Differences in dental care for pregnant women in the public sector after the creation of Previne Brasil

Aim: To compare performance differences among dental surgeons in the public sector of the state of Minas Gerais regarding prenatal dental care before and after the establishment of Previne Brasil. Methods: A cross-sectional study was conducted, gathering data through a structured questionnaire. The sample consisted of dental surgeons working in the public sector of municipalities in MG and utilizing the snowball effect. Data analysis was performed using the IBM-SPSS® version 29.0, employing Pearson's Chi-square statistical test (P<0.05). Results: Out of the 28 State Health System (SRS) present in MG. A total of 1696 responses were collected, but after applying the exclusion criteria, 1001 responses remained, specifically related to dental surgeons working in MG public sector. 78.6% comprised professionals who graduated before 2019, while 20.1% graduated after that year. The morning and the second or other gestational trimesters were the most common periods considered optimal for caring for pregnant women. A significant portion of the professionals had not undergone any specific courses or training on this topic, reporting an average satisfaction level of 5.52 regarding the accessibility of information during their education aimed at this audience. Conclusion: Variances were observed in the care provided to pregnant women by dental surgeons working in the public sector of Minas Gerais, distinguishing those trained before and after the implementation of Previne Brasil. The debunking of myths and taboos stands as crucial for enhancing the acceptance of prenatal dentistry

Evaluation of the expression of nerve fiber markers in healthy and inflamed dental pulp

Abstract The diagnosis of irreversible pulpitis (IP) depends on clinical data, especially the chief complaint of the patient, visual inspection, response to the application of stimuli, and radiographic examination. The characterization of nerve fibers (NF) in IP may contribute to better interpret painful symptoms, but has been barely explored. This study sought to characterize the density and integrity of NF in 16 samples of IP and in five healthy pulps (HP) using S-100 and PGP 9.5 markers. Immunohistochemistry was performed to determine the density/mm2 of S-100+ and PGP 9.5+ in NF. The amount of degenerated NF was obtained by subtracting the total NF density from the amount of intact NF. Associations between NF density and integrity and symptomatology were calculated. All samples were positive for S-100 and PGP 9.5. Compared to HP samples (38.20/mm2), IP samples had a lower density of intact NF (6.24/mm2). A significantly higher density of degenerated NF was found in IP samples with spontaneous pain (39.59/mm2) compared to those with provoked pain (23.96/mm2) (p = 0.02). No association was observed between intensity of the inflammatory infiltrate and NF density and integrity (p > 0.05). The findings of this study suggest that pulpitis may involve different stages of degeneration and may be more advanced in cases with spontaneous pain. The symptoms reported by affected individuals do not appear to depend on the intensity of the inflammatory infiltrate, but rather on the integrity of NF.

Assessment of child's dental anxiety/fear and stress during dental treatment: a systematic review by CEDACORE

Abstract: There is a lack of evidence on the correlation between salivary biomarkers and subjective measures of dental fear and anxiety in children. This systematic review aimed to retrieve the scientific evidence comparing the results of dental anxiety measured by salivary biomarkers with patient-reported outcomes in pediatric dental setting. The PECOS was as follows: population: pediatric patients aged ≤ 18 years; exposure: patient-reported outcome measures, such as scales and/or questionnaires; comparator: salivary biomarkers; outcome: anxiety, fear, phobia or stress during dental treatment; study design: observational studies or controlled trials. Electronic searches were conducted in PubMed, Scopus, Web of Science, and Ovid databases. Studies that compared scales/questionnaires and salivary biomarkers for the evaluation of dental anxiety, fear, and stress in children/adolescents during dental treatment were included. Certainty of evidence was assessed with GRADE. Risk of bias of the included studies was assessed with the Cochrane tool or the University of Adelaide tool. From the 314 studies identified, eight were included. Participants' age ranged from three to 13 years. The most used salivary biomarkers and instruments were cortisol and the Dental Subscale of the Children's Fear Survey Schedule, respectively. Most studies showed a weak correlation between objective and subjective measures. The main issues regarding bias were on allocation concealment, blinding of assessors, follow up, and exposure assessment. Certainty of evidence was low/very low. Evidence of salivary biomarkers and patient-reported outcome measures to investigate anxiety, fear and stress in children during in the dental environment is limited. There was no correlation between subjective and objective measures in almost all included studies.