Mothers of a Child with Cerebral Palsy: Perception on the Diagnosis Moment and the Child's General and Oral Health

ABSTRACT Objective: To analyze the perception of mothers of children with Cerebral Palsy (CP) on the diagnosis moment and the child's health. Material and Methods: Research with a qualitative approach, carried out with 19 mothers of children with CP, in a public higher education institution, in the state of Minas Gerais, Brazil. For data collection, the interview was used and for data interpretation, content analysis. Results: Mothers reported that the diagnosis of a child with CP resulted in major changes in the family's daily life, increasing their responsibility and demands. After the diagnosis, mothers revealed oscillating feelings, with progressively replaced by her motherly ability to take care, reestablishing the psychic balance. The health associated with the absence of disease and curative practices was frequently observed. Mothers reported a great concern with oral hygiene habits and frequent visits to the dentist. Conclusion: The diagnosis of a child with CP led to changes in the family's priorities and routine. After the moment of anguish, uncertainty and fear, the mothers accepted the reality. The biomedical principle significantly influenced the mother´s perception of health, being health perceived as the absence of disease and curative practices. In relation to oral health, practices widely spread and recommended by the media and health services, such as correct tooth brushing, showed an orientation of patients to maintain oral health.

O cuidado no atendimento às crianças no consultório odontológico frente à pandemia da COVID-19 / Dental care for children in dental clinics faced with the COVID-19 pandemic

Objetivo: O presente trabalho visa orientar o odontólogo sobre as novas regras de uso de EPIs, normas de biossegurança, técnicas odontológicas utilizadas no atendimento da criança, para que possamos realizar os procedimentos odontológicos com segurança antes, durante e após a pandemia da COVID-19. Métodos: Após busca em diversos bancos de dados (Google, SciELO, Bireme, Portal de Periódicos da CAPES, PubMed), em 30/03/2020, 21 artigos relacionados ao atendimento odontológico durante a pandemia foram selecionados. O critério de inclusão dos artigos foi se relacionar às normas específicas de biossegurança para o atendimento odontológico durante a pandemia, especialmente em crianças. Resultados: Vinte e um artigos foram incluídos no trabalho sendo sete deles, específicos do atendimento odontopediátrico. As consultas odontopediátricas devem ser marcadas de forma espaçada, evitando o encontro de pessoas na sala de espera. A criança deve vir acompanhada de apenas um acompanhante. Algumas barreiras devem ser usadas nas crianças como máscara, gorro e óculos. O odontólogo deve usar máscara N95 e protetor facial, além dos outros EPI's. Previamente ao atendimento, bochecho de peróxido de hidrogênio a 1% deve ser realizado pela criança. Técnicas operatórias (ART, aplicação de diamino fluoreto de prata e técnica Hall) que gerem menos aerossóis dever ser priorizadas. Se necessário o uso de baixa e alta rotação, estas deverão ser com sistema anti-reflexo e esterilizadas a cada paciente. Um intervalo de 1 a 2 horas deve ser dado entre pacientes, permitindo a ventilação da sala, diminuição dos aerossóis e desinfecção de todo o ambiente clínico. Conclusão: A pandemia do COVID-19 se tornou um risco ocupacional para odontólogos, crianças e responsáveis. Para evitar contágio e transmissão da doença, os odontólogos devem se capacitar por meio de informações seguras e cumprir as normas de biossegurança sugeridas.

