O paciente diabético na clínica odontológica: diretrizes para o acolhimento e atendimento / The diabetic patient in the dental clinic: care and treatment guidelines

Introdução: Diabetes Mellitus é um grupo de doenças metabólicas quevem se tornando cada vez mais frequente na população mundial,sendo considerado um problema de saúde pública. Essa patologiapode apresentar na cavidade bucal suas primeiras manifestações,predispondo o paciente a várias alterações bucais. O cirurgião-dentistanecessita conhecer a doença e conduzir um correto manejo dessespacientes. Objetivo: Propor um protocolo de atendimento e manejoodontológico para pacientes diabéticos. Desenvolvimento: Naanamnese, reunir informações sobre a doença: tipo, tempo dediagnóstico, farmacoterapia, manifestações sistêmicas e bucais,histórico de crise hipoglicêmica ou hiperglicêmica. Ao exame físico,atentar para verificação de sinais vitais, índice de massa corporal,avaliação de tecidos moles e preenchimento do odontograma eperiograma. Avaliar hemoglobina glicada de pacientes previamentediagnosticados e encaminhar pacientes com suspeita para o médico.No dia da consulta, recomendar que o paciente se alimentenormalmente e realize o uso de suas medicações. As consultas devemser curtas, no início da manhã e glicosimetria deve ser realizada noinício do atendimento. Pacientes compensados prescindem o uso deantibioticoprofilaxia e podem receber anestésico com vasoconstrictoradrenérgico. Em casos de urgência por crise hipoglicêmica, a mesmadeve ser solucionada antes de torna-se uma emergência médica.Conclusão: Com exame clínico e complementares, coletar o máximode informações sobre a doença para classificar o paciente em relaçãoao risco que apresenta ao atendimento. Pacientes compensados nãonecessitam de tratamento odontológico diferenciado. Pacientesdescompensados não devem sofrer nenhum tratamento eletivo edevem ser tratados de acordo com as limitações presentes.

Introduction: Diabetes mellitus, a group of metabolic diseases, isbecoming increasingly more common among the world population,and consequently being considered a public health issue. Diabetesmay showearly signs in the oral cavity, predisposing patients tovarious oral diseases. Knowledge of the disease is important for thecorrect management and treatment of these patients. Objective: Topropose a protocol of dental care and management for diabeticpatients. Development: During anamnesis of medical history, gatherinformation about the disease: type, time since diagnosis, medications,systemic and oral manifestations, history of hypoglycemic/hyperglycemic crisis. During physical examination, verify vitalsigns,body mass index, and intra-oral soft tissues, as well as completetheodontogram and periodontal chart. Glycated hemoglobin ofpreviously diagnosed patients should be evaluated, and patients atrisk should be referred to their physician. On the day of treatment,patients should be instructed as to eat and take their medications.Visits should be short and early in the morning, and glucose should bechecked beforethe patient is treated. Patients with controlled glucoselevels do not require antibiotic prophylaxis and may receive anestheticswith vasoconstrictor. In case of a hypoglycemia episode, one musttry to control it before it becomes a medical emergency. Conclusion:With clinical and complementary examination, collect as muchinformation about the disease as possible to classify the degree ofrisk that treatment may pose to the patient. Compensated patients donot require differential dental treatment. Decompensated patientsshould not undergo any elective treatment and should be treated accordingly.

Childrenæs perception of dentists through the interpretation of drawings

To evaluate the perceptions of students aged 05-12 years about dentists through the interpretation of drawings.Material and Methods:This is a cross-sectional study whose sample consisted of 1015 children aged 5-12 years from 10 public schools of Salvador, Brazil. The students produced drawings about their main idea associated with the dentist and answered a semi-structured interview consisting of seven items.Results:Males (521 volunteers -51.3%) were more prevalent than females (494 volunteers, 48.6%), 688 (67.7%) children had experienced dental care, and need for treatment was the reason for seeking dental care to 306 (30.1%) of them. In describing the professional using one word, positive words totaled 805 (79.1%) responses, negative words accounted for 24 (2.2%) and 186 (18.3%) participants could not answer. The drawing category that had the largest number of volunteers was ôProceduresõ, with 238 (23.4%) drawings, followed by: ôDental Consultationõ with 228 (22.4%), ôOther Professionalsõ with 174 (17.1%), ôDentistõ with 115 (11.3%), ôOral Healthõ with 71 (6.9%), ôMiscellaneousõ with 71 (6.9%), ôDental Officeõ with 55 (5.4%), ôMouthõ with 36 (3.5%) and ôPain / Fearõ with 27 (2.6%). Conclusion:Drawings were effective in representing the particular vision of students and showed a plurality and complexity of concepts and ideas related to the dentist. In addition to procedures and consultation, professional behavior, knowledge transmitted to patients, physical environment and experienced sensations, factors linked to the origin of the main idea about the professional were also relevant. The perception of volunteers was positive both in the drawings as in the responses of the semi-structured interview...