Factors associated with oral health-related quality of life in homeless persons: a cross-sectional study

Abstract This study aimed to evaluate the clinical and sociodemographic factors associated with the oral health-related quality of life (OHRQoL) of homeless persons. A cross-sectional study was conducted, with participants (n = 176) attending a Specialized Reference Center for the Homeless Population in Teresina, Brazil. Dental caries (DMFT index, WHO criteria), periodontal disease (CPI index), and the consequences of untreated caries (PUFA index) were measured by a single calibrated examiner (Kappa ≥0.83). Sociodemographic, oral health, and OHRQoL (OHIP-14) data were obtained through interviews. Data analysis included descriptive statistics and Poisson regression, with a significance level of 5%. Most of the participants were male (86.4%) and from the age group of 30 to 43 years (52.2%). Mean DMFT was 11 (SD ± 6.9) and mean total PUFA score was 1.2 (SD ± 2.2). Most of the participants (88.6%) had dental calculus and 8.5% and 1.7% of the sample had gingival bleeding and periodontal pocket > 3.5mm, respectively. The highest prevalence of negative impact in the OHRQoL was associated with females (1.4 (95%CI 1.1-1.7)), low educational level (2.0 (95%CI 1.3-3.0)), caries (1.6 (95%CI 1.1-2.6)), fistulas (1.9 (95%CI 1.3-3.1)), gingival bleeding (1.7 (95%CI 1.1- 2.7)), dental calculus (1.8 (95% CI 1.3-2.5)), periodontal pockets > 3 mm (1.5 (95%CI 1.1-2.0)), and need for extraction (2.3 (95%CI 1.1-5.0)). In conclusion, the negative impact on the OHRQoL of homeless persons was associated with low educational level, presence of decayed teeth, gingival bleeding, and dental calculus.

Dental Caries Experience and Associated Factors Among Brazilian Homeless Persons: A Cross-Sectional Study / Experiencia de Caries Dental y Factores Asociados entre Personas sin Hogar Brasileñas: Un Estudio Transversal

ABSTRACT: The objective of this study was to evaluate the dental caries experience and its associated factors in homeless persons. A non-probabilistic sample of 176 participants (mean age 37.8 years) was included in this cross-sectional study. Interviews and clinical examinations were performed. Dental caries experience was recorded based on the decayed, missing and filled teeth-index (DMFT). The dental caries experience was observed among 98.9 % of participants (mean DMFT 11.0 ± 6.95). Individuals in the "Over 44 years" age groups (PR = 1.4; 95 % CI = 1.1-1.6) and "30 to 36 years" (PR = 1.2; 95 % CI = 1.0 -1.4) had significantly higher caries experience. Individuals who do not brush or brush only 1x/day have 40 % and 20 % higher caries experience, respectively. Homeless persons had a high experience of dental caries, with significant tooth loss. Individuals in the advanced age groups, lack of income and non-achievement or low frequency of tooth brushing are factors associated with a greater experience of the disease in these individuals.

RESUMEN: El objetivo de este estudio fue evaluar la experiencia de caries dental y sus factores asociados en personas sin hogar. En este estudio transversal se incluyó una muestra no probabilística de 176 participantes (edad media 37,8 años). Se realizaron entrevistas y exámenes clínicos. La experiencia de caries dental se registró en fun- ción del índice de dientes cariados, perdidos y obturados (DMFT). Se observó una experiencia positiva de caries dental entre el 98,9 % de los participantes (DMFT promedio 11,0 ± 6,95). Las personas en los grupos de edad "Ma- yores de 44 años" (PR = 1,4; IC del 95 % = 1,1-1,6) y "30 a 36 años" (PR = 1,2; IC del 95 % = 1,0 -1,4) tuvieron una experiencia de caries significativamente mayor. Las perso- nas que no se cepillan, o se cepillan solamente 1x / día tienen una tasa mayor de caries, de 40 % y 20 % más, respectivamente. En las personas en situación de calle se observó una alta tasa de caries dental, con una pérdida dentaria significativa. Los factores asociados a una mayor tasa de la enfermedad, fueron personas de edad avanzada, la falta de ingreso, no lograr el cepillado, o tener una menor frecuencia de cepillado.

