neoplasias del sistema maxilofacial y las diferentes secuelas de tratamientos antineoplásicos. En este contexto, se han desarrollado métodos que ofrecen una mejor calidad de vida para los pacientes diagnosticados con esta patología, así como modelos de vacunas preventivas que, en un futuro no muy lejano, pueden contribuir a alcanzar este objetivo con éxito.
Subject(s)
Humans , Dental Care , Genes, Neoplasm/genetics , Head and Neck Neoplasms/geneticsABSTRACT
O tratamento oncológico por meio da quimioterapia e radioterapia consiste em destruir ou impedir o crescimento das células tumorais, visando a cura ou controle da doença. No entanto, esses tratamentos podem ocasionar danos às células saudáveis e consequentes efeitos colaterais, especialmente na cavidade oral, causando alterações como: mucosite, xerostomia, disgeusia, infecções orais, trismo e osteorradionecrose. Objetivo:Sumarizar estudos sobre a importância da prevenção ecuidado das alterações bucais no manejo odontológico a pacientes em tratamento oncológico.Metodologia:Revisão integrativa, a partir da identificação do tema e elaboração da questão norteadora com busca sistematizada da literatura realizada entre os meses de setembro e novembro de 2022. Foram realizadas buscasnas bases de dados da Biblioteca Virtual em Saúde, Google Acadêmicoe PubMed, excluindo-se artigos publicados há mais de cinco anos.Resultados:Obteve-se uma amostra final de seteestudos, após aplicação dos critérios de inclusão e exclusão.Houve concordância entre todos eles acerca das alterações bucais durante o tratamento oncológico, enfatizando a necessidade de assistência odontológica nesses pacientes antes, durante e após a terapia antineoplásica, além deminimizar efeitos desta intervenção. Conclusões:A atuação do cirurgião-dentista no cuidado aos pacientes oncológicos tem grande relevância, uma vez que as condições de saúde bucal impactam a qualidade de vida desses indivíduos. Em suma, o presente estudo contribuino entendimento das alterações bucais e cuidados para o bem-estar do paciente (AU).
Oncologicaltreatment through chemotherapy and radiotherapy consists of destroying or preventing the growth of tumor cells, aiming at curing or controlling the disease. However, these treatments can cause damage to healthy cells and consequent side effects, especially in the oral cavity, causing changes such as: mucositis, xerostomia, dysgeusia, oral infections, trismus and osteoradionecrosis. Objective:To summarize studies on the importance of prevention and care for oral changes in the dental management for patients undergoing oncologicaltreatment.Methodology:Integrative reviewfrom theidentification of the theme and elaboration of the guiding question with a systematic search of the literature carried out between September and November 2022. They were carried out searchesin the Virtual Health Librarydatabase, Google Scholar and PubMed, excluding articles published more than five years ago.Results:A final sample of 07 studies was obtained, after applying the inclusion and exclusion criteria. There was agreement among all of them about oral changes during cancer treatment, emphasizing the need for dental care in these patients before, during and after antineoplastic therapy, in addition to minimizing the effects of this intervention.Conclusions:The performance of the dental surgeon in the care of cancer patients is of great relevance, since oral health conditions impact the quality of life of these individuals. In short, the presentstudy contributesto the of oral changesand care for the patient's well-being (AU).
El tratamiento oncológicopor mediodequimioterapia y radioterapia consiste en destruir o impedir el crecimiento de las células tumorales, visando lacurar o controla de la enfermedad. Sin embargo, estos tratamientos pueden causar daño a las células sanasy en consecuenciaefectos secundarios, especialmenteen la cavidad oral, causandoalteraciones como: mucositis, xerostomía, disgeusia, infecciones orales, trismoy osteorradionecrosis.Objetivo: Resumir estudios acerca de la importancia de la prevención y cuidados de las alteracionesorales en el manejo dental apacientes en tratamiento oncológico.Metodología: Revisión integrativa, apartir de la identificación detema y elaboración de la pregunta guía con buscasistematizadade la literatura realizada entre los meses de septiembre y noviembre de 2022. Fueron realizadas búsquedas en las bases de datos de la Biblioteca Virtual en Salud, Google Académico y PubMed, excluyéndoseartículos publicados hace más de cinco años. Resultados: Se obtuvo una muestra final de siete estudios, después aplicaciones de los criterios de inclusión y exclusión. Hubo concordancia entre todos acerca de las alteracionesorales durante el tratamiento oncológico, enfatizando la necesidad de asistencia odontológica en esespacientes antes, durante y después de la terapia antineoplásica, además de minimizar efectos de esta intervención.Conclusiones: La actuación del cirujano dentistaen el cuidado a lospacientes oncológicos tienegran relevancia, una vez que las condiciones de salud oral impactan la calidad de vida de los individuos. En suma, el presente estudio contribuyeen el entendimientode las alteraciones orales y cuidados para el bienestar del paciente (AU).
