What do people do before going to the dentist? qualitative study of cultural practices of pain relief in primary care

Objective: to describe and classify the main cultural practices used to relieve orodental pain in people who seek emergency dental care in vulnerable urban and rural areas of central Chile. methodology: a sample of 88 adults residing in urban and rural sectors, who received treatment at primary care emergency dental services in three districts of the central area of Chile was studied using a qualitative descriptive approach of sociocultural epidemiological orientation based on grounded theory. interviews were conducted in the waiting room of the emergency service or at the patient's home. empirical saturation and triangulation of temporal data were protected. results: practices of biomedical origin (self-medication and care received at dental emergency services) and socio-cultural practices were documented. they include the use of chemical products (iodine, phosphorus, battery acid, hydrogen peroxide, gasoline, and alcoholic drinks, among others), herbal infusions (buddleja globosa, aloe vera), mechanical-physical techniques (use of cold or heat, massage); subjects also perform the mechanical manipulation of the area with sharp objects, occasionally extracting the tooth itself. practices occur more frequently at home when the person feels the pain in the affected area, and end on the dental chair with the tooth extraction. conclusions: the coexistence of biomedical practices and alternative cultural strategies was observed. these practices complement each other and make people postpone seeking professional dental care, which may worsen their health condition.

Automedicación con aines por pacientes con odontalgia en la consulta pública y privada / Self-medication with nsaids in patients with toothache in public consultation and private

Introducción: Conocer la proporción de automedicación con antiinflamatorios no esteroideos (AINES) entre los pacientes que acuden a la consulta odontológica en dos centros de atención (privado y público), Juliaca. Material y Método: estudio descriptivo transversal observacional. Sujetos: 100 pacientes mayores de edad, de dos servicios de atención odontológica, el Centro odontológico "Global Dent" ­ Juliaca y el servicio de odontología del Centro de Salud Paratia ­ Lampa. Resultados: Se automedicarón el 69% de los pacientes, no habiendo diferencias significativas respecto al sexo y a la edad, el medicamento de mayor elección fue el Ibuprofeno, seguido por el naproxeno y diclofenaco, el 11% de pacientes que se automedicar on tenían idea de algún efecto adverso. Conclusiones: Existe una importante proporción de pacientes que se automedican con AINES con un bajo conocimiento sobre los efectos adversos que estos fármacos pueden producir. (AU)

Introduction: (AINES) Knows the proportion of automedication with antiinflammatory not esteroideos between the patients who come to the odontologic consultation in two centers of attention (private and public). Material and Method: descriptive transverse study observacional. Subjects: 100 major patients of age, of two services of odontol ogic attention, the odontologic Center " Global Dent " - Juliaca and the service of odontolgy of the Center of Health Paratia - Lampa. Results: automedicarón 69 % of the patients, there being no significant differences with regard to the sex and the age, the medicine of major choice was the Ibuprofeno followed by the naproxeno and diclofenaco, 11 % of patients who autotook medicine had idea of some adverse effect. Conclusions: There exists a patients' important proportion that they automedicate with AINES with a low knowledge on the adverse eff ects that these medicaments can produce. (AU)

Dentin hypersensitivity treatment of non-carious cervical lesions – a single-blind, split-mouth study