Revascularização pulpar em dentes permanentes imaturos sem vitalidade pulpar: uma revisão integrativa / Pulp revascularization in immature permanent teeth without pulp vitality: an integrative review

Introdução: Dentes permanentes imaturos que evoluem para necrose pulpar representam um desafio para tratamento endodôntico. A endodontia regenerativa e técnicas de revascularização pulpar surgem como um campo dinâmico e potencialmente ideal para terapia clínica em dentes com desenvolvimento radicular incompleto. Objetivo: Revisar a literatura sobre as técnicas de revascularização pulpar no tratamento de dentes com ausência de vitalidade pulpar com ápice radicular imaturo. Métodos: Os descritores "pulp revascularization", "pulp necrosis", "immature permanent tooth", "revascularization", "revitalization", "dental pulp", "regeneration" foram utilizados para obtenção de artigos em língua inglesa, que apresentassem conteúdo disponibilizado na íntegra e publicados nos últimos 15 anos. Foram excluídos os trabalhos de relatos de caso e/ou séries de casos. Conclusão: Artigos revisados apresentaram uma heterogeneidade de resultados quanto à efetividade da técnica de revascularização pulpar, visto que os critérios estabelecidos para determinação do sucesso variavam entre os autores. O material mais comumente utilizado na técnica empregada consiste no Agregado Trióxido Mineral (MTA) em consistência pastosa aplicada sobre coágulo sanguíneo com formação induzida no interior do canal. Foi observada escassez de estudos laboratoriais e clínicos sobre as técnicas e materiais em revascularização pulpar, que suportem sua indicação, o que representa uma lacuna em potencial na literatura e requer cautela na indicação desta técnica.

Introduction: Immature permanent teeth that evolve to pulp necrosis represent a challenge for endodontic treatment. Regenerative endodontics and pulp revascularization techniques appear as a dynamic and potentially ideal field for clinical therapy in teeth with incomplete root development. Objective: To review the literature on pulpal revascularization techniques in the treatment of teeth with absence of pulp vitality with immature root apex. Methods: The descriptors "pulp revascularization", "pulp necrosis", "immature permanent tooth", "revascularization", "revitalization", "dental pulp" and "regeneration" were used to obtain articles in English that presented content available in full and published in the last 15 years. Works of case reports and/or series of cases were excluded. Conclusion: Reviewed articles presented a heterogeneity of results regarding the effectiveness of the pulp revascularization technique, since the established criteria for determining success varied among the authors. The material most commonly used in the technique used consists of the Mineral Trioxide Aggregate (MTA) in paste consistency applied on blood clot with induced formation inside the canal. A shortage of laboratory and clinical studies on pulp revascularization techniques and materials that support its indication has been observed, which represents a potential gap in the literature and requires caution in the indication of this technique.

Uso racional de antimicrobianos em Odontologia: percepção e conhecimento dos cirurgiões dentistas de Teresina / Rational use of antimicrobials in dentistry: perception and knowledge of Teresina dentists

Introdução: os cirurgiões-dentistas frequentemente empregam antimicrobianos em sua prática clínica a fim de controlar infecções bucais. O emprego indiscriminado de antimicrobianos tem desencadeado resistências bacterianas. Objetivo: determinar o perfil dos cirurgiões-dentistas de Teresina em relação à percepção e conhecimento sobre resistência bacteriana a antimicrobianos e o uso racional destes medicamentos em sua prática clínica. Material e métodos: questionários semiestruturados aplicados aos profissionais com atuação na cidade de Teresina. Os profissionais a participarem foram selecionados aleatoriamente através de uma lista disponibilizada pelo Conselho Regional de Odontologia do Piauí. Foram obtidos 90 questionários totalmente respondidos, que constituiu a amostra final. Resultados: a maioria dos participantes (78,9%) nunca procurou realizar curso de atualização em microbiologia e/ou farmacologia, e relatam que buscam atualizar seus conhecimentos através, principalmente, de artigos científicos (51,1%) e congressos (37,7%). Quanto à percepção dos processos que podem desencadear em resistência bacteriana a antimicrobianos, 74,2% dos participantes consideram que a sua prática clínica pode ocasionar processos adversos e 94,4% consideram que o emprego de posologia correta é o principal meio de prevenir tais processos. Quanto às situações que mais prescreviam antimicrobianos, os cirurgiões-dentistas citaram processos inflamatórios com envolvimento sistêmico (77,7%), procedimentos invasivos em pacientes portadores de válvula cardíaca (74,4%), abscessos dentoalveolares agudos (68,9%), tratamento de pericoronarite (50%), profilaxia antibiótica diante extração de terceiros molares (47,8%), dentre outras. Conclusões: os participantes demonstraram deficiência em conhecimentos sobre os mecanismos de resistência bacteriana e uso racional de antimicrobianos, prescrevendo-os em diversas situações desnecessárias, sugerindo o abuso no uso dos mesmos.