Subject(s)
Oral Health/education , Dental Care , Head and Neck Neoplasms/radiotherapy , Antineoplastic AgentsABSTRACT
Durante la pandemia por COVID-19, se incrementaron las preocupaciones, la ansiedad y el miedo, especialmente al brindar atención estomatológica. El objetivo de esta investigación fue analizar la percepción del miedo al COVID-19 en estomatólogos generales y especialistas durante la pandemia. Se diseñó un estudio observacional, analítico, unicéntrico y homodémico. Se incluyeron estomatólogos generales y especialistas de cualquier sexo de diversas disciplinas estomatológicas como ortodoncia, endodoncia, cirugía maxilofacial, etc. La muestra estuvo constituida por 72 estomatólogos, 42 de práctica general (58,3 %) y 32 especialistas (41,6 %). Los datos se recolectaron durante marzo a septiembre del 2021. Participaron 72 estomatólogos (M= 39 años, D.E. 10,82). El 69,4 % de la muestra (n =50) fueron mujeres. De acuerdo con el análisis de medias de la escala total, se encontró que los hombres se perciben ligeramente con más miedo al Covid-19 (M=3,09) que las mujeres durante su práctica estomatológica (M=2,78) sin diferencias significativas. La edad impactó en las respuestas, ya que los mayores de 40 años percibieron más miedo M= 3.23 (IC 95%: 2,65-3,81) que el grupo de 20 a 40 años M=2,73 (IC 95%: 2,37-3,09). Los especialistas, también percibieron mayor miedo al COVID-19 contrastados con los estomatólogos de práctica general (M=2,63) vs (M=3,06). Los resultados denotaron que el 36,1 % de los estomatólogos tuvieron miedo al COVID-19. La investigación anterior mostró resultados similares al estudio de Monterrosa-Castro et al. (2020) en médicos generales colombianos en el que el 37,1 % presentó síntomas de miedo al COVID-19 (FCV-19S). El contexto de pandemia, además de la incertidumbre del comportamiento del COVID-19 y la falta de vacunación masiva al momento de levantar los datos, jugaron un papel muy importante en la percepción del miedo al COVID-19. Los especialistas observaron mayor miedo al COVID-19 al igual que el grupo de mayor edad.
During the COVID-19 pandemic, worries, anxiety and fear increased, especially when providing dental care. The objective of this research was to analyze the perception of fear of COVID-19 in general dentists and specialists during the pandemic. An observational, analytical, single center and homodemic study was designed. General stomatologists and specialists of any sex from various dental disciplines such as orthodontics, endodontics, maxillofacial surgery, etc., were included. The sample consisted of 72 dentists, 42 general practice (58.3 %) and 32 specialists (41.6 %). Data was collected from March to September 2021. 72 dentists participated (M= 39 years, S.D. 10.82). 69.4 % of the sample (n = 50) were women. According to the analysis of means of the total scale, it was found that men perceive themselves to be slightly more afraid of Covid-19 (M=3.09) than women during their dental practice (M=2.78) without significant differences. Age had an impact on the responses, since those over 40 years of age perceived more fear M= 3.23 (95% CI: 2.65-3.81) than the group from 20 to 40 years M=2.73 (95% CI: 2.37- 3.09). Specialists also perceived greater fear of COVID-19 compared to general practice dentists (M=2.63) vs (M=3.06). The results denoted that 36.1 % of the dentists were afraid of COVID-19. Previous research showed similar results to the study by Monterrosa-Castro et al. (2020) in Colombian general practitioners in which 37.1 % presented symptoms of fear of COVID-19 (FCV-19S). The pandemic context, in addition to the uncertainty of the behavior of COVID-19 and the lack of mass vaccination at the time of collecting the data, played a very important role in the perception of fear of COVID-19. The specialists observed greater fear of COVID-19 as well as the older group.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Dental Care , Oral Medicine , COVID-19/psychology , Perception , Surveys and Questionnaires , Fear/psychologyABSTRACT
The aim of this systematic review is to assess the safety of local anaesthetics (LA) combined with vasoconstrictors (VC) for patients with controlled hypertension undergoing dental procedures. A comprehensive search strategy were used to identify all relevant randomized controlled trials (RCTs) that evaluated the effect of LA combined with VC. All searches covered the period from 1990 to February 2021. We performed a meta-analysis using random-effect models and assessed overall certainty in evidence using GRADE approach. Our search strategy yielded 1262 references. Finally, seven randomised trials were included, but only three were included in the meta-analysis. The use of LA with VC may result in little to no difference in the heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP), but the certainty of the evidence was assessed as low. Death, stroke, acute myocardial infarction, need for hospitalization, pain and bleeding were not reported by the included studies. The hemodynamic changes using VC do not imply an increased risk of occurrence of adverse cardiovascular events. The use of VC could even be recommendable considering their multiple advantages.