Aim: The present work aims to guide the dentist as regards the new rules for the use of PPEs, biosafety standards, and dental techniques used in pediatric dental care, so that we can safely perform dental procedures before, during, and after the COVID-19 pandemic. Methods:After searching several databases (Google, SciELO, Bireme, Portal de Periódicos da CAPES, PubMed), on March 30, 2020, 21 articles related to dental care during the pandemic were selected. The inclusion criteria for the articles was to relate to specific biosafety standards for dental care during the pandemic, especially in children. Results: Twenty-one articles were included in the work, with seven of these specifically treating pediatric dental care. Dental appointments should be scheduled in a staggered manner, avoiding the meeting of people in the waiting room. The child must be accompanied by only one family member or guardian. Some barriers should be used with children, such as a mask, hat, and glasses. The dentist must wear an N95 mask and face shield, in addition to the other PPEs. Before attending, 1% hydrogen peroxide mouthwash must be used by the child. Operative techniques (ART, application of silver diamine fluoride and Hall technique), which generate less aerosols, should be given priority. If the use of low and high speed is necessary, they must be with an anti-reflective system and sterilized for each patient. An interval of 1 to 2 hours must be given between patients, allowing for the ventilation of the room, a reduction in aerosols, and the disinfection of the entire clinical environment. Conclusion: The COVID-19 pandemic has become an occupational hazard for dentists, children, and guardians. To avoid contagion and transmission of the disease, dentists must train themselves through secure information and comply with the suggested biosafety rules.

Impact of malocclusion on the quality of life of children aged 8 to 10 years

ABSTRACT Objective: The aim of the present cross-sectional study was to assess the impact of malocclusion on the quality of life of children aged 8 to 10 years attending public elementary schools in Belo Horizonte, State of Minas Gerais, Brazil. Methods: The Brazilian version of the Child Perceptions Questionnaire 8-10 (CPQ8-10) was used to evaluate oral health-related quality of life. The children were examined for the diagnosis of malocclusion using the Dental Aesthetic Index (DAI). The data were analyzed by bivariate and multivariate descriptive statistics using Poisson regression at a 5% significance level. A total of 270 children participated in the study. Results: Children with normal occlusion or mild malocclusion (DAI ≤ 25) were 56% less likely (95%CI: 0.258-0.758; p= 0.003) to have their quality of life affected compared with children diagnosed with extremely severe malocclusion (DAI ≥ 36). Children with a maxillary anterior overjet ≥ 3 mm had higher CPQ8-10 mean scores (19.4; SD = 17.1) than those with an overjet < 3 mm (13.6; SD = 11.7; p= 0.038). Conclusions: Extremely severe malocclusion and pronounced maxillary anterior overjet were associated with a negative impact on quality of life.

RESUMO Objetivo: o objetivo do presente estudo transversal foi avaliar o impacto da má oclusão na qualidade de vida de crianças na faixa etária de 8 a 10 anos de idade, estudantes de escolas da rede pública da cidade de Belo Horizonte, estado de Minas Gerais, Brasil. Métodos: o instrumento utilizado para medir a qualidade de vida relacionada à saúde bucal foi a versão brasileira do Child Perceptions Questionnaire 8-10 (CPQ8-10). As crianças foram examinadas para diagnóstico de má oclusão utilizando-se o Dental Aesthetic Index (DAI). A análise dos dados foi realizada por meio de estatística descritiva, bivariada e multivariada por meio da regressão de Poisson, com nível de significância de 5%. Participaram do estudo 270 crianças. Resultados: crianças com oclusão normal ou má oclusão leve (DAI ≤25) apresentaram 56% menos probabilidade (IC 95%: 0,258-0,758; p= 0,003) de impacto na qualidade de vida, comparadas com crianças diagnosticadas com má oclusão muito grave (DAI ≥ 36). Crianças com sobressaliência superior anterior ≥ 3 mm apresentaram maiores escores médios de CPQ8-10 (19,4; DP = 17,1) do que aqueles com sobressaliência < 3 mm (13,6; DP=11,7; p= 0,038). Conclusões: a má oclusão muito grave e a sobressaliência superior anterior aumentada se associaram ao impacto negativo na qualidade de vida.