Introduction: dentists often employ antimicrobial agents in their clinical practice in order to control infections of the oral cavity. The indiscriminate use of antimicrobials has triggered resistance bacterial. Objective: to determine the profile of surgeon dentists of Teresina in relation to perception and knowledge about bacterial resistance to antimicrobials and the rational use of these medicines in their clinical practice. Material and methods: questionnaires (semistructured) applied to professionals working in the city of Teresina. Professionals to participate were selected randomly through a list provided by the Regional Council of Dentistry of Piauí. Data was obtained out of 90 questionnaires fully answered, which constituted the final sample. Results: the majority of the respondents (78.9%) never sought to carry out refresher course in microbiology and/or pharmacology, and report that wish to update their knowledge through mainly scientific articles (51.1%) and congress (37,7%). As to the perception of the processes that can trigger in bacterial resistance to antimicrobials, with 74.2% of the participants consider that their clinical practice may result in processes adverse and 94.4% consider that the job of dosage correct is the primary means of preventing such processes. As to the situations that the more it is prescribed antimicrobials, dentists cited the inflammatory processes with systemic involvement (77.7%), invasive procedures in patients with heart valve (74.4%), abscesses dentoalveolares acute (68.9%), the treatment of pericoronarite (50%), antibiotic prophylaxis before extraction of third molars (47,8%), among others. Conclusions: participants showed deficiency in knowledge about the mechanisms of bacterial resistance and rational use of antimicrobial agents, prescribing in some unnecessary situations, suggesting the abuse in the use of the same.

Efetividade de dentifrícios clareadores sobre esmalte de dentes bovinos / Effectiveness of whitening dentifrices on bovine teeth enamel

Introdução: devido à insatisfação relatada pelos pacientes com a coloração dos dentes e a busca por procedimentos que envolvam estética do sorriso associado com o desenvolvimento de técnicas e materiais amplamente propagados na mídia, as empresas responderam com a oferta no mercado de uma variedade de opções de dentifrícios que propõem efeito clareador prático e rápido. Objetivo: avaliar a efetividade de dentífricos clareadores em diferentes formas de apresentação sobre esmalte de dentes bovinos. Material e Métodos: quinze dentes bovinos foram imersos diariamente por um período de 1 hora em refrigerante a base de cola e em seguida foram divididos equitativamente em três grupos, onde cada grupo foi escovado com um dentifrício especifico por 2 minutos. O grupo A foi escovado com dentifrício Colgate Luminous White (Colgate ­ Palmolive), em forma de pasta, o grupo B com dentifrício Closeup Diamond Attraction Delicate White (Unilever) em forma de gel e o grupo C com dentifrício Oral-B Complete (Procter & Gamble) em forma de pasta. Resultados: as diferentes formas de apresentação estudadas foram efetivas na remoção das manchas extrínsecas em dentes bovinos; O dentifrício Colgate Luminous White na forma de apresentação pasta clareador apresentou-se mais efetivo na remoção das manchas extrínsecas; O dentifrício Oral ­ B Complete na forma de pasta foi efetivo, porém em menor intensidade em comparação aos dentifrícios clareadores estudados. Conclusão: as diferentes formas de apresentação dos dentifrícios utilizados foram efetivas na remoção de manchas extrínsecas.

Introduction: due to dissatisfaction reported by patients with tooth staining and the search for procedures involving smile aesthetics associated with the development of techniques and materials widespread on social medias, companies responded by offering to the market a variety of toothpaste choices in order to provide practical and fast bleaching effects. However, these dentifrices appear to have a limited efficiency since they only contain abrasives for the removing of extrinsic tooth stain. Objective: his research aimed to assess the effectiveness of different forms of presentation of bleaching agents on bovine teeth enamel. Methods: daily, fifteen bovine teeth were immersed in cola soft drink for a period of 1 hour and then they were divided into three groups (each group containing five bovine teeth). Each group was brushed with a specific dentifrice for 2 minutes: the group A was brushed with Colgate Luminous White in paste form (Colgate ­ Palmolive); the Group B with Diamond Closeup Attraction Delicate White in gel form (Unilever), and the group C with Oral-B complete in paste form (Procter & Gamble). Results: color change was observed through photographs and analysis of the interpreted samples based on the theoretical background. Conclusion: the dentifrices used were able to remove extrinsic stains and the bleaching dentifrice Colgate Luminous White was more effective as a result in this connection.