El objetivo de esta revisión sistemática es evaluar la seguridad del uso de anestésicos locales (AL) combinados con vasoconstrictor (VC) en pacientes con hipertensión controlada durante procedimientos dentales. Se realizó una estrategia de búsqueda para identificar todos los estudios clínicos aleatorizados (ECA) relevantes que evaluaban el efecto del AL combinado con VC. Todos los estudios fueron del periodo entre 1990 a febrero del 2021. Se realizó un meta-análisis usando modelos de efecto aleatorizado y una revisión de la certeza de la evidencia usando el método GRADE. Nuestra estrategia de búsqueda arrojó 1262 referencias. Finalmente, siete estudios clínicos aleatorizados fueron incluidos, de los cuales tres fueron incluidos en el meta-análisis. El uso de AL con VC produce una pequeña a ninguna diferencia en el pulso cardiaco, presión sistólica y diastólica, pero la certeza de la evidencia fue baja. Muerte, infarto agudo al miocardio, accidente cerebrovascular, necesidad de hospitalización, dolor y hemorragia no fueron reportados en los estudios incluidos. Los cambios hemodinámicos en el uso de VC no implican un aumento de riesgo de ocurrencia de efectos adversos cardiovasculares. El uso de VC puede ser recomendable considerando sus múltiples ventajas.
Subject(s)
Humans , Dental Care , Hypertension/surgery , Anesthetics, Local/therapeutic use , Vasoconstrictor Agents/therapeutic use , Hemodynamics/drug effectsABSTRACT
Introdução:A Atenção Primária à Saúde é caracterizada como a porta de entrada preferencial do Sistema Único de Saúde, ocupando lugar central no serviço. Todavia, a pandemia da COVID-19 instigou a necessidade de mudanças naorganização do trabalho das equipes de saúde da atenção básica.Objetivo:Neste cenário, torna-se fundamental conhecer a atuação docirurgião-dentista da Atenção Primária à Saúdeno que se refere à oferta dos serviços odontológicos, alterações no processode trabalho e capacidade técnica de ação, frente às condições estabelecidas pela pandemiadaCOVID-19.Metodologia:Trata-se de um estudo de caráter transversal descritivo e abordagem quantitativa, desenvolvido em um município do interior baiano, com 29 cirurgiões-dentistas vinculados àatenção básica. Esses profissionais foram convidados a responder um questionário on-lineque abordou questões relativas ao desempenho dos cirurgiões-dentistas e a condução das ações de saúde bucal frente às medidas restritivas impostas pela pandemiada COVID-19.Resultados:Foi possível identificar que o processo de trabalho e acesso da população aos serviços de odontologia sofreram interferências, expressas através da limitação do acesso da população à saúde bucal, alterações nas técnicas terapêuticas e interrupção das ações em saúde de abrangência coletiva.Conclusões:O presente estudo apontou limitaçõesno processo de trabalho do cirurgião-dentista da Atenção Primária à Saúdedurante a pandemia da COVID-19, como a dificuldade para atuar em equipe interprofissional e atender as proposições estabelecidas pelaPolítica Nacional da Atenção Básica (AU).
Introduction:Primary Health Care is the preferred gateway to the Brazilian Unified Health System, occupying a central place in the service. However, the COVID-19 pandemic instigated the need for changes in the organization of work of primary care health teams.Objective:In this scenario, it is essential to know the performance of dental surgeons in terms ofdental care offer, changes in the work process and of their technical capacity for action, in the face of the conditions established by the pandemic.Methodology:This is a descriptive cross-sectional study with a quantitative approach developed in a city in the countryside of Bahia with 29 dental surgeons linked to primary care. These professionals were invited to answer an online questionnaire that addressed issues related to the performance of dental surgeons and the management of oral health actions in the face of the restrictive measures imposed by the COVID-19 pandemic.Results:It was possible to identify that the pandemic interfered with the work process and the population's access to dental services, expressed through the limitation of the population's access to oral health, changes in therapeutic techniques and interruption of collective health actions.Conclusions:The present study pointed out limitations in the work process of the primary care dentist during the COVID-19 pandemic, such as the difficulty in working in an interprofessional team and meeting the propositions established by the Brazilian National Primary Care Policy in Health (AU).
