Self-report on COVID-19: a survey of paraguayan dentists / Autorreporte acerca del contagio de COVID-19: una encuesta a odontólogos paraguayos

Aim: To determine the frequency of signs and/or symptoms compatible with COVID-19 in Paraguayan dentists, as well as the possible source of contagion. Material and Methods: Online survey consisting of 13 questions, applied to all dentists in Paraguay from January 20 to February 15, 2021. Results: A total of 433 dentists participated in the survey; 47.5% displayed symptoms compatible with COVID-19 and 13.39% indicated that they had contracted the disease, providing confirmation via a positive test result. Headache, loss of smell, loss of taste, cough, and fatigue were the most prevalent symptoms among COVID-19 positive cases. The main source of contagion was the family nucleus. Only one participant reported having contracted the disease while providing dental care. Conclusion: Almost half of the dentists displayed symptoms compatible with COVID-19. Only 13.39% tested positive for COVID-19. Only one case of contagion was reported to have happened during the provision of dental care.

Conocimiento sobre deberes y obligaciones que rigen la práctica odontológica en el Paraguay

RESUMEN La atención odontológica requiere del cumplimiento de todas las normas legales referente al protocolo de atención, ya que tanto el profesional como el paciente deben estar protegidos previendo cualquier conflicto que pudiera surgir. El objetivo de este trabajo fue evaluar el nivel de conocimiento sobre deberes y obligaciones en la práctica odontológica en el Paraguay. El estudio fue observacional descriptivo de corte transversal, con una muestra total de 100 odontólogos del Hospital Central de Policía Rigoberto Caballero. El cuestionario constó de 20 preguntas de las cuales 4 fueron sobre características sociodemográficas y académicas, 13 preguntas de conocimiento sobre deberes y obligaciones en la práctica odontológica, 1 sobre capacitación recibida en legislación, 1 sobre cumplimiento de obligaciones tributarias y 1 sobre barreras de protección usadas contra rayos X. El nivel de conocimiento fue clasificado teniendo en cuenta el porcentaje de respuestas correctas: insuficiente (<60%) y suficiente (≥60%). Ochenta por ciento de los encuestados fueron del sexo femenino con edad promedio de 40 años. El nivel de conocimiento general sobre deberes y obligaciones que rigen la práctica odontológica fue suficiente en el 71% de los odontólogos encuestados. No se encontraron diferencias significativas entre el nivel de conocimiento según la universidad (p=0,21) y año de egreso (p=0,34). El nivel de conocimiento sobre deberes y obligaciones que rigen la práctica odontológica en el Paraguay fue suficiente, sin embargo, algunos aspectos específicos como conocimiento tributario, documentaciones que rigen las leyes, recibo de comisiones y notificaciones de enfermedades transmisibles deben ser todavía más explorados, estudiados y difundidos.

ABSTRACT Dental care requires compliance with all legal regulations regarding the care protocol, since both the professional and the patient must be protected anticipating any conflict that may arise. The objective of this study was to evaluate the level of knowledge about duties and obligations in dental practice in Paraguay. The study was descriptive, cross-sectional, observational, with a total sample of 100 dentists from the Rigoberto Caballero Central Police Hospital. The questionnaire had 20 questions of which 4 were about knowledge on sociodemographic and academic characteristics, 13 on duties and obligations in dental practice, 1 on training received on legislation, 1 on compliance with tax obligations and 1 on barriers used for protection againts X-ray. The level of knowledge was classified considering the percentage of correct answers: insufficient (<60%) and sufficient (≥60%). Eighty percent of those surveyed were female with an average age of 40 years. The level of general knowledge about duties and obligations that govern dental practice was sufficient in 71% of the surveyed dentists. No significant differences were found between the level of knowledge according to university (p = 0.21) and year of graduation (p = 0.34). The level of knowledge about duties and obligations that govern dental practice in Paraguay was sufficient, however, some specific aspects such as tax knowledge, documentations that govern the laws, receipt of commissions and notifications of communicable diseases must be even more explored, studied and disseminated.