This study aims to compare the in vivo effect of a desensitizing therapy associated with a restorative technique for the treatment of cervical dentin hypersensitivity (CDH) in non-carious lesions. The sample consisted of 68 teeth with moderate or severe dentin hypersensitivity in 17 individuals (one tooth per quadrant). The sensitivity levels of the teeth were scored, and the teeth were randomly distributed into four groups: T1 – desensitizing gel applied once per week until remission of pain; T2 – desensitizing gel applied once per week followed immediately by restoration with resin composite (Filtek Z250, 3M Espe); T3 – desensitizing gel once per week until remission of pain and then restoration with resin composite; and T4 - restoration with resin composite. Dentin hypersensitivity was assessed at 0, 7, 30, 90 and 180 days. The Kruskal-Wallis, Wilcoxon and Mann-Whitney (p< 0.05) tests were used to compare the treatments. The mean baseline CDH scores were T1 - 2.41, T2 - 2.41, T3 - 2.47, and T4 - 2.70 (p > 0.05). At seven and 180 days, the mean CDH scores were as follows: T1 - 1.47/0.65, T2 - 1.35/0.71, T3 - 0.71/0.53, and T4 - 1.12/0.59, all of which were significantly lower (p< 0.001) than the baseline scores. The scores at 30, 90 and 180 days were not significantly different when compared to the score of the previous period. At 180 days, CDH scores were similar among groups (p> 0.05). Teeth with moderate or severe hypersensitivity that required a filling responded similarly regardless of whether the desensitizing procedure was carried out prior to the filling.

Feeding and oral hygiene habits of children attending daycare centres in Bangalore and their caretakers oral health knowledge, attitude and practices.

Aim: Caretakers in day-care centers play a significant role in imparting good oral hygiene practices and also extend a working relationship with parents with regard to their children's oral health. As a result of this, caregiver's dental knowledge, attitudes, beliefs and practices affect the child's oral condition. Settings and Design: A descriptive cross-sectional study involved caretakers working in day-care centers of Bangalore. Fifty-two day-care centers were randomly selected from the different zones of Bangalore city, from which 246 caretakers provided consent for participation. Materials and Methods: A comprehensive, closed-ended, self-administered questionnaire was employed which was designed to collect the sociodemographic details and to evaluate the oral health knowledge, attitudes, practice of caretakers. The institutional review committee approved the study. Data were entered using SPSS 13.01. Results: Seventy-nine percent of the subjects had good knowledge of child's tooth eruption time, clinical presentation of dental caries and the role of fluoride in caries prevention. Yet, half of the subjects found routine dental examination after all the milk teeth have erupted in the oral cavity insignificant and 41% strongly agreed that dentist should be consulted only when the child has a toothache. In spite of the good knowledge, 77% preferred to use pacifier dipped in honey/sugar if the children acted troublesome. Analogous to this, 45% gave milk/juice with sugar before the child's nap time. Conclusions: The results of this study indicate that caretaker's attitude toward oral health care needs is far from acceptable standards to mirror any positive impact on the children.

Submasseteric abscess: A rare head and neck abscess.

The objective of the article is to highlight and make people aware of a rare abscess which is often missed or misdiagnosed. As only a few cases have been reported, the authors feel that reporting such a case would help in proper management of the disease. We are presenting a 6.5-year-old male child with 3 weeks history of right facial swelling in the parotid region, with low-grade fever and trismus. Submasseteric abscess is a rare abscess which is often misdiagnosed as a parotid abscess or parotitis. Only a few cases have been reported. The cause is mostly dental in origin. Intravenous antibiotics often fail to alleviate the symptoms as this is a closed space and needs prompt drainage. Therefore, awareness of this complication of dental infections is vital for proper diagnosis and timely management.

Oferta e utilização de serviços de saúde bucal no Amazonas, Brasil: estudo de caso em população ribeirinha do Município de Coari / Provision and utilization of dental services in Amazonas State, Brazil: a case study in a riverine population in Coari Municipality

O presente estudo de caso teve o objetivo de descrever a oferta e utilização de serviços odontológicos em duas comunidades ribeirinhas do Município de Coari, Amazonas, Brasil. Para tanto, foram colhidos dados sobre freqüência de utilização de serviços de saúde bucal, por entrevistas estruturadas com indivíduos acima de 18 anos, e dados sobre oferta de serviços obtidos por entrevistas semi-estruturadas com informantes-chave. Nas análises bivariadas, embora sem diferença estatística, os indivíduos da comunidade mais distante da sede do município apresentaram maior tempo decorrido da última consulta, e menor proporção de atendimentos pelo serviço público e por barcos de saúde. A análise qualitativa das entrevistas revelou: ausência de serviço odontológico permanente nas comunidades; oferta esporádica através de barcos da saúde, com menor ocorrência dos serviços na comunidade mais distante; alto custo do deslocamento do ribeirinho à sede do município; e tratamento odontológico voltado para o controle da dor, basicamente se resumindo à extração dentária. O acesso precário dos ribeirinhos aos serviços de saúde bucal aponta para a necessidade de implantação de medidas amplas de promoção de saúde, aliada a maior oferta de serviços.