Introducción: La Atención Primaria de Salud se caracteriza por ser la puerta de entrada preferente al Sistema Único de SaludBrasileño, ocupando un lugar central en el servicio. Sin embargo, la pandemia de COVID-19 instigó la necesidad de cambios en la organización del trabajo de los equipos de salud de atención primaria.Objetivo: En este escenario, es fundamental conocer el desempeño del odontólogo en cuanto, oferta de cuidado dental, cambios enel procesode trabajo, ya su capacidad técnica de actuación, ante las condiciones establecidas por la pandemiaMetodología: Se trata de un estudio descriptivo transversal con enfoque cuantitativo, desarrollado en una ciudad del interior de Bahía, con 29 odontólogos vinculados a la atención primaria. Estos profesionales fueron invitados a responder un cuestionario en línea que abordaba cuestiones relacionadas con la actuación de los odontólogos y la realización de acciones de salud bucal frente a las medidas restrictivas impuestas por la pandemia de la COVID-19.Resultados: Con los resultados fue posible identificar que el proceso de trabajo y el acceso de la población a los servicios odontológicos sufrieron interferencias, expresadas a través de la limitación del acceso de la población a la salud bucal, cambios en las técnicas terapéuticas e interrupción de las acciones de salud colectiva. Conclusiones: El presente estudio señaló limitaciones en el proceso de trabajo del cirujano dentista de la atención en lasaluddurante la pandemia de COVID-19, como la dificultad para trabajar enequipo interprofesional y cumplir con las proposiciones establecidas por la Política Brasileña de Atención Primaria en Salud (AU).
Subject(s)
Humans , Male , Female , Primary Health Care , Oral Health , Dental Care , Dentists , COVID-19/transmission , Unified Health System , Cross-Sectional Studies/methods , Surveys and Questionnaires , Working Conditions , Health PromotionABSTRACT
The objective of this research was to use the Dental Satisfaction Questionnaire to determine the level of patient's satisfaction who come to the School of Dentistry of the University of Costa Rica. The research was conducted with the entire population of patients who received dental care in the Undergraduate Student Clinics of the School of Dentistry between April and September 2021. A digital survey was generated with the questions of the DSQ and sociodemographic variables, which was sent by email. Descriptive statistics were performed to establish the absolute and relative frequency, as well as measures of central tendency and variability, according to the nature of the variables. The Kolmogorov-Smirnov test was used in the conformity assessment of the data for the normal distribution. The relationships between the scores obtained from the Dental Satisfaction Questionnaire and the sociodemographic variables were analyzed using the Mann-Whitney U Test and the Kruskal-Wallis Test. A response rate of 36% was obtained. 98.5% of the subjects were satisfied with the services received. There was a statistically significant difference between the frequency of visits and the dental satisfaction scale (p=0.001). The scoring by type of clinic with regards to access, pain management, cost and availability were statistically significant (p=0.001, p=0.014, p=0.001, p=0.001, respectively). The differences in the relationship between the age groups and access was significant (p=0.014); in addition to that between education level and cost (p=0.001). A large majority of patients who come to the services of the School of Dentistry UCR are satisfied with the service received.
El objetivo de esta investigación fue utilizar el cuestionario DSQ para determinar el nivel de satisfacción de los pacientes que acuden a la Facultad de Odontología de la UCR. La investigación se realizó con toda la población de pacientes que recibieron atención dental en las Clínicas de pregrado y grado de la Facultad de Odontología UCR entre abril y setiembre del 2021. Se generó una encuesta digital con las preguntas del cuestionario DSQ y variables sociodemográficas, la cual se envió por medio del correo electrónico. Se realizó estadística descriptiva estableciendo la frecuencia absoluta y relativa, así como medidas de tendencia central y variabilidad, según la naturaleza de las variables. La prueba de Kolmogorov-Smirnov fue utilizada en la evaluación de la conformidad de los datos para la distribución normal. Las relaciones entre las puntuaciones obtenidas del Cuestionario de Satisfacción Dental y las variables sociodemográficas se analizaron mediante las pruebas de Prueba U de Mann-Whitney y la Prueba de Kruskal-Wallis. Se obtuvo un índice de respuesta del 36%. El 98,5% de los sujetos estuvo satisfecho con los servicios recibidos. Hubo diferencia estadísticamente significativa entre la frecuencia de visitas y la escala de satisfacción dental (p=0,001). También hubo diferencia estadísticamente significativa entre las diferentes clínicas y el acceso, manejo del dolor, costo y disponibilidad (p=0,001, p=0,014, p=0,001, p=0,001, respectivamente). De igual forma, hubo diferencia significativa en los grupos de edad y el acceso (p=0,014) y entre el nivel educativo y el costo (p=0,001). Una gran mayoría de los pacientes que acuden a los servicios de la Facultad de Odontología UCR están satisfechos con el servicio recibido.