Decision-making for dental pulp exposure: a survey in graduate programs at Brazilian universities

Abstract Clinical decision-making tends to be based on what clinicians have been taught during undergraduate and graduate programs. The aim of the present study was to assess the clinical approach and to identify the factors that influence the decision-making for dental pulp exposure among graduate students and coordinating professors in endodontics programs offered at Brazilian universities. The study used a mail-out survey developed in the Qualtrics platform, based on seven clinical reports in which dental pulp exposure was evidenced. Descriptive statistics showing vital pulp therapy (VPT) and root canal treatment (RCT) were calculated for each clinical report. Data on the participants' (n = 113) profile and variables related to clinical and radiographic characteristics of the cases were evaluated as to their potential to affect decision-making and analyzed by logistic regression (p < 0.05). VPT was likely to be indicated in cases of patients with immature teeth (OR = 0.017; 95%CI = 0.004 -0.073). RCT indications were related to the presence of symptoms (OR = 5.326; 95%CI = 1.429-19.852) and old age (OR = 21.057; 95%CI=6.809-65.120). In pulp exposure secondary to trauma, time of pulp exposure was significantly associated with RCT indication (OR=3.267; 95%CI=1.332-8.012). The present study demonstrated that patient age, root development, and symptom features were the main factors affecting participants' decision-making.

Medidas empleadas por odontólogos paraguayos para disminuir el riesgo biológico en la práctica odontológica durante la pandemia de Covid-19 / Infection control procedures used by Paraguayan dentists to reduce biological risk in dental practice during the Covid-19 pandemic

Resumen Introducción: los profesionales en odontología han sido identificados como de muy alto riesgo de exposición al coronavirus, específicamente cuando llevan a cabo procedimientos de generación de aerosoles en pacientes infecciosos. El objetivo fue conocer los mecanismos mecánicos y químicos usados por los odontólogos paraguayos para evitar la propagación del COVID-19. Evaluar el porcentaje de odontólogos que hayan atendido pacientes COVID positivo y que posteriormente hayan desarrollado la enfermedad. Métodos: estudio observacional descriptivo de corte transversal. Participaron del estudio odontólogos paraguayos con acceso a internet. La difusión del enlace de acceso se realizó por redes sociales. Se recolectaron datos sociodemográficos y medidas de protección utilizadas en el consultorio a fin de disminuir el riesgo biológico. Resultados: participaron 428 odontólogos, 84,11 % fueron mujeres, 38,32 % tenía de 30-39 años. Las medidas de desinfección y cuidados más utilizadas fueron la desinfección del sillón dental (96,7 %), lavado de manos del profesional (93,46 %) y desinfección de superficies con alcohol 70 (88,08 %). El 59,1% utilizaba el peróxido de hidrógeno al 1% como enjuague bucal preoperatorio. La mayoría utilizaba tapabocas KN95 (48,83%), bata de tela tejida (78,04 %), bata desechable (72,20%); uso de gorrito (89,49%) y/o cubre calzado (76,40 %) por parte del paciente, y esterilizan en autoclave sus instrumentales (82,48%). Un profesional relató haberse contagiado en el consultorio odontológico. Conclusión: La mayoría de los odontólogos paraguayos encuestados cumple con los protocolos establecidos por el Ministerio de Salud y organismos internacionales, los cuales aparentan ser efectivos como mecanismos de protección contra el COVID-19 en el ambiente clínico.

Abstract Introduction: dental professionals have been identified as having a very high risk of exposure to coronavirus, specifically when they carry out procedures to generate aerosols in infectious patients. The objective was identifying the mechanical and chemical mechanisms used by Paraguayan dentists to prevent the spread of COVID-19. Evaluate the percentage of dentists who have treated positive COVID patients and who have subsequently developed the disease. Methods: it was a cross-sectional descriptive observational study. Paraguayan dentists with internet access participated. The questions were about sociodemographic data and protection measures used in the office to reduce biological risk. The access link was disseminated through social networks. Results: 428 dentists participated in the study, 84.11 % were women, 38.32 % were 30-39 years old. The most used disinfection and care measures were dental chair disinfection (96.7 %), hand washing (93.46 %) and surface disinfection with alcohol 70 (88.08 %). 59.1% used 1% hydrogen peroxide as a preoperative mouthwash. The majority wore KN95 masks (48.83 %), woven cloth robe (78.04 %), disposable robe (72.20 %); The patient is fitted with a disposable surgeon's cap (89.49 %) and/or shoe covers (76.40 %), and their instruments are sterilized in an autoclave (82.48%). One professional reported having been infected in the dental office. Conclusion: most of the Paraguayan dentists surveyed comply with the protocols established by the Ministry of Health and international organizations, which appear to be effective as protection mechanisms against COVID-19 in the clinical environment.