Desinfección y esterilización en odontología frente al COVID-19 / Disinfection and sterilization in dentistry against COVID-19 / Desinfecção e esterilização em odontologia contra a COVID-19

A partir de la declaración de la Organización Mundial de la Salud del comienzo de la pandemia COVID-19 causada por el virus SARS-CoV-2 en marzo de 2020, los profesionales de la salud se vieron expuestos a esta enfermedad altamente contagiosa y potencialmente mortal que generó múltiples desafíos a toda la comunidad científica. Provocando cambios de paradigmas en la atención de los pacientes y en el uso de las barreras de protección personal. A nivel mundial se crearon múltiples protocolos para la atención odontológica a medida que se iba desarrollando e investigando el comportamiento del virus. Esta revisión bibliográfica resume las indicaciones y recomendaciones basadas en las evidencias disponibles para disminuir las posibilidades de contaminación ante la exposición a este virus, incluyendo medidas a utilizar desde el ingreso del paciente, los métodos de protección personal, la descontaminación y esterilización del material, así como también la desinfección del área de trabajo. Aunque se ha hecho un gran esfuerzo por mejorar los procesos de bioseguridad a nivel científico tecnológico, hay evidencias de que el factor humano sigue siendo el eslabón más débil de esta cadena.

Since the declaration by the World Health Organization of the beginning of the COVID-19 pandemic caused by the SARS-CoV-2 virus in March 2020, health professionals were exposed to this highly contagious and potentially fatal disease that generated multiple challenges to the entire scientific community. It caused paradigm shifts in patient care and in the use of personal protective barriers. Multiple protocols for dental care were created worldwide as the behavior of the virus was developed and investigated. This bibliographic review summarizes the indications and recommendations based on the available evidence to reduce the possibilities of contamination when exposed to this virus, including measures to be used from patient admission, personal protection methods, decontamination and sterilization of material, as well as disinfection of the work area. Although a great effort has been made to improve biosafety processes at the scientific and technological level, there is evidence that the human factor continues to be the weakest link in this chain.

Desde a declaração pela Organização Mundial da Saúde do início da pandemia de COVID-19 causada pelo vírus SARS-CoV-2 em março de 2020, os profissionais de saúde foram expostos a essa doença altamente contagiosa e potencialmente fatal, que criou vários desafios para toda a comunidade científica. Ela causou mudanças de paradigma no atendimento ao paciente e no uso de barreiras de proteção individual. Em todo o mundo, vários protocolos para atendimento odontológico foram criados à medida que o comportamento do vírus foi desenvolvido e pesquisado. Esta revisão da literatura resume as indicações e recomendações baseadas em evidências para reduzir a probabilidade de contaminação por exposição a esse vírus, incluindo medidas a serem usadas desde a admissão do paciente, métodos de proteção individual, descontaminação e esterilização de equipamentos, bem como desinfecção da área de trabalho. Embora muitos esforços tenham sido feitos para melhorar os processos de biossegurança em nível científico e tecnológico, há evidências de que o fator humano continua sendo o elo mais fraco dessa cadeia.

Análisis de la calidad de vida relacionada con salud oral en adultos con maloclusión / Analysis of the Oral Health-Related Quality of Life in Adults with Malocclusion / Análise da qualidade de vida relacionada à saúde bucal em adultos com má oclusão

aquellos pacientes que requirieron tratamiento de ortodoncia informaron impactos negativos en su calidad de vida relacionada con salud oral, en comparación con aquellos pacientes conclusión normal. El objetivo fue analizar la calidad de vida relacionada con la salud oral en pacientes con diferentes niveles de severidad de maloclusión que acudieron a consultorios odontológicos públicos de Paraguay durante el 2017. Materiales y métodos: estudio transversal. Se midieron variables sociodemográficas (como sexo, edad, residencia y nivel de estudios) y variables clínicas (como diastema, máxima irregularidad anterior maxilar y mandibular, resalte incisal y mordida cruzada anterior). Se utilizó el cuestionario Perfil de Impacto de Salud Oral en su versión paraguaya (ohip-14Py) y el Índice de Estética Dental (IED). Resultados: formaron parte del estudio 269 pacientes, la mayoría mujeres (75.1 %). El puntaje IED fue de 31.6 ± 11.6. Se observó resalte incisal aumentado (>2 mm) en poco más de la mitad (52.4 %) y una baja frecuencia de mordida cruzada anterior (5.9 %) y mordida abierta (10.0 %). Al evaluar por dimensiones, la incapacidad psicológica (p = 0.028), social (p = 0.034) y la minusvalía (p = 0.552) aumentaron conforme el nivel de severidad de maloclusión, por lo que fueron estadísticamente significativas las dos primeras. Conclusión: conforme aumenta la gravedad de la maloclusión, disminuye significativamente la calidad de vida oral para las dimensiones incapacidad psicológica e incapacidad social.

Patients requiring orthodontic treatment reported negative impacts on oral health-related qual-ity of life compared to patients with normal occlusion. Objective: To analyze the oral health-related quality of life in patients with different levels of severity of malocclusion attending public dental offices in Paraguay in 2017. Methodology: This was a cross-sectional study. Both, the sociodemographic variables, like sex, age, res-idence, and educational level, and the clinical variables, like diastema, maximum anterior maxillary, and mandibular irregularity, incisal overhang, and anterior crossbite were measured. The Oral Health Impact Profile questionnaire was used in its Paraguayan version (ohip-14Py) and the Dental Aesthetic Index (ied) scale. Results: A total of 269 patients were a part of the study. Moreover, 75.1 % of them were women. The ied score was 31.4 ± 11.6. An increase in the incisal protrusion (>2 mm) was seen in 52.4 % of the patients. Whereas a low frequency of anterior crossbite and open bite were seen in 5.9 % and 10.0 % of the population, respec-tively. While conducting an evaluation based on the dimensions, the psychological disability (p = 0.028), social disability (p = 0.034), and handicap (p = 0.552) increased according to the level of severity of malocclusion, being statistically significant in the first two. Conclusion: As the severity of the level of malocclusion increases, the oral quality of life decreases for the psychological disability and social disability dimensions.