This case study described the conditions in the provision and utilization of dental services in two riverine populations in the municipality (county) of Coari, Amazonas State, Brazil. Structured questionnaires were applied to individuals 18 years and older to measure dental services utilization rates. Semi-structured interviews were also conducted with key informants to characterize the provision of such services. Although the bivariate analysis did not detect any statistically significant differences, residents of the area farthest from the county seat had gone more time since their last dental visit and received less care from public health services and riverboat clinics. The qualitative analysis showed: no permanent dental services in the communities; sporadic services provided by riverboat clinics, with less frequent visits to the remotest community; high transportation cost for river-dwellers to seek treatment in the county seat; and dental treatment focused on pain control, mainly through tooth extraction. Limited access to dental services for riverine populations highlights the need to implement comprehensive health promotion measures and expand the availability of services.

Terapêutica do abcesso periapical sem fístula / Therapeutics of periapical abscess without fistula

Verificou-se em estudos longitudinais o manejo de abscessos periapicais sem fístula, através de revisão sistemática. Utilizou-se de fontes de catalogação bibliográfica identificadas eletronicamente e manuais a partir de 1952 até 29 de agosto de 2002. Como estratégia de busca empregou-se os termos - Endodontic(s) and Alveolar Abcess, Endodontic(s) and Acute Apical Periodontitis, Endodontic(s) and Periapical Abscess, Endodontic(s) and Dento-Alveolar Abscess, Endodontic(s) and Acute Abscess, Endodontic(s) and Acute Periapical Abscess. Do total de 543 artigos encontrados, apenas um artigo satisfez os critérios de inclusão. Considerando a estimativa de sucesso clínico, observa-se que o controle microbiano local e sistêmico, associado à dreangem (sempre que possivel), auxilia as defesas do hospedeiro e favorece a redução do rumo do processo infeccioso.

Fatores associados à automedicação em dor de dente: análise a partir dos profissionais dos estabelecimentos farmacêuticos da cidade do Recife, PE / Factors associated with self-medication for toothache: analysis using pharmacy personnel in the city of Recife, PE

Este artigo pretende descrever os fatores associados à automedicação relacionada à dor de dente na cidade do Recife, Pernambuco, Brasil. O desenho do estudo foi do tipo transversal. A amostra foi selecionada através de sorteio aleatório das farmácias cadastradas no Conselho Regional de Farmácia de Pernambuco e distribuída nos Distritos Sanitários. Foi analisado o nível de conhecimento dos profissionais de farmácias sobre a automedicação relacionada à dor de dente. Foram entrevistados 179 profissionais em 120 estabelecimentos visitados. Os dados foram coletados através de questionário. Como resultado, 67,0 por cento dos entrevistados atenderam pessoas que relataram dor facial nos últimos seis meses, e uma freqüência de 91,6 por cento relataram dor de dente; 83,7 por cento homens e 73,3 por cento mulheres indicaram medicamentos sem prescrição; profissionais com 2º grau indicam mais medicamentos sem prescrição para pacientes com dor de dente (48,6 por cento). Concluiu-se que é comum a procura de medicamentos sem prescrição para dor de modo geral, entre estas a dor de dente. O impacto da dor de dente na utilização de medicamentos reforça a necessidade de informar a população sobre o uso adequado destes medicamentos.