Subject(s)
Humans , Quality of Health Care/statistics & numerical data , Dental Care , Academic Medical Centers , Costa RicaABSTRACT
Introducción: El objetivo fundamental de la práctica estomatológica contemporánea es dar solución no solo a aquellas entidades que afectan el aparato estomatognático, sino prevenir y tratar aquellas urgencias médicas que puedan presentarse durante el ejercicio de la profesión. Este propósito solo resulta posible mediante la formación de un estomatólogo con una elevada preparación científico-técnica. Objetivo: Evaluar los contenidos relacionados con las urgencias médicas durante la atención estomatológica en los planes de estudio D y E de la carrera de estomatología. Métodos: Se realizó un análisis documental de los planes de estudio D y E. Durante el cual se revisaron el perfil profesional, los modos de actuación, y los programas de la disciplina integradora Estomatología Integral y de las asignaturas. Asimismo, se valoraron los contenidos relacionados con las urgencias médicas durante la atención estomatológica, el semestre en que se imparte la asignatura, los objetivos, los temas, y el sistema de conocimientos y habilidades. Resultados: Las asignaturas y disciplinas que incorporaron contenidos relacionados con las urgencias médicas durante la atención estomatológica fueron: Operatoria Clínica, Atención Integral a la Familia III, Farmacología y Preparación para la Defensa. El análisis documental realizado y las entrevistas ejecutadas mostraron la existencia de diversos criterios en relación con estos contenidos en las asignaturas abordadas. Conclusiones: Los contenidos relacionados con las urgencias médicas durante la atención estomatológica en los programas de las asignaturas y disciplinas evaluados resultaron limitados e insuficientes, y presentaron algunas deficiencias desde el punto de vista didáctico(AU)
Introduction: The fundamental objective of contemporary oral care practice is to provide solutions not only to those entities that affect the oral apparatus, but also to prevent and treat those medical emergencies that may appear during professional practice. This purpose can be achieved only through the training of an oral physician with a high scientific-technical preparation. Objective: To assess the contents related to medical emergencies during oral care in the D and E study plans of the dental medicine major. Methods: A documentary analysis of the D and E study plans was carried out; the process consisted in reviewing the professional profile, the modes of action and the syllabuses of the integrating discipline Comprehensive Dental Medicine, as well as of the subjects. Likewise, an assessment was carried out of the contents related to medical emergencies during oral care, the semester in which the subject is taught, the objectives, the topics, as well as the system of knowledge and skills. Results: The subjects and disciplines including contents related to medical emergencies during oral care were Clinical Surgery, Comprehensive Family Care III, Pharmacology and Preparation for Defense. The conducted documentary analysis and the performed interviews showed the existence of diverse criterions with respect to these contents in the addressed subjects. Conclusions: The contents related to medical emergencies during oral care in the assessed syllabuses of subjects and disciplines were concluded to be limited and insufficient, as well as presented some deficiencies from the didactic point of view(AU)
Subject(s)
Humans , Professional Practice , Dental Care , Evaluation of Medical School Curriculum , Epidemiology, Descriptive , Cross-Sectional Studies , Education, MedicalABSTRACT
Introducción: El consentimiento informado es el resultado de la evolución de la relación entre las personas profesionales de la salud y sus pacientes o usuarios donde el principio de autonomía está por encima de cualquier otra cosa. Existen muchos artículos sobre el consentimiento informado pero ninguno de los estudios encontrados evaluó si los pacientes realmente lo comprenden. El objetivo de esta investigación fue determinar el nivel de comprensión del consentimiento informado por parte de los pacientes de la Clínica de Exodoncia y Cirugía de la Facultad de Odontología de la Universidad de Costa Rica, en el período agosto a septiembre del 2022, mediante un cuestionario que permitiera correlacionar la comprensión con el nivel de escolaridad. Materiales y métodos: Se realizó un cuestionario a 100 personas dividido en dos partes, una sobre datos sociodemográficos y la otra para establecer la comprensión del consentimiento informado y determinar si el grado de escolaridad tenía relación con la comprensión de este. Resultados: El grupo entre 20 y 30 años fue el mayor, de estos el 51% tuvo estudios universitarios, y aunque la mayoría (98%) refirió conocer el concepto de consentimiento informado, únicamente el 33 % obtuvo las respuestas correctas a las preguntas clínicas realizadas. Conclusiones: A pesar de que los pacientes refieren conocer qué es el consentimiento informado los resultados sugieren una comprensión poco clara de conceptos importantes como complicaciones o reacciones adversas inmediatas o tardías producidas por el efecto de los tratamientos odontológicos o procedimientos quirúrgicos.