os pacientes que necessitaram de tratamento ortodôntico relataram impactos negativos na qualidade de vida relacionada à saúde bucal em comparação aos pacientes com oclusão normal. Objetivo:analisar a qualidade de vida relacionada à saúde bucal em pacientes com diferentes graus de severi-dade da má oclusão que compareceram a consultórios odontológicos públicos no Paraguai durante o ano de 2017. Metodologia: estudo transversal. Foram mensuradas variáveis sociodemográficas como sexo, idade, residência e escolaridade e variáveis clínicas como diastema, irregularidade anterior maxilar e mandibular máxima, sobressaliência incisal e mordida cruzada anterior. Foram utilizados o questioná-rio Perfil de Impacto em Saúde Bucal em sua versão paraguaia (ohip-14Py) e o Índice de Estética Dental (ied). Resultados: fizeram parte do estudo 269 pacientes, sendo a maioria mulheres (75,1 %). A pontuação do ied foi de 31,6 ± 11,6. Observou-se aumento da saliência incisal (>2 mm) em pouco mais da metade (52,4 %) dos pacientes, além de baixa frequência de mordida cruzada anterior (5,9 %) e mordida aberta (10,0 %). Ao avaliar por dimensões, a incapacidade psicológica (p = 0,028), incapacidade social (p = 0,034) e desvantagem (p = 0,552) aumentaram de acordo com o grau de severidade da má oclusão, sendo as duas primeiras estatisticamente significativas. Conclusão: à medida que a gravidade da má oclusão aumenta, a qualidade de vida oral diminui significativamente para as dimensões de incapacidade psicológica e incapacidade social.

Les risques de contamination infectieuse des praticiens dans les cabinets dentaires de Conakry: origine, conséquence et prévention / The risks of infectious contamination of practitioners in dental practices in Conakry: origin, consequence and prevention

INTRODUCTION: La pratique de la dentisterie implique un risque d'exposition à des microorganismes responsables de nombreuses maladies telles que l'Hépatite, la COVID-19, le VIH-SIDA. OBJECTIFS: Contribuer à l'étude des risques de contamination infectieuse des praticiens. MÉTHODOLOGIE: Il s'agissait d'une étude transversale de type descriptive d'une durée de quatre mois allant de juin à septembre 2022. RÉSULTATS: Parmi les 100 praticiens interrogés, les chirurgiens-dentistes ont été les plus représentés avec un taux de 63%. Moins de la moitié des praticiens soit 46% avaient une expérience professionnelle compris entre 5 et 10 ans. Parmi nos enquêtés, 62% connaissaient les techniques de prévention d'hygiène. 76% ont été vaccinés contre la COVID-19 et 49% ont été vaccinés contre l'Hépatite B et 65% ont affirmé avoir été piqués ou coupés par un objet souillé. CONCLUSION: Il ressort de cette étude la nécessité de sensibiliser les praticiens sur les mesures de prévention contre les infections au cabinet dentaire.

INTRODUCTION: The practice of dentistry involves a risk of exposure to microorganisms responsible for many diseases such as Hepatitis, COVID-19, HIV-AIDS. OBJECTIVE: Contribute to the study of the risks of infectious contamination of practitioners. METHODOLOGY: This was a descriptive cross-sectional study lasting four months from June to September 2022. RESULTS: Among the 100 practitioners questioned, dental surgeons were the most represented with a rate of 63%. Less than half of the practitioners, or 46%, had professional experience of between 5 and 10 years. Among our respondents, 62% knew the hygiene prevention techniques. 76% had been vaccinated against COVID-19 and 49% had been vaccinated against Hepatitis B and 65% said they had been bitten or cut by a soiled object. CONCLUSION: This study shows the need to educate practitioners on preventive measures against infections in the dental office.

Manifestaciones orales de la viruela símica y recomendaciones para su prevención en la práctica odontológica / Oral manifestations of monkeypox and recommendations for its prevention in dental practice

El brote reciente de viruela símica ha despertado el interés de la comunidad internacional por su creciente número de contagiados en países no endémicos. Entre sus síntomas se encuentran la fiebre, dolor de cabeza, fatiga, dolor muscular, exantema y linfadenoma. La cavidad bucal es el lugar en el que suelen aparecer los primeros signos de la enfermedad. Por tanto, el objetivo de este trabajo fue establecer las principales manifestaciones orales de la viruela del mono y enumerar algunas recomendaciones de prevención. Para ello, se hizo una revisión bibliográfica entre 2012 y 2022 en la base de datos PubMed, usando las palabras clave, en inglés, monkeypox, oral manifestation y transmission. Se garantizó que, de los 14 documentos seleccionados, al menos el 80%, fueran publicaron en 2022. Las manifestaciones orales más frecuentes fueron: úlcera eritematosa, vesículas-ulcerosas y las asociadas a linfadenopatía (disfagia, odinofagia y faringitis). Entre las recomendaciones se encuentran: uso de mascarilla N95 y visores faciales, lavado constante de manos y espacios y atención de contagiados solo por eventos agudos (urgencias). Aunque no se ha confirmado, es posible que el Tecovirimat sea de ayuda en pacientes con sintomatología grave. Se concluye que es necesario que los odontólogos sepan distinguir los signos orales de la enfermedad para que contribuyan a cortar la cadena de contagio y deriven prontamente a los sospechosos para que se hagan las pruebas diagnósticas y las terapias medicamentosas de manera oportuna(AU)