This paper aims to describe the factors associated with self-medication related to toothache in the city of Recife, Pernambuco, Brazil. The investigation was designed as a cross-sectional study. The sample was random selected among the pharmacies registered in the Regional Pharmacy Council of Pernambuco and distributed over the Health Districts. The level of knowledge of the pharmacy personnel about self-medication related to toothache was analyzed. One hundred and seventy nine professionals from 120 establishments were interviewed. The data were collected by means of a questionnaire. According to the results, 67.0 percent of the interviewees had attended individuals relating orofacial pain in the last six months, among them 91.6 percent relating toothache; 83.7 percent male and 73.3 percent female personnel had indicated medications for toothache without prescription; personnel with high-school level indicated more medications without prescription (48.6 percent) The study concludes that to buy pain relievers without prescription including for toothache is common and reinforces the need of informing the population about the correct use of these medicaments.

First dental visit of a child.

OBJECTIVES: The aim of the study was to assess the common chief complaints of the Indian children and the average age group at which they report for in their first dental visit. MATERIALS AND METHODS: A retrospective study was carried out using the case records of 716 children who reported to the postgraduate section of Department of Pediatric dentistry, Meenakshi Ammal Dental College, Chennai, in 2007. The age groups of the children were divided into three categories 0-3 years, 3-6 years and 6-12 years. The various chief complaints were categorised as follows, Orientation to prevention, Routine visit, Deposits/Discoloration, Habits, Unerupted/Missing or Extra Tooth, Pain, Dental caries, Malocclusion, Trauma, others. The average age group and most common complaint at the first dental visit was assessed. A prospective study was done in January 2008, were 215 children were screened. The assessment was made as explained above. RESULTS: Retrospective study Maximum number of children who reported for their first dental visit was between 6-12 years (59.08%). Most common chief complaint for the visit was pain (42.04%). Second common complaint being dental caries (28.49%). Prospective study Maximum number of children who reported for their first dental visit was between 6-12 years (69.77%). Most common chief complaint was dental caries (34.88%). Second common complaint being pain (27.91%). CONCLUSION: Children report for the first dental visit most commonly only after 6 years and for complaints like pain and dental caries. Orientation to prevention is not considered and preventive dentistry is yet to reach the common population in India.

Manejo clínico-farmacológico del dolor dental / Clinical and pharmacological management of toothache

En la práctica odontológica es frecuente el tratamiento farmacológico con analgésicos para mitigar el dolor en pacientes que han sido sometidos a algún procedimiento odontológico mayor, con el fin de prevenir o disminuir el dolor provocado con el procedimiento. Sin embargo, a la fecha no se puede hablar de un manejo estandarizado para todo tipo de pacientes y la investigación en la búsqueda del mejor tratamiento farmacológico es continua. Se presentan en esta revisión los aspectos fundamentales del dolor, las características del dolor dental, los diferentes fármacos y estrategias de manejo del dolor que se han utilizado en diferentes estudios clínicos y algunas recomendaciones.

Plantas empleadas en odontalgias I / Plants used for toothache

En la consulta estomatológica, las odontalgias son padecimientos frecuentes, los cuales por su magnitud disminuyen la capacidad y rendimiento del individuo. Para tratar dichas alteraciones se emplean fármacos de diversa naturaleza, aunque desde tiempos remotos diversas plantas también han sido empleadas. Nuestra flora medicinal es una de las más diversas del mundo y por supuesto incluye algunas utilizadas con la misma finalidad. En este estudio, se presentan 51 especies que corresponden a 29 familias botánicas reportadas como utilizadas en odontalgias en diferentes países, principalmente en México y que son usadas por la medicina tradicional. Dichas plantas elaboran, entre otros, metabolitos secundarios con posible actividad biológica: aceites esenciales, alcaloides, cardenólidos, ciclitoles, glucósidos-iridoides, heterósidos cianogenéticos, mucílagos, resinas, saponinas, sesquiterpenos, taninos y triterpenos. Las partes de los vegetales empleadas son muy variadas e incluyen en algunos casos a la planta entera fresca. Las formas de uso más frecuentemente reportadas fueron las infusiones y los cocimientos. La vía de administración es local, tópica o por medio de enjuagues, o bien ingiriendo la infusión o el cocimiento, aunque algunas plantas se aplican en forma de cataplasma.