Impacto das lesões cariosas cavitadas e das consequências da cárie dentária não tratada na qualidade de vida de crianças de 08 a 10 anos de idade / Impact of cavitated carious lesions and the consequences of untreated dental caries on the quality of life of children aged 8 to 10 years

Objetivo: Avaliar o impacto da cárie dentária (lesões cariosas cavitadas/CPOD/ceo-d e lesões não-tratadas/PUFA) na qualidade de vida relacionada à saúde bucal (QVRSB) de crianças de 8 a 10 anos.Métodos: A QVRSB foi medida pela versão brasileira do Child Perceptions Questionnaire-CPQ8-10 de 30 crianças das Clínicas de Infantil da Universidade Estadual de Montes Claros. Os dados clínicos (CPOD/ceod e PUFA) e as entrevistas foram coletados por 5 examinadores calibrados. O Programa Estatístico das Ciências Sociais, versão 20.0 foi usado para a análise descritiva e bivariada.Resultados: Setenta por cento das crianças apresentaram experiência de cárie. Onze crianças apresentaram as consequências da doença não tratada. Na análise bivariada, a variável lesões cariosas cavitadas mostrou uma associação estatisticamente significante ao impacto negativo na QVRSB destas crianças.Conclusão: Lesões cariosas cavitadas foram associadas à um alto impacto negativo na qualidade de vida relacionada à saúde bucal em crianças de 8 a 10 anos de idade. Políticas públicas de saúde para crianças em fase de dentadura mista devem ser encorajadas.

Aim: To evaluate the impact of dental caries (cavitated caries lesions/DMFT/dmft and consequences of untreated lesions / PUFA) on the oral health-related quality of life (OHRQoL) of 8 to 10-year-old children.Methods: OHRQoL was measured by the Brazilian version of the Child Perceptions Questionnaire-CPQ8-10of 30 children from the Children's Clinics of the State University of Montes Claros. Clinical data and interviews were collected by 5 calibrated examiners. The Statistical Program of Social Sciences, version 20.0, was used for descriptive and bivariate analysis. Results: Seventy percent of the children presented caries experience. Only 11 children presented the consequences of the untreated disease. In the bivariate analysis, the variable cavitated carious lesions showed a statistically significant association with the negative impact on the OHRQoL of these children. Conclusion: Cavitated caries lesions were statistically associated with a high negative impact on oral health related quality of life of 8 to 10-year-old children. Public health policies for children in mixed dentition phases should be encouraged.

Prevalence of and factors associated with enamel fracture and other traumas in Brazilian children 8-10 years old

Abstract The aim of this study was to assess the prevalence and discriminate the associated factors between enamel fractures and other trauma/trauma sequelae in 8 to 10-year-old Brazilian schoolchildren. A representative sample of 1,201 children from public and private schools were enrolled in this cross-sectional study. Questionnaires about sociodemographic characteristics were answered by parents. The outcome variable (traumatic dental injury, TDI) was multi-categorized. Independent individual variables were sex, age, number of residents in household, parents/caregivers' level of education, family income, dental caries, and overjet. Type of school was considered an independent contextual variable. Multilevel analysis, bivariate, and multivariate multinomial logistic regression models were performed. The prevalence of TDI was 14.0% (2.8% with other trauma/trauma sequelae). The multilevel analysis revealed no significant difference between the type of school and TDI. The multinomial logistic regression showed that boys (OR = 2.3; 95%CI: 1.1-4.8), older children (OR = 1.8; 95%CI: 1.1-3.0) and individuals with an overjet > 3 mm (OR = 2.5; 95%CI: 1.0-6.2) were more likely to present other trauma/trauma sequelae. Enamel fracture was not significantly associated with any variables. The prevalence of TDI in 8 to 10-year-old schoolchildren was 14% but only 2.8% of other trauma/trauma sequelae. Differences regarding the associated factors of TDI involving enamel fracture or other trauma/trauma sequelae were detected, suggesting that the different TDI classification cannot be evaluated as a single category.

Base of the skull morphology and Class III malocclusion in patients with unilateral cleft lip and palate