The recent outbreak of monkeypox has aroused the interest of the international community due to its growing number of infections in non-endemic countries. Its symptoms include fever, headache, fatigue, muscle pain, rash, and lymphadenoma. The oral cavity is the place where the first signs of the disease usually appear. Therefore, the objective of this work was to establish the main oral manifestations of monkeypox and list some prevention recommendations. For this, a bibliographic review was carried out between 2012 and 2022 in the PubMed database, using the keywords, in English, monkeypox, oral manifestation and transmission. It was guaranteed that, of the 14 selected documents, at least 80% would be published in 2022. The most frequent oral manifestations were: erythematous ulcer, ulcer-vesicles and those associated with lymphadenopathy (dysphagia, odynophagia and pharyngitis). Among the recommendations are: use of N95 mask and face visors, constant washing of hands and spaces, and attention to those infected only due to acute events (emergencies). Although it has not been confirmed, it is possible that Tecovirimat is helpful in patients with severe symptoms. It is concluded that it is necessary for dentists to know how to distinguish the oral signs of the disease so that they contribute to breaking the chain of contagion and promptly refer suspects to diagnostic tests and drug therapies in a timely manner(AU)

Patient satisfaction regarding biosecurity protocols in the face of COVID-19, Faculty of Dentistry, University of Costa Rica / Satisfacción de los pacientes respecto a los protocolos de bioseguridad ante el COVID-19, Facultad de Odontología, Universidad de Costa Rica

Abstract Biosecurity protocols are particularly important in dental practice. The aim of this research was to determine the level of patient satisfaction regarding biosecurity protocols used in the School of Dentistry of the University of Costa Rica, to avoid COVID-19 infections during dental care. A survey was sent by email to all patients who received dental consultations at the School of Dentistry between April and September 2021. They were asked about sociodemographic variables (sex, age range, approved educational level, and place of origin), as well as whether they considered safe the protocols used during the dental consultation to avoid COVID-19 infections. Descriptive statistics were performed proving the absolute and relative frequency of the socio-demographic variables and the satisfaction of patients with the protocols used. A Chi-square test was used to determine if there was a difference in patient satisfaction with biosecurity protocols to avoid COVID-19 infections during dental care and sociodemographic variables. 95.9% of the respondents considered the biosafety protocols used to be safe and there was no statistically significant difference between patient satisfaction with the protocols and sociodemographic variables. A large majority of patients who come to the UCR School of Dentistry are satisfied with the biosecurity protocols used to avoid COVID-19 infections during dental care.

Resumen Los protocolos de bioseguridad son muy importante en la consulta odontológica. El objetivo de esta investigación fue conocer el nivel de satisfacción de los pacientes respecto a los protocolos de bioseguridad utilizados en la Facultad de Odontología para evitar los contagios por COVID-19 durante la atención dental. Se envió una encuesta por medio del correo electrónico a todos los pacientes que recibieron consulta dental en la Facultad de Odontología entre abril y setiembre del 2021. Se les consultó sobre variables sociodemográficas (sexo, rango de edad, nivel educativo aprobado y lugar de procedencia), así como si consideraban seguros los protocolos empleados durante la consulta dental para evitar los contagios por COVID-19. Se realizó estadística descriptiva estableciendo la frecuencia absoluta y relativa de las variables sociodemográficas y la satisfacción de los pacientes con los protocolos empleados en la Facultad. Se utilizó la prueba de chi cuadrado para determinar si existía diferencia en la satisfacción de los pacientes respecto a los protocolos de bioseguridad para evitar los contagios por COVID-19 durante la atención dental y las variables sociodemográficos. El 95.9% de los encuestados consideró seguros los protocolos de bioseguridad empleados y no hubo diferencia estadísticamente significativa entre la satisfacción de los pacientes con los protocolos y las variables sociodemográficas. Una gran mayoría de los pacientes que acuden a la Facultad de Odontología UCR están satisfechos con los protocolos de bioseguridad empleados para evitar los contagios por COVID-19 durante la atención dental.

Drogas antiagregantes plaquetárias e anticoagulantes em pacientes que se submeterão à cirurgia oral: conduta / Antiagregant platelet and anticoagulant drugs in patients who will submit oral surgery: conduct

Objetivo: Como a frequência de pacientes em uso de anticoagulantes e antiagragantes plaquetários nos consultórios odontológicos é crescente, este trabalho objetivou avaliar através de Revisão de Literatura, qual o melhor manejo desses medicamentos na prática odontológica perioperatória. Metodologia: Trata-se de uma revisão integrativa da literatura, utilizadas as bases de dados Scielo e PubMed. Foram escolhidos os seguintes descritores disponíveis na BVs e PubMed em inglês "Platelet Aggregation Inhibitors", "Oral Surgical Procedures" e "Antigoagulants" no período de 2016 a 2021. Também foram consultados livros e sites de diretrizes do Governo. Foram escolhidos 20 artigos para elaboração da pesquisa. Resultados: doenças cardiovasculares e outras condições clínicas pró-coagulantes tem prevalência crescente e são conhecidos fatores de risco para a ocorrência de fenômenos tromboembólicos graves. A terapia antitrombótica tem papel definido nesses casos. No perioperatorio de cirurgias orais, a decisão por suspender ou manter a terapia deve ser individualizada e pode ser orientada por guidelines. Conclusão: procedimentos orais de baixo risco de sangramento podem ser conduzidos sem a descontinuação da terapia antitrombótica. Cirurgias de moderado a alto risco frequentemente requerem suspensão temporária das medicações para fins de minimizar os riscos de complicações hemorrágicas... (AU)

Objective: As the frequency of patients using anticoagulants and antiplatelet agents in dental offices is increasing, this study aimed to evaluate, through a Literature Review, which is the best management of these medications in dental perioperative practice. Methodology: This is an integrative literature review, being used Scielo and PubMed databases. The following descriptors available in BVs and PubMed "Platelet aggregation inhibitors", "Oral Surgical Procedures" and "Antigoagulants" were used, from 2016 to 2021. In addition, the search was also performed in guideline books and Government websites. Twenty articles were chosen for research elaboration. Results: established cardiovascular disease and other procoagulant clinical conditions have an increasing prevalence, especially among the elderly, and are known risk factors for the occurrence of severe thromboembolic phenomena. Antithrombotic therapy has defined role in these cases. In the perioperative period of oral surgery, the decision to suspend or maintain therapy must be individualized and may be guided by guidelines. Age appears as a clinical criterion in the main ones used. Conclusion: oral procedures with low risk of bleeding can be carried out without discontinuing antithrombotic therapy. Moderate to high-risk surgeries usually require its temporary suspension in order to minimize the risk of bleeding complications... (AU)