Odontalgia is a very common disorder, frequently observed in patients visiting the dentist office. Due to its severity, odontalgia may significantly reduce the performance capability of the subject. At present, many drugs from different origins are being used for the odontalgia treatment. However, from ancient times, several plants have also been used. As our medicinal flora has one of the greatest diversity in the world, it certainly includes some plants that can be employed for such purpose. This study includes 51 species, belonging to 20 botanical families, which have been reported as useful for odontalgia treatment by traditional medicine in several countries, mainly in Mexico. Such plants produce several secondary metabolites with probable biologic activity, among them: essential oils, alkaloids, cardenolides, ciclitols, glycoside-iridoids, heterosides, cyanogenics, mucilages, resins, saponines, sesquiterpenes tannins and triterpenes. The parts of the plant that might be used for the odontalgia control are diverse; sometimes even the whole fresh plant can be used. The most frequently reported methods of preparation are infusion and concoction. The administration is mainly local (topic) or as mouthwash, or by drinking the infusion or decoction. Some of the plants can be prepared and applied as poultice.

Odontalgia atípica: revisão de literatura / Atypical odontalgia: review of literature

A Odontalgia Atípica (OA) é uma entidade clínica importante, pois a dor é neuropática por desaferentação e ocorre “no dente”, porém não é “dor de dente”. É caracterizada por dor em um dente ou dor em um sítio onde um dente foi extraído, com ausência de sinais clínicos ou radiográficos que acusem uma doença. Muitas vezes por insistência dos pacientes o tratamento endodôntico é realizado, mas não ocorre alívio da dor. Assim, tratamentos invasivos continuam sendo realizados incluindo retratamento endodôntico, apicetomia e finalmente a extração do dente. Sendo uma enfermidade que pode trazer alguma dificuldade diagnóstica para o cirurgião-dentista, o conhecimento de suas características se torna necessário. Deste modo, este artigo apresenta uma revisão de literatura sobre esta entidade, onde são abordados os seguintes tópicos: epidemiologia e sinais clínicos, critérios de diagnóstico, etiologia, diagnóstico diferencial e abordagens terapêuticas.

The Atypical Odontalgia (AO) it is an important clinical entity, because the pain is neuropatic for deafferentation and it happens “in the tooth”, however it is not “toothache.” It is characterized by pain in a tooth or pain in a ranch where a tooth was extracted, with absence of clinical signs or radiographics that accuse a disease. A lot of times for the patients’ insistence the endodontic treatment is accomplished, but it doesn’t happen relief of the pain. Like this, invasives treatments continue being accomplished including endodontic retreatment, apicectomy and finally the extraction of the tooth. Being an illness that can bring some diagnostic difficulty for the surgeon-dentist, the knowledge of their characteristics becomes necessary. This way, this article presents a literature revision on this entity, where the following topics are approached: epidemiology and clinical signs, diagnosis criteria, aetiology, differential diagnosis and therapeutic approaches.

Laser therapy in the treatment of dentine hypersensitivity

A hipersensibilidade dentinária cervical é a queixa mais frequente entre os relatos de odontalgia. Este estudo avaliou a eficácia de dois tipos de lasers, vermelho com 660nm e infravermelho com 830nm de comprimento de onda, como dessensibilizadores dentinários, como também os efeitos terapêuticos imediato e tardio em indivíduos de 25 a 45 anos de idade. Um total de 40 dentes com exposição cervical foram tratados em 4 sessões, divididos em 2 grupos - laser vermelho e infravermelho. A sensibilidade dentinária ao estímulo nociceptivo frio foi avaliada por meio de uma escala numérica de dor, de 0 a 10, antes de cada sessão de tratamento, aos 15 e 30 minutos após a irradiação e num período de seguimento de 15, 30 e 60 dias após o término do tratamento. Níveis significantes de dessensibilização dentinária foram apenas encontrados em pacientes com idade entre 25 a 35 anos. O laser díodo vermelho de 660nm foi mais eficaz comparado com laser infravermelho de 830nm e foi observado um nível mais alto de dessensibilização nas mensurações realizadas aos 15 e 30 minutos após irradiação. O efeito terapêutico imediato e tardio do laser díodo vermelho de 660nm é maior quando comparado com o infravermelho de 830nm em ambas faixas etárias.