Introduction: Informed consent is the result of the evolution of the relationship between health professionals and their patients or users where the principle of autonomy is above anything else. There are many articles on informed consent but none of the studies found assessed whether patients really understand it. The objective of this research was to determine the level of understanding of informed consent by the patients of the Clinic of Oral Surgery of the Faculty of Dentistry of the University of Costa Rica, in the period August to September 2022, by means of a questionnaire that would allow correlating the understanding with the level of schooling. Materials and methods: A questionnaire was administered to 100 people divided into two parts, one on sociodemographic data and the other to establish the understanding of informed consent and to determine whether the level of schooling was related to the understanding of the same. Results: The group between 20 and 30 years of age was the largest, of these 51% had university studies, and although the majority (98%) referred to knowing the concept of informed consent, only 33% obtained the correct answers to the clinical questions asked. Conclusions: Even though patients refer to knowing what informed consent is the results suggest an unclear understanding of important concepts such as complications or immediate or late adverse reactions produced by the effect of dental treatments or surgical procedures.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Patients , Dental Care/ethics , Academic Medical Centers , Informed Consent , Costa RicaABSTRACT
INTRODUCTION: After the onset of the Covid-19 pandemic, oral health care in Primary Health Care (PHC) services in Brazil focused on emergency care. OBJECTIVE: To evaluate the impact of the Covid-19 pandemic on the number of emergency dental visits in PHC in Brazil. METHODS: This was an analytical and ecological study with data from the Health Information System for Primary Care referring to the number of attendances performed from March to December 2018 to 2020 in PHC services throughout Brazil for toothache, abscess, and dentoalveolar trauma. Differences between the monthly medians of the number of attendances before the pandemic (April to December 2018 and 2019) and during (April to December 2020) were analyzed using the independent-samples Mann-Whitney U test considering the interquartile ranges (IQR). RESULTS: Approximately 14 million cases were analyzed, with almost one-third of them occurring during the pandemic. There was a reduction in the median of the monthly number of emergency department visits in Brazil (-16.5%; p<0.031). Attendances for toothache reduced from a monthly median of 448,802.0 to 377,941.5 (IQR before [IQRa]: 416,291.7-506,150.5; IQR during [IQRd]: 310,251.0-454,206.5), dentoalveolar abscess attendances reduced from 34,929.0 to 27,705.5 (IQRa: 30,215.0-37,870.5; IQRd: 22,216.0-30,048.2) and to dentoalveolar trauma from 16,330.5 to 10,975.0 (IQRa: 14,800.0-18,472.7; IQRd: 8,111.2-13,527.5). CONCLUSION: Significant reductions were observed in the performance of emergency dental procedures in PHC during the COVID-19 pandemic.
INTRODUÇÃO: Após a instalação da pandemia da Covid-19, a atenção em saúde bucal nos serviços de Atenção Primária à Saúde (APS) no Brasil se concentrou nos atendimentos de urgência. OBJETIVO: Avaliar o impacto da pandemia da COVID-19 no número de atendimentos a urgências odontológicas na APS no Brasil. MÉTODOS: Trata-se de um estudo analítico e ecológico com dados do Sistema de Informação em Saúde para a Atenção Básica referentes ao número de atendimentos realizados de março a dezembro de 2018 a 2020 nos serviços de APS de todo o Brasil para dor de dente, abscesso e traumatismo dentoalveolares. Diferenças entre as medianas do número de atendimentos mensais antes da pandemia (abril a dezembro de 2018 e 2019) e durante (abril a dezembro de 2020) foram analisadas usando o teste não paramétrico de Mann-Whitney U para amostras independentes considerando os intervalos interquartílicos (IIQ). RESULTADOS: Foram analisados aproximadamente 14 milhões de atendimentos, sendo quase um terço deles ocorridos durante a pandemia. Houve redução na mediana do número mensal de atendimentos a urgências no Brasil (-16,5%; p<0,031). Atendimentos a dor de dente reduziram de uma mediana mensal de 448.802,0 para 377.941,5 (IIQ antes [IIQa]: 416.291,7-506.150,5; IIQ durante [IIQd]: 310.251,0-454.206,5), atendimentos de abscesso dentoalveolar reduziram de 34.929,0 para 27.705,5 (IIQa: 30.215,0-37.870,5; IIQd: 22.216,0-30.048,2) e a traumatismos dentoalveolares de 16.330,5 para 10.975,0 (IIQa: 14.800,0-18.472,7; IIQd: 8.111,2-13.527,5). CONCLUSÃO: Foram observadas reduções significativas na realização de procedimentos odontológicos de urgência na APS durante a pandemia de COVID-19.