Medidas de biossegurança nos consultórios odontológicos durante a pandemia de COVID-19: estudo com profissionais de saúde bucal do estado do Paraná / Biosafety measures in dental offices during the COVID-19 pandemic: a study with oral health professionals in the state of Paraná

Com o surgimento da pandemia causada pelo SARS-Cov-2, houve a necessidade de reestruturação dos serviços de saúde no Brasil, incluindo a clínica odontológica. O objetivo do presente estudo é descrever as medidas de biossegurança realizadas ou modificadas na prática de saúde bucal no estado do Paraná, em nível público e privado, envolvendo três categorias profissionais: cirurgiões-dentistas (CD), técnicos em saúde bucal (TSB) e auxiliares de saúde bucal (ASB). Esta pesquisa transversal descritiva foi realizada nos meses de agosto a outubro de 2020, com o envio de questionários on-linepor e-maile divulgação em redes sociais. Foram envolvidos 1072 profissionais, sendo 75,6% CD, 16,3% ASB e 8,1% TSB. O gênero feminino foi predominante entre os participantes (81,1%), com 46,1% apresentando idade entre 40 e 59 anos. Gorro, máscara cirúrgica, óculos de proteção e protetor facial são referidos como sempre utilizados, respectivamente, por 92,3%, 81,0%, 80,0% e 79,1% dos participantes. A máscara N95/PFF2 (67,5%) e o avental impermeável (20,3%) tiverem os maiores percentuais de "nunca disponíveis ou utilizados". Cerca de 50% afirmaram que tiveram acesso à Nota Técnica GVIMS/GGTES/ANVISA Nº 04/2020. Os profissionais avaliados, em geral, realizaram mudanças em suas práticas de biossegurança, mas precisam ser acompanhados durante toda a extensão da pandemia.

With the emergence of the SARS-Cov-2 pandemic, there was a need to restructure health services in Brazil, including the dental clinic. The aim of the present study was to describe the biosafety measures performed or modified in oral health practice at public and private levels, involving the three professional categories: dental surgeons (DDS), oral health technicians(OHT), and health assistants (HA) in the state of Paraná. This escriptive cross-sectional survey was carried out from August to October 2020, with an online questionnaire being sent by email and published on social networks. There were 1072 professionalsinvolved, of which 75.6% were DDS, 16.3% were OHT, and 8.1% were HA. The female gender was predominant among the participants (81.1%), and 46.1% were aged between 40 and 59 years. 92.3%, 81.0%, 80.0%, and 79.1% of the articipants, respectively, said theyalways used a cap, surgical mask, protective glasses, and face shield. The N95/PFF2 mask (67.5%) and the waterproof apron (20.3%) are two of the most frequently mentioned items as never being available or used. About 51% said they had access to Technical Note GVIMS/GGTES/ANVISA No. 04/2020. In general, the professionals evaluated have been making changes in their biosafety practices, but they still need to be monitored throughout the pandemic.

Intensidad lumínica de las lámparas de fotocurado LED en los consultorios odontológicos de Piura, Perú / Output intensity of LED light curing units in dental offices of Piura, Peru

Introducción: La lámpara de fotocurado, que utiliza diodos emisores de luz (LED), se emplea en odontología para la conversión polimérica de los materiales de restauración dental. Se ha comunicado que una intensidad lumínica inadecuada de la lámpara no aseguraría la correcta polimerización del material de restauración. Objetivo: Determinar la intensidad lumínica de las lámparas de fotocurado LED en consultorios odontológicos de la ciudad de Piura, Perú, 2020. Métodos: Estudio observacional, descriptivo. Se midió la intensidad lumínica en 70 lámparas de fotocurado LED, usando un radiómetro con una longitud de onda de 400-500 nm, con capacidad de medida de la intensidad lumínica de hasta 3500 mw/cm2. Por debajo de los 400 mw/cm2 indica intensidad baja, de 400 a 800 mw/cm2 intensidad media, de 800 a 1200 mw/cm2 intensidad alta y por encima de los 1200 mw/cm2 indica intensidad muy alta. Resultados: El 48,5 por ciento de las lámparas analizadas presentaban intensidad media, el 22,86 por ciento intensidad alta, mientras que el 15,71 por ciento intensidad baja y finalmente el 12,86 por ciento de las lámparas presentaban intensidad muy alta. Se reportó menor frecuencia de lámparas con mayor uso clínico. Conclusiones: Las lámparas de fotocurado LED, utilizadas en los consultorios dentales de la provincia de Piura durante el 2020, emiten una intensidad lumínica promedio de 778,14 mW/cm2, equivalente a la intensidad media(AU)

Introduction: Light curing lamps that use light-emitting diodes (LED) are used in dentistry for the polymeric conversion of dental restorative materials. It has been reported that inadequate light intensity in the lamp would not ensure the appropriate polymerization of restorative materials. Objective: Determine the output intensity of LED light curing units used in dental offices of the city of Piura, Peru, in the year 2020. Methods: An observational descriptive study was conducted. Measurements were taken of the light output of 70 LED light curing lamps using a radiometer with a wavelength of 400-500 nm and a light intensity measurement capacity of up to 3 500 mw/cm2. Intensity below 400 mw/cm2 was recorded as low, from 400 to 800 mw/cm2 as medium, from 800 a 1 200 mw/cm2 as high and above 1 200 mw/cm2 as very high. Results: Intensity was medium in 48.5 percent of the lamps analyzed, high in 22.86 percent, low in 15.71 percent and very high in 12.86 percent. A lower frequency of lamps with greater clinical use was reported. Conclusions: The LED light curing lamps used in dental offices of the province of Piura during the year 2020 emit an average output intensity of 778.14 mW/cm2, which corresponds to medium intensity(AU)

La COVID-19 y sus repercusiones en la práctica odontológica / COVID-19 and their repercussions on dental practice