Knowledge of dental health and diseases among dental patients, a multicentre study in Saudi Arabia.

The aim of this study was to assess the knowledge of dental patients about dental health and diseases. A questionnaire was developed with three sets of questions, 1-general knowledge of dental conditions, 2-use of alternate methods in prevention and treatment of dental diseases, 3-awareness about personal oral health. Six hundred questionnaires were distributed in 6 cities from 4 different regions (i.e. Makkah, Riyadh, Tabuk, Gizan). 367 respondents (61% response rate) constituted 233 (63.5%) male and 134 (36.5%) female with the age range 11-70 years (mean 30 +/- 11.9). The data were analyzed by SPSS version 9.0 and results presented in frequency distributions. 99% male and 96% female considered their teeth for chewing food, 97% male and 96% female knew that increased carbohydrate intake and poor oral hygiene are related to tooth decay, 89% male and 96% female used toothbrush and paste to prevent dental diseases and 75% male and 66% female were regular user of miswak (chewing sticks.) 67% male and 59% female visit dentist, only in pain. 46% used miswak after their meals, only 14% of the subjects used miswak on their lingual and palatal surfaces of teeth, while 38% of the subjects used clove as remedy for toothache, 25.6% used saline and 10% used lemon for bleaching their teeth. 15% considered honey important for their good oral health. Regarding personal oral health, 35% had pain in gums, 36.8% were with bad breath, 28% had tooth hypersensitivity, and almost 50% used toothbrush twice daily while 42% had bleeding gums. It is important to note that knowledge and awareness about dental health and disease conditions are better in male subjects, dietary habits and oral hygiene methods need to be addressed in future investigations. There is a need to provide more health education to female subjects to improve their oral health.

Odontalgias: su terapéutica homeopática / Pain of teeth: its homeopathic treatment

Se realiza un estudio descriptivo de algunos medicamentos homeopáticos extraídos de la Materia Médica con el propósito de compilar una guía útil y práctica de los medicamentos que se utilizan con más frecuencia para la odontalgia, reflejando los síntomas generales y particulares más característicos, lo que resultará de gran valor para las consultas estomatológicas y el cuerpo de guardia

Introducción de la digitopuntura en la estomatología cubana / Introduction of digital acupuncture in Cuban Dentistry

Se describen los trabajos realizados acerca de la investigación, aplicación y extensión de la digitopuntura con fines terapéuticos en los servicios estomatológicos del país. La investigación realizada demostró la efectividad de esta técnica en el tratamiento de las algias más frecuentes, en los pacientes que acuden a solicitar atención estomatológica. Su efecto analgésico se hizo patente en el 97,9 por ciento de los pacientes objeto de estudio, atendiendo a las diferentes proporciones de disminución del dolor establecidas en el protocolo. Se concluye que se trata de una técnica sencilla, no invasiva, que no requiere de habilidades especiales, de bajo costo, acción analgésica inmediata, no produce efectos secundarios, ofrece una alternativa terapéutica y su uso y dominio pueden ser extendidos a toda la población

Aerodontalgia: diagnóstico, tratamento e prevenção / Aerodontalgia: diagnostic, treatment and prevention

Os autores descrevem um tipo de odontalgia - Aerodontalgia - que é provocada por exposições dentárias a mudanças de pressão atmosférica durante vôos ou submersões. São relatadas as dificuldades do diagnóstico, além dos diferentes tipos de Aerodontalgia e sua patogênese, tratamento e prevenção