Subject(s)
Primary Health Care , Dental Care , Health Information Systems , Ambulatory Care , COVID-19 , Periapical Abscess , Toothache , Brazil , Tooth Injuries , Ecological StudiesABSTRACT
O manejo odontológico adaptado ao paciente que é diagnosticado com câncer é fundamental para a melhoria e manutenção da qualidade de vida dos mesmos. Esses indivíduos devem ser submetidos a uma avaliação odontológica prévia ao tratamento anticancerígeno, a fim de estabelecer as etapas necessárias às intervenções e o que pode ser realizado antes, durante e pós-tratamento, sendo essas fases executadas na clínica diária ou até mesmo no ambiente hospitalar, exercendo um trabalho multidisciplinar. A presente revisão de literatura tem como objetivo direcionar a atenção dos cirurgiões dentistas para o planejamento e atendimento personalizado dos pacientes oncológicos, de acordo com suas necessidades e particularidades.
Dental management adapted to patients diagnosed with cancer is essential for improving and maintaining their quality of life. These individuals must undergo a dental evaluation prior to anticancer treatment, in order to establish the necessary steps for interventions and what can be done before, during and after treatment, these phases being performed in the daily clinic or even in the hospital environment, exercising multidisciplinary work. This literature review aims to direct the attention of dentists to the planning and personalized care of cancer patients, according to their needs and particularities.
El manejo odontológico adaptado a los pacientes diagnosticados de cáncer es esencial para mejorar y mantener su calidad de vida. Estas personas deben someterse a una evaluación odontológica previa al tratamiento anticanceroso, con el fin de establecer los pasos necesarios para las intervenciones y lo que se puede hacer antes, durante y después del tratamiento, siendo estas fases realizadas en la clínica diaria o incluso en el ámbito hospitalario, ejerciendo un trabajo multidisciplinar. Esta revisión bibliográfica pretende dirigir la atención de los odontólogos a la planificación y atención personalizada de los pacientes con cáncer, de acuerdo con sus necesidades y particularidades.
Subject(s)
Patients , Mouth Neoplasms , Dental Care , Xerostomia , Dentistry , Dentists , Drug Therapy , Planning , Medical OncologyABSTRACT
Objetivo: Determinar la incidencia de complicaciones de la técnica anestésica Spix en procedimientos odontológicos a pacientes atendidos en la clínica de la Universidad Andrés Bello (UNAB). Material y Métodos: Se analizó a 37 pacientes que fueron atendidos por alumnos de cuarto y quinto año de la clínica odontológica, a los cuales se le realizó la técnica anestésica Spix para realizar el procedimiento odontológico. Se consignó mediante la observación la presencia de formación de hematomas intraorales en el sitio de punción, rotura de la aguja, cantidad de tubos de solución anestésica inyectados, presencia de dolor a la inyección de solución anestésico y la presencia o no de parálisis facial. Mediante la recolección de datos y posterior encuesta a los participantes se consignó la presencia de trismus al día siguiente de la atención y parestesia persistente al día siguiente de la atención. Resultados: De 37 pacientes estudiados que recibieron la técnica anestésica Spix, 6 presentaron hematoma intraoral (16,2%), ninguno reportó rotura de la aguja, 1 presentó parálisis facial (2,7%), 1 presentó parestesia persistente al día siguiente (2,7%), 12 presentaron trismus posterior a la inyección (32,4%). El rango de dolor reportado fue entre 1 y 4 según la escala EVA. Conclusión: Hay una baja incidencia de las complicaciones asociadas a la técnica anestésica Spix en la clínica odontológica de la UNAB, siendo el trismus la complicación más frecuente. Se necesita un mayor número de muestra para entender mejor esta realidad.
Objective: To determine the incidence of complications of the Spix anesthetic technique in the dental procedures of patients attended at the Andrés Bello University dental clinic. Material and Methods: 37 patients who were cared for by fourth- and fifth-year students from the dental clinic of the Andrés Bello University were analyzed, who underwent the Spix anesthetic technique to perform the dental procedure. The presence of intraoral hematoma formation at the puncture site, needle breakage, number of injected anesthesia tubes, presence of pain upon injection of anesthetic and the presence or not of facial paralysis were recorded. Through data collection and subsequent survey of the participants, the presence of trismus was recorded the day after care. Results. Of the 37 cases of patients studied who received the Spix anesthetic technique, 6 had intraoral hematoma (16.2%), no needle break was reported, 1 had facial paralysis (2.7%), 1 had persistent paresthesia at the next day (2.7%), 12 presented trismus after the injection (32.4%), the pain range was between 1 and 4 according to the VAS scale. Conclusion. There is a low incidence of complications associated with the Spix anesthetic technique in the Andrés Bello University dental clinic, trismus being the most frequent (32.4%). A larger sample number should be needed to better understand this reality.