La llegada del COVID-19 generó diversos cambios significativos en el área de la salud y particularmente en el área odontológica, donde se priorizaron los tratamientos de urgencia relegando los procedimientos menores y atención de citas a la vía virtual. Otras modificaciones se concentraron en el uso de equipos de protección personal y logística de atención tanto para el paciente como para el profesional, siguiendo las indicaciones de las normas diseñadas para esta función; adicionalmente se hicieron adecuaciones en las áreas de recepción y práctica odontológica, y se capacitó a los profesionales en temas relativos a la enfermedad. El objetivo del presente artículo es analizar las implicaciones generadas en la práctica odontológica durante la pandemia por COVID-19 en los ámbitos de triaje, infraestructura, normativa y capacitación (AU)

The arrival of COVID-19 produced a series of significant changes in the health area and particularly in the dental area where emergency treatments were prioritized, relegating minor procedures and appointment care to the virtual route, other modifications focused on the use of personal protective equipment and care logistics for both the patient and the professional following the indications of the standards designed for this function, additionally adjustments were made in the reception and dental practice areas, and professionals were trained on issues related to the disease. The objective of this article is to analyze the implications generated in dental practice during the COVID-19 pandemic in the areas of triage, infrastructure, regulations and training (AU)

The impact of the COVID-19 pandemic on dental practice in Brazil / O impacto da pandemia de COVID-19 na prática odontológica no Brasil

INTRODUCTION: Dentists are at high risk of contamination by COVID-19 due to the proximity to the patients' oral cavity and airways. OBJECTIVE: To elucidate thebehaviors and adversities experienced by dentists because of the COVID-19 pandemic. METHODS: This descriptive study invited 1.811 dentists affiliated with professional associations, dental cooperatives, and health insurance providers from São Paulo State, Brazil, in 2020 of which 473 agreed to participate. The data collection, using Google Forms, included the variables: sociodemographic conditions; characteristics of dental work; level of healthcare and sources of information about the pandemic; changes in the work process, financial impact with personal protective equipment (PPE) andbiosafety measures; and consequences of the pandemic in the professional practice. RESULTS: The 473 dentists (40.36±13.44 years), were mostly women (52.22%), had a specialty (55.60%), and were self-employed professionals (73.36%). It was observed that 78.01% of professionals had a reduction in their monthly income. The average ofpatients treated daily decreased by 35.48%. It was found that 30.44% of professionalshad difficulty with the use of PPE, 3.59% contracted COVID-19, and 53.03% decided to postpone the appointment if the patient with suspected or confirmed COVID-19 sought treatment, even in emergencies. The use of high-speed handpieces was reported by most professionals (n=428; 90.48%). CONCLUSION: Behaviors: dentists used PPE and assigned very high or high levels of precaution about COVID-19. Adversities: dentists reported an increase in operating costs, changes in the work process, a decrease in appointments, and a reduction in the monthly income.

INTRODUÇÃO: Os cirurgiões-dentistas apresentam alto risco de contaminação pelo COVID-19 devido à proximidade com a cavidade oral e vias aéreas dos pacientes. OBJETIVO: Elucidar os comportamentos e adversidades vivenciados por cirurgiões-dentistas devido à pandemia de COVID-19. MÉTODOS: A pesquisa descritiva envolveu 1.811 cirurgiões-dentistas de associações profissionais, cooperativas odontológicas e convênios do Estado de São Paulo, Brasil, em 2020, dos quais 473 concordaram em participar. A coleta de dados, por meio do Formulários Google, incluiu as variáveis: condições sociodemográficas; características do trabalho odontológico; nível de atenção e fontes de informação sobre a pandemia; mudanças no processo de trabalho, impacto financeiro com equipamentos de proteção individual (EPI) e medidas de biossegurança; e consequências da pandemia na prática profissional. RESULTADOS: Dos 473 dentistas (40,36±13,44 anos), a maioria era mulher (52,22%), especialista (55,60%) e trabalhava como autônomo (73,36%). Observou-se que 78,01% dos profissionais apresentaram redução na renda mensal. A média de pacientes atendidos diminuiu 35,48%. Constatou-se que 30,44% dos profissionais tiveram dificuldade com o uso de EPI, 3,59% contraíram COVID-19 e 53,03% postergaram o atendimento de paciente com suspeita ou confirmação de COVID-19, mesmo em emergências. O uso de peça de alta rotação foi relatado pela maioria dos profissionais (n=428; 90,48%). CONCLUSÃO: Como comportamentos: os dentistas usaram EPI e atribuíram níveis muito altos ou altos de cuidados sobre o COVID-19. Como adversidades: os dentistas relataram aumento nos custos operacionais, mudanças no processo de trabalho, diminuição no atendimento e redução na renda mensal.

Maintenance of sterility in SMS packaging in dental environments: concern with biosafety

Healthcare services must be guided by biosafety practices and microbial control. This control is highly influenced by humidity, which directly impacts the maintenance of sterility of the materials used in the appointments. High concentration of moisture, in the form of aerosol, splashes and spills, is caused during dental care. During the COVID-19 times the contamination by aerosol and droplets worries greatly. Considering that it could cause harm to the sterility of an autoclaved material, especially in dental environments, the objective was to evaluate the behavior of SMS sterilization packages (Spunbonded / Meltblown / Spunbonded) against microbial penetration in an aqueous vehicle. SMS of three brands were challenged, equally divided into two groups: virgin and processed (subjected to a single autoclaving cycle). Each specimen was aseptically deposited on Macconkey agar. Subsequently, 5 µL of Escherichia coliATCC 25922 saline solution [108CFU mL-1] was deposited in center of the SMS specimen and the dish incubated at36°C/ 48h. Reading was performed by the presence or absence of bacterial growth typical of the species under the SMS, observed on the back of Petri dish. The lowest penetration rate observed was 60% for one of the brands in the virgin condition, and 75% for two brands in the processed condition. Statistical analysis showed an association between bacterial penetration and the evaluated group, this association being valid only in the virgin condition. The different SMS behave similarly in terms of resistance to bacterial penetration after being processed. The data show that moisture can assist in bacterial transport through sterilized SMS. Therefore, SMS packages are not able to prevent bacterial penetration, and possibly other microorganisms, when in aqueous vehicles, offering a potential risk of breaking the aseptic chain. Thus, care must be taken in routines for handling and storage sterile packaging.