OBJECTIVE: The aim of the present study was to determine the morphological differences in the base of the skull of individuals with cleft lip and palate and Class III malocclusion in comparison to control groups with Class I and Class III malocclusion. METHODS: A total of 89 individuals (males and females) aged between 5 and 27 years old (Class I, n = 32; Class III, n = 29; and Class III individuals with unilateral cleft lip and palate, n = 28) attending PUC-MG Dental Center and Cleft Lip/Palate Care Center of Baleia Hospital and PUC-MG (CENTRARE) were selected. Linear and angular measurements of the base of the skull, maxilla and mandible were performed and assessed by a single calibrated examiner by means of cephalometric radiographs. Statistical analysis involved ANCOVA and Bonferroni correction. RESULTS: No significant differences with regard to the base of the skull were found between the control group (Class I) and individuals with cleft lip and palate (P > 0.017). The cleft lip/palate group differed from the Class III group only with regard to CI.Sp.Ba (P = 0.015). Individuals with cleft lip and palate had a significantly shorter maxillary length (Co-A) in comparison to the control group (P < 0.001). No significant differences were found in the mandible (Co-Gn) of the control group and individuals with cleft lip and palate (P = 1.000). CONCLUSION: The present findings suggest that there are no significant differences in the base of the skull of individuals Class I or Class III and individuals with cleft lip and palate and Class III malocclusion. .

OBJETIVO: o objetivo do presente estudo foi determinar diferenças morfológicas da base do crânio de indivíduos portadores de fissura de lábio e palato e de má oclusão de Classe III, comparado-os com indivíduos controle com má oclusão de Classes I ou III. MÉTODOS: oitenta e nove indivíduos, de ambos os sexos, com idade variando entre 5 e 27 anos, Classe I (n = 32), Classe III não fissurados (n = 29) e Classe III com fissura labiopalatina unilateral (n = 28), oriundos do Centro de Odontologia e Pesquisa da PUC-MG e do Centro de Atendimento de Fissurados do Hospital da Baleia e da PUC-MG (CENTRARE), foram selecionados. Medições lineares e angulares da base do crânio, maxila e mandíbula foram realizadas e avaliadas por um único examinador calibrado, por meio de radiografias cefalométricas. Foram utilizados os testes ANCOVA e correção de Bonferroni para a análise estatística dos dados. RESULTADOS: com relação à base do crânio, os resultados não indicaram diferença estatística entre indivíduos controle (Classe I) e os indivíduos com fissuras (p > 0,017). O grupo com fissura foi diferente do grupo Classe III somente em relação à medida CI.Sp.Ba (p = 0,015). O comprimento maxilar (Co-A) apresentou diferença estatisticamente significativa na comparação entre o grupo controle (Classe I) e o grupo com fissuras (p < 0,001), sendo que os fissurados apresentaram uma maxila menor. Não foram encontradas diferenças na mandíbula (Co-Gn) entre indivíduos do grupo controle (Classe I) e indivíduos fissurados (p = 1,000). CONCLUSÃO: os resultados sugerem que não houve diferença estatisticamente significativa na base do crânio entre indivíduos Classe I e III e indivíduos com fissuras de lábio e palato com má oclusão de Classe III. .

Dental caries and social factors: impact on quality of life in Brazilian children

The objective of this study was to evaluate the impact of dental caries and social determinants in the Oral Health Related Quality of Life (OHRQoL) of children in Belo Horizonte, Brazil. This is a population-based cross-sectional study with a representative sample of 1,204 children aged 8 to 10 years randomly selected from 19 public and private schools. The children were clinically examined at school by two trained and calibrated examiners (Kappa = 0.78 - 1.00). The Decayed, Missing and Filled Teeth Index (DMF-T and dmf-t) was used for the diagnosis of dental caries. The social factors were determined by parents’/caregivers’ schooling, household income, number of people in the household, type of school, and by the Social Vulnerability Index. The Brazilian version of the Child Perceptions Questionnaire for ages 8 to 10 years was used to assess the impact on quality of life. A total of 278 (23.1%) out of 1,204 children had at least one cavitated carious lesion and 47.0% presented a negative impact on OHRQoL. In the final multivariate Poisson’s regression model, household income and presence of untreated dental caries were statistically associated with a negative impact on OHRQoL (p < 0.001).Children with dental caries and from low-income families had a higher negative impact on OHRQoL.