Subject(s)
Humans , Pain , Postoperative Complications , Trismus , Anesthesia, Local , Mandibular Nerve , Nerve Block , Patients , Dental CareABSTRACT
Objetivo: compreender a percepção de gestantes e puérperas a respeito do pré-natal odontológico. Método: estudo descritivo, exploratório com abordagem qualitativa, realizado em um Hospital Maternidade de um município do interior cearense, mediante entrevistas junto as gestantes, a partir do terceiro trimestre, e puérperas. A coleta de dados ocorreu em 2020. Em seguida, o conteúdo empírico foi analisado e categorizado em seguindo os pressupostos da análise temática. Resultados: participaram da pesquisa, 20 mulheres entre gestantes e puérperas. A partir da percepção das participantes, foram elaboradas três categorias, a saber: a percepção do pré-natal odontológico, segundo a ótica das gestantes e puérperas; relações dialógicas entre gestantes e profissionais de saúde; e implicações da falta de informação sobre a assistência odontológica na gestação. Conclusão: as gestantes reconhecem que o acompanhamento odontológico no período da gravidez é importante, mas demonstraram não entender quais as consequências positivas da assistência
Objective: to understand the perception of pregnant and postpartum women about dental prenatal care. Methods: descriptive, exploratory study with qualitative approach, conducted in a maternity hospital of a city in the interior of ceará, through interviews with pregnant women, from the third trimester, and postpartum women. Data collection occurred in 2020. Then, the empirical content was analyzed and categorized following the assumptions of thematic analysis. Results: twenty women among pregnant and postpartum women participated in the research. From the perception of the participants, three categories were elaborated, namely: the perception of dental prenatal care, according to the pregnant and postpartum women's point of view; dialogical relations between pregnant women and health professionals; and implications of the lack of information on dental care during pregnancy. Conclusion: pregnant women recognize that dental care during pregnancy is important, but they do not understand the positive consequences or the meaning of this assistance
Objetivo: conocer la percepción de las mujeres embarazadas y puérperas sobre el cuidado prenatal dental. Métodos: estudio descriptivo, exploratorio con abordaje cualitativo, realizado en un hospital materno de un municipio del interior cearense, mediante entrevistas junto a las gestantes, a partir del tercer trimestre, y puérperas. La recogida de datos se realizó en 2020. A continuación, el contenido empírico fue analizado y categorizado siguiendo los puntos de vista del análisis temático. Resultados: participaron en la investigación 20 mujeres entre gestantes y puérperas. A partir de la percepción de los participantes, se elaboraron tres categorías, a saber: la percepción del prenatal odontológico, según la óptica de las gestantes y puérperas; las relaciones dialógicas entre gestantes y profesionales de la salud; y las implicaciones de la falta de información sobre la asistencia odontológica en la gestación. Conclusión: las gestantes reconocen que el acompañamiento odontológico en el periodo de gestación es importante, pero demuestran no entender cuáles son las consecuencias positivas o el sentido de esta asistencia
Subject(s)
Humans , Female , Pregnancy , Prenatal Care , Dental Care , Pregnant WomenABSTRACT
ABSTRACT Objective: To assess the awareness about COVID-19 among dental patients and determine the association between COVID-19 awareness and perceived stress among dental patients. Material and Methods: A selfadministered knowledge, attitude and practices (KAP) questionnaire and perceived stress scale (PSS) were employed to assess the knowledge and attitude among dental patients visiting the outpatient department. A p-value of ≤ 0.05 was considered statistically significant. An independent t-test was used to compare the KAP and PSS scores based on age, gender, occupation and the responses to unscorable questions. Spearman's correlation was employed to assess the association between KAP and PSS scores. Results: The older participants (mean KAP score = 16±2.2), the participants who answered that the Coronavirus outbreak changed their daily routine (mean KAP score = 15.8±2.2) and the participants who answered that they changed their plans due to the Coronavirus outbreak (mean KAP score = 16±2.14) had significantly higher KAP scores when compared to their respective counterparts. The Spearman's correlation value of -0.45 suggested a moderate negative association between the KAP and PSS scores, but this correlation was not statistically significant. Conclusion: The participants had a moderate to good level of knowledge related to COVID-19 and were positive in their approach and outlook on overcoming the pandemic.