Relaciones entre los estilos de crianza actuales, el empleo de las técnicas de orientación del comportamiento y su enseñanza en Odontopediatría. Revisión bibliográfica. / Relações entre os estilos de criação atuais, a utilização das técnicas de orientação comportamental e seu ensino em Odontopediatria. Revisão bibliográfica. / Relationships between current parenting styles, the use of behavioral guidance techniques and their teaching in Pediatric Dentistry. A bibliographic review.

Introducción: Los cambios en los estilos de crianza de los últimos 25 años han llevado a desestimar en Odontopediatria algunas técnicas de orientación conductual (TODC) clásicas porque los padres las consideran poco apropiadas para sus hijos. Esto ha generado cambios en los programas de formación en Odontopediatría. Objetivo: Revisar las TODC más empleadas actualmente por odontopediatras, las más enseñadas en los programas de Odontología y la influencia de la aceptación parental en ello. Material y método: se realizó una revisión descriptiva de la literatura. Para establecer la base documental, constituida por 42 artículos, se realizó una búsqueda en las bases de datos: Cochrane, SciElo, Medline y Google Academy. Resultados:La familia ha experimentado un proceso de transformación con nuevos modelos de relaciones familiares y de crianza. Aunque los odontopediatras reconocen que la crianza autoritativa es la que favorece un comportamiento más positivo en el consultorio, perciben una tendencia parental hacia la permisividad. Eso ha favorecido que el empleo de algunas TODC clásicas, como control de voz o la estabilización física activa haya disminuido y la formación y entrenamiento al respecto también. Conclusiones:La formación de los odontopediatras está influenciada por el entorno socio-cultural y por aspectos ético-legales cambiantes. Ante la tendencia actual a un patrón de crianza más permisivo las TODC más enseñadas en los programas de Odontopediatría y, las más empleadas por los odontopediatras son las de comunicación. Conocer el patrón de crianza parental puede orientar al profesional para sugerir las TODC más adecuadas a cada entorno familiar

Introdução: As mudanças nos estilos de criação dos últimos 25 anos levaram a rejeitar algumas técnicas de orientação comportamental (TOC) clássicas em Odontopediatria porque os pais as consideravam inapropriadas para seus filhos. Isto gerou mudanças nos programas de formação em Odontopediatria. Objetivo: Revisar as TOC mais utilizadas atualmente pelos odontopediatras, as mais ensinadas nos programas de Odontologia e a influência da aceitação parental em todo isso. Material e método: Foi feita uma revisão descritiva da literatura. Para estabelecer a base documental, composta por 42 artigos, realizou-se uma pesquisa nas bases de datos: Cochrane, SciElo, Medline y Google Academy. Resultados: A família passou por um processo de transformação com novos modelos de relacionamento familiar e parental. Embora os odontopediatras reconheçam que a criação autoritativa é a que favorece um comportamento mais positivo no consultório, percebem também uma tendência dos pais à permissividade. Isso tem favorecido que o emprego de algumas TOC clássicas, como controle de voz ou a estabilização física ativa, tenha diminuído e a formação e treinamento a esse respeito também. Conclusões: A formação dos odontopediatras é influenciada pelo entorno sócio-cultural e por aspetos ético-legais mutáveis. Dada a tendência atual para um modelo de criação mais permissivo as TOC mais ensinadas nos programas de Odontopediatria e, as mais empregadas pelos odontopediatras são as de comunicação. Conhecer o modelo parental pode orientar o profissional para sugerir as TOC mais adequadas a cada ambiente familiar

Introduction: The changes in parenting styles in the last 25 years have led to the dismissal in pediatric dentistry of some classic behavioral guidance techniques (BGT) because parents consider them inappropriate for their children. This has generated changes in the training programs in Pediatric Dentistry. Objective: To review the BTG most currently used by pediatric dentists, the most taught in Dentistry programs and the influence of parental acceptance on it. Material and method: A descriptive review of the literature was carried out. To establish the documentary base, consisting of 42 articles, a search was carried out in the databases: Cochrane, SciElo, Medline and Google Academy. Results: The family has undergone a process of transformation with new models of family and parenting relationships. Although pediatric dentists recognize that authoritative parenting is the one that favors a more positive behavior in the dental office, they perceive a parental tendency towards permissiveness that has favored the decrease in the use of some classic BGT, such as voice control or active physical stabilization, and the learning and training about them as well. Conclusions: The training of pediatric dentists is influenced by the socio-cultural environment and by the changing ethical-legal aspects. Given the current trend towards a more permissive parenting pattern, the most taught and most used BGT in Pediatric Dentistry programs are communication techniques. Knowing the parental upbringing pattern can guide the professional to suggest the most appropriate BGT for each family environment

Utilização de serviços odontológicos por pacientes em tratamento oncológico / Use of dental services by patients in oncological treatment

Introdução: a busca por atendimento odontológico é um parâmetro importante para averiguar como os indivíduos compreendem a saúde bucal. Objetivo: avaliar a utilização de serviços odontológicos e fatores associados em pacientes oncológicos em Minas Gerais, Brasil. Material e método: estudo transversal, realizado com uma amostra de 441 pacientes adultos frequentadores de uma associação voluntária de apoio a pacientes oncológicos no Estado de Minas Gerais, Brasil. O desfecho foi avaliado por meio do autorrelato de consulta odontológica no último ano. As variáveis independentes incluíram condições socioeconômicas, saúde geral e relacionada ao câncer, saúde bucal e cuidados odontológicos. As associações entre o desfecho e as variáveis independentes foram testadas por meio de regressão logística bivariada e múltipla, sendo os resultados expressos por meio de odds ratio (OR) e intervalos de confiança de 95% (IC95%). Resultado: a prevalência de consulta odontológica no último ano foi de 33,3%. Os indivíduos que possuem entre quatro e sete (OR: 1,80; IC95%: 1,02-3,18) e aqueles com oito ou mais anos de estudo (OR: 3,20; IC95%: 1,07-9,60) apresentaram maiores, enquanto os edêntulos (OR: 0,44; IC95%: 0,21-0,92) apresentaram menores chances de consulta odontológica no último ano, independentemente de condições socioeconômicas, saúde geral e saúde bucal. Conclusão: foi baixa a procura por consulta odontológica no último ano entre os pacientes oncológicos. Além disso, houve desigualdades relacionadas à escolaridade e ao número de dentes remanescentes na utilização dos serviços. A identificação e priorização dos grupos com acesso desfavorável aos serviços são fundamentais no planejamento da prestação de cuidados odontológicos a essa população.