A cultura bullying na escola a partir do olhar das vítimas / Bullying culture in school from the view of the victims

No Brasil a preocupação com o fenômeno da violência no ambiente escolar surgiu a partir da década de 1980, mas foi no final da década de 1990 e início dos anos 2000 que os estudos passaram a investigar as relações interpessoais agressivas envolvendo alunos e professores. A presente pesquisa é um estudo descritivo de abordagem qualitativa que objetivou investigar o fenômeno bullying entre escolares da rede particular de ensino de Teresina-PI, Brasil. A análise das falas dos escolares vítimas de bullying mostrou que o fenômeno bullying foi caracterizado por meio de atos de violência verbal, física e/ou psicológica realizados diariamente, os quais geraram sentimentos negativos e de mal estar entre as vítimas. Além disso, tais atos resultaram em prejuízos imediatos aos escolares, como dificuldades de concentração, comunicação, e baixo rendimento escolar, que raramente foram denunciados por conta de impunidade aos agressores...

In Brazil, the preoccupation with the phenomenon of violence in the schoolenvironment emerged from the 1980s, but it was in the late 1990s and early2000s that studies began to investigate aggressive interpersonal relationsinvolving students and teachers. The following research is a description ofquality approach that focuses to investigate the bullying phenomenon inbetween the students of the private high schools of Teresina-PI, Brazil. Theanalysis of the bullyings victims testimonies showed that the bullyingphenomenon was characterized by language, physical and/or physiological daily violence, in which has generated feelings of sickness and sadness on the victims. Also, these actions caused immediate effects on the students such as, difficulties of concentration, communication and difficulty in thelearning process, that were rarely noticed given the lack of punishment tothe aggressors...

Informative microsatellites for genetic population studies of black-faced lion tamarins (Leontopithecus caissara)

Leontopithecus caissara is a critically endangered primate species from the Brazilian Atlantic Forest. Nineteen microsatellite loci, previously developed for congeneric species, were tested with 34 L. caissara individuals from Superagüi Island. Of the 19 loci, 17 (89.4 percent) produced robust alleles, nine (47.4 percent) of these proved to be polymorphic, with a total of 23 alleles and an average of 2.56 alleles per locus. Expected and observed heterozygosity averaged 0.483 and 0.561, respectively. The exclusion power for identifying the first parent of an arbitrary offspring was 0.315 over all loci. The results thus indicate both the usefulness and limitations of these nine microsatellite loci in the genetic analysis of L. caissara, as well as their potentiality for genetic investigation in other congeneric species.

Programa de abordagem interdisciplinar no tratamento do transtorno de personalidade borderline: relato da experiência no ambulatório Melanie Klein do Hospital Psiquiátrico São Pedro / Program for an interdisciplinary approach in the treatment of borderline personality disorder: report on the experience at the Melanie Klein out-patient clinic at Hospital Psiquiátrico São Pedro

INTRODUÇÃO: Os transtornos de personalidade são uma classe diagnóstica em Psiquiatria cujo tratamento não está ainda claramente definido. Devido ao grande número de alterações que o transtorno de personalidade borderline ocasiona na vida de seus portadores, propomos um atendimento interdisciplinar integrado. Esta proposta organiza-se em quatro eixos: psicoterapia individual de orientação analítica, grupoterapia de orientação analítica, psicofarmacoterapia e intervenções sociais. METODOLOGIA: Este estudo baseia-se na descrição da experiência obtida pelos autores na implantação de um Programa de Abordagem Interdisciplinar no Tratamento do Transtorno de Personalidade Borderline, utilizando como exemplo dois relatos de caso sucintos, a respeito de duas pacientes com transtorno de personalidade borderline. Foram avaliados critérios qualitativos para descrever a melhora obtida pelas pacientes através do Programa (relacionamento interpessoal, interesses e atividades ocupacionais e de lazer, autonomia) e quantitativos (número de internações, tentativas de suicídio, procura por serviços de emergência). RESULTADOS E DISCUSSÃO: As intervenções sociais mostraram-se eficazes ao incrementar as terapêuticas já tradicionalmente colocadas. Houve melhoras relacionadas aos critérios acima colocados. CONCLUSÃO: Os resultados encontrados alertam-nos para a necessidade de observarmos os pacientes em seus diversos contextos, de forma a apresentar intervenções que dêem conta dessas múltiplas dimensões.