Introduction: the search for dental care is an important parameter to determine how individuals understand the oral health. Objective: to evaluate the use of dental services and associated factors in cancer patients in Minas Gerais, Brazil. Material and method: a cross-sectional study carried out with a sample of 441 adult patients attending a voluntary association to support cancer patients in the State of Minas Gerais, Brazil. The outcome was assessed through self-report of dental appointments in the last year. Independent variables included socioeconomic status, general and cancer-related health, oral health, and dental care. The associations between the outcome and the independent variables were tested using bivariate and multiple logistic regression, and the results were expressed as odds ratios (OR) and 95% confidence intervals (95%CI). Result: the prevalence of dental appointments in the last year was 33.3%. Individuals who have between four and seven (OR: 1.80; 95%CI: 1.02-3.18) and those who have eight or more years of schooling (OR: 3.20; 95%CI: 1.07-9 .60) had greater, whereas, the edentulous (OR: 0.44; 95%CI: 0.21-0.92) had less odds to have had a dental appointment in the last year, independently of socioeconomic status, general health and oral health conditions. Conclusion: recent dental care was uncommon among cancer patients. Furthermore, there were inequalities related to schooling and the number of remaining teeth in the use of services. The identification and prioritization of groups with unfavorable access to services are fundamental in planning the provision of dental care to this population.

Are We Hearing Right? The Negative Impact of New SARS-CoV-2 Preventive Measures and Prolonged Use of Treatment Modalities during Orthodontic Treatment

Abstract Since the dental treatment involves the use of various instruments and machines, there is ample presence of both distracting as well as destructive noise, and these are defined based on various parameters. With an increase in safety measures incorporated into dental practices, such as extra-oral suction devices and respirators, there has also been a corresponding rise in noise levels usually present in a clinic. Previous clinical experiments and trials have shown that the noise in a dental office can permanently bring about hearing damage. In addition to this, working with added safety measures during the pandemic, such as the use of personal protective equipment, respirators, and face shields can decrease operator efficiency and the ability to communicate normally. Dentistry has already been demonstrated to be one of the most hazardous occupations because of the high risk of infections. An Orthodontist must protect their eyes and mouth from potentially hazardous situations and the ears to prevent hearing damage.

Endodontic treatment during COVID-19 pandemic - Economic perception of dental professionals

Aim: This study evaluated, by the application of questionnaires, the impact of the COVID-19 pandemic on the clinical routine and inspection by the competent authorities, on the flow of patients in the office, as well as on possible changes in Endodontic treatment costs and the amounts charged to patients. Methods: This cross-sectional study was conducted from May 2nd, 2020 to May 6th, 2020, using an online questionnaire with a convenience sample. The inclusion criterion was professionals who perform endodontic treatments in daily clinical practice and who professional setting is private practice. The questionnaire brought questions about the impact on costs and the amount charged to the patient. Results: A total of 1042 questionnaires were answered from all the different states of Brazil, by professional who usually perform Endodontic treatment, and who is working in private practice. A total of 1010 (96.9%) respondents affirm it was necessary to modify the protective equipment in endodontic treatment due to pandemic and longer intervals between appointments was cited by 922 (88.5%), economically affecting the dental practice. There was no association between routine changes and economic impacts with gender, professional experience, area of residence or education level. Conclusion: In conclusion, most dental professionals recognized changes in the routine of endodontic treatment during the COVID-19 pandemic. They have a perception of increase in endodontic costs, and reduction in the volume of patients

La periodontitis y su relación con las enfermedades cardiovasculares. Promoción de la salud cardiovascular desde el consultorio dental / Periodontitis and its relationship with cardiovascular diseases. Promotion of cardiovascular health from the dental office

Resumen Las enfermedades periodontales son infecciones que involucran al tejido de soporte dental, inducen inflamación y pueden provocar la pérdida dental si no son controladas. La enfermedad cardiovascular se presenta por trastornos cardiacos y de vasos sanguíneos, y es la principal causa de muerte en todo el mundo. La periodontitis clínica se asocia con un mayor riesgo de enfermedad cardiovascular debido a la inflamación sistémica como vínculo etiopatogénico; por infestación metastásica, puede llegar a diferentes órganos anatómicos y ocasionar cambios patológicos. El consultorio odontológico es un lugar adecuado para tomar medidas de prevención en los pacientes, tanto en el ámbito oral como en la salud cardiovascular. Se realizó una búsqueda bibliográfica en PubMed, Cochrane, Google Scholar y SciELO, y en este artículo se hace una revisión de la literatura sobre la periodontitis y su relación con las enfermedades cardiovasculares y la promoción de la salud cardiovascular.

Abstract Periodontal diseases are infections that involve the dental support tissue that induce inflammation and can cause tooth loss if it is not controlled. Cardiovascular disease occurs due to heart and blood vessel disorders, it is the leading cause of death worldwide. Clinical periodontitis is associated with an increased risk of cardiovascular diseases through systemic inflammation as an etiopathogenic link; due to metastatic infestation, they can reach different anatomical organs and cause pathological changes. The dental office is an appropriate place to take preventive measures for patients in both the oral and cardiovascular health fields. A current bibliographic search was carried out with the key words in PubMed, Cochrane, Google Scholar and SciELO, and this article reviews the literature on periodontitis, its relationship with cardiovascular diseases and the promotion of cardiovascular health.

The unfolding consequences of postponing routine dental care / Explorando las consecuencias de posponer las atenciones odontológicas de rutina

The COVID-19 pandemic represents some of the most distressing challenges for health systems all over the world in the past decades, forcing clinicians to modify standards, prioritise treating conditions that require immediate care, and implement elements of remote attention in record time (Douglas et al., 2020). These challenges have also had an impact in the population's oral health.

Consideraciones para la atención de tratamientos endodóncicos en el contexto de la pandemia de COVID-19 / Considerations for the care of endodontic treatments in the context of the COVID-19 pandemic

La enfermedad COVID-19 fue declarada pandemia por la Organización Mundial de la Salud el 11 de marzo de 2020. El síndrome respiratorio agudo severo coronavirus-2 (SARS-CoV-2) es un virus transmitido de animales a seres humanos, altamente contagioso, cuyo periodo de incubación es de uno a 14 días. Los momentos por los que atraviesan la mayoría de los países debido a la pandemia declarada del COVID-19 han llevado a la proclamación de órdenes gubernamentales y/o recomendaciones en relación a la atención dental que debe dispensarse. En el momento actual, no se dispone de protocolos específicos oficiales, ni nacionales ni internacionales, que aborden de manera clara cómo debe proceder el odontólogo en su práctica diaria en la etapa posterior al confinamiento para trabajar con las mejores garantías de protección para los pacientes y el equipo humano de la consulta odontológica. Este estudio tuvo como objetivo analizar consideraciones para la atención de tratamientos endodóncicos en el contexto de la pandemia de COVID-19. Para lograr este objetivo se realizó una revisión bibliográfica en diferentes bases de datos, como: Google Scholar, Springer Link, Scopus, PubMed, para ello se emplearon estrategias de búsqueda, utilizando descriptores como: «endodontic¼, «recomendations¼, «odontology¼, «COVID-19¼, «pandemic¼ y operadores booleanos, con la finalidad de obtener información relevante y precisa. Contribuyendo a la práctica de la endodoncia con un protocolo general para el manejo de emergencias que muestre el fundamento del diagnóstico, los procedimientos clínicos y el uso de equipos de protección personal y barreras en el consultorio odontológico durante el brote de COVID-19 (AU)

The COVID-19 disease was declared a pandemic by the World Health Organization on March 11, 2020. The severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a virus transmitted from animals to humans, highly contagious, whose incubation period is one to 14 days. The times that most countries are going through due to the declared COVID-19 pandemic have led to the proclamation of government orders and/or recommendations regarding the dental care that should be provided. At the present time, there are no specific official national or international protocols that clearly address how the dentist should proceed, in their daily practice, in the post-confinement stage, to work with the best guarantees of protection for the patients and the human team of the dental practice. The objective of this study was to analyze considerations for the care of endodontic treatments in the context of the COVID-19 pandemic. To achieve this objective, a bibliographic review was carried out in different databases, such as: Google Scholar, Springer Link, Scopus, PubMed, for this, search strategies were used, using descriptors such as: «endodontic¼, «recommendations¼, «odontology¼, «COVID-19¼, «pandemic¼ and Boolean operators, in order to obtain relevant and accurate information. Contributing to the practice of endodontics a general protocol for emergency management that shows the rationale for diagnosis, clinical procedures and the use of personal protective equipment and barriers in the dental office during the COVID-19 outbreak (AU)

Conocimientos, percepciones y actitudes de estudiantes y pasantes de odontología mexicanos con relación al COVID-19: Estudio descriptivo / Knowledge, perceptions and attitudes in Mexican dental students and interns related with COVID-19: A descriptive study

La enfermedad de COVID-19 es causada por el nuevo coronavirus SARS-CoV-2 (síndrome respiratorio agudo severo), convertida hoy en día en una pandemia, emergencia sanitaria y crisis de salud pública. El propósito de este estudio fue evaluar el conocimiento, la percepción y actitudes frente a dicha pandemia de en los estudiantes y pasantes de odontología. Material y métodos: Investigación cuantitativa con diseño transversal, descriptivo y exploratorio. El tamaño de la muestra fue de 167 participantes a través de encuestas en línea, donde se describieron sus actitudes, conocimiento y percepción, por medio de un cuestionario de autorreporte el cual consistió de 24 ítems relacionados con la comprensión de la COVID-19. Resultados: La mayoría de los discípulos tiene un entendimiento moderado en relación con la normatividad, y su competencia, en su entorno con dicho trastorno viral, es adecuada. La mayoría (89.5%) respondieron tener actitudes adecuadas con el manejo del control de infecciones y prevenciones. En cuestión a la percepción, la mayoría (82.4%) sí tenía medidas de prevención a fin de evitar la transmisión y medicación adecuadas. Conclusión: Estos estudiantes están conscientes de la COVID-19 y sus medidas de prevención y precaución, requieren adquirir mayores saberes de normas sanitarias, así como llevar estrictos protocolos de control de infecciones para garantizar el ambiente seguro a los alumnos y pacientes que acuden a las clínicas odontológicas (AU)

The COVID-19 disease is caused by the new coronavirus SARS-CoV-2, which today has become a pandemic, health emergency, and public health crisis. The purpose of this study was to evaluate the knowledge, perception and attitudes towards such pandemic in dental students and interns. Material and methods: Quantitative research with a crosssectional, descriptive and exploratory design. The sample size was 167 participants through online surveys, where attitudes, knowledge and perception were described, through a self-report questionnaire which consisted of 24 items related to their knowledge of this malaise. Results: The majority of study participants have a moderate knowledge in relation to the normativity, and the knowledge of the disease in their environment is adequate. The majority (89.5%) responded having adequate attitudes with the management of infection control and prevention. Regarding perception, the majority (82.4%) did have adequate medication and preventive measures to avoid transmission. Conclusion: These students are aware of the COVID-19 sickness and its prevention and precaution measures and they require acquiring greater knowledge of health regulations as well as carrying out strict infection control protocols to guarantee a safe environment for students and patients who attend dental clinics (AU)