Factors associated with the number of filled teeth in adolescents from public schools: a cohort study

Abstract This study aimed to assess the association of demographic conditions, socioeconomic status, clinical variables, and psychosocial factors with the number of filled teeth in adolescents from public schools. This cohort study comprised 1,134 12-year-old adolescents enrolled in public schools in Santa Maria, Brazil, in 2012. They were followed-up in 2014, where 743 individuals were reassessed (follow-up rate of 65.52%) for the number of filled teeth. Data were collected via dental examinations and structured interviews. Demographic and socioeconomic characteristics were collected from parents or legal guardians. The psychosocial factor comprised students' subjective measurement of happiness (Brazilian version of the Subjective Happiness Scale - SHS). Dental examinations were performed to assess the number of filled teeth through decay, missing, and filled teeth index (DMF-T). Unadjusted and adjusted Poisson regression analyses were performed to assess the association between baseline variables and filled teeth at follow-up. The number of filled teeth in 2012 and 2014 were 193 (17.02%) and 235 (31.63%), respectively. The incidence of filled teeth in 2014 was 42 (5.65%). Adolescents with untreated dental caries, those who visited the dentist in the last 6 months, those that exhibited being happier, and those who had filled teeth at baseline were associated with a higher number of filled teeth at follow-up. We conclude that the number of filled teeth in adolescents was influenced by clinical and psychosocial factors, emphasizing the need to focus on oral health policies in individuals with higher disease burden and those who feel psychologically inferior.

Adaptação infantil ao tratamento odontológico: relato de caso / Child adaptation to dental treatment: a case report

Na odontopediatria, o ambiente odontológico gera medo e ansiedade, demonstrados de diversas formas pela criança, de modo que há necessidade de promover sua adaptação para que entenda o processo e se sinta parte dele. É importante, ainda, que se identifiquem situações em que o desconforto estético possa gerar constrangimento na convivência diária das crianças. Objetivo: relatar um caso clínico de resolução de comprometimento estético causado por defeito de desenvolvimento do esmalte (DDE) e utilização de técnicas de adaptação de comportamento. Relato de caso: uma paciente do sexo feminino, 3 anos de idade, nascida prematura, apresentava DDE no incisivo central superior esquerdo, que, ao sorrir, cobria com as mãos. O perfil da criança foi avaliado e, a partir das suas características, foram escolhidas as técnicas de dizer-mostrar-fazer, controle de voz, reforço positivo, distração e repetição, usando-as de forma associada para melhores resultados, considerando a necessidade da repetição das visitas ao consultório. Após cinco consultas, foi possível realizar a restauração com resina fotopolimerizável, restabelecendo a estética e o conforto para a criança. Considerações finais: para o atendimento odontológico de crianças, é de fundamental importância conhecer técnicas de manejo infantil e usá-las de acordo com as necessidades individuais, com a finalidade de tornar as crianças participativas no processo, diminuindo a ansiedade, o medo e as reações que podem dificultar ou impedir o atendimento. (AU)

In pediatric dentistry, the clinical environment generates fear and anxiety, which children show in a number of ways, causing the need to promote their adaptation so they understand the process and feel part of it. It is also important to identify situations in which the aesthetic discomfort may lead to embarrassment in the daily lives of the children. Objective: to report a clinical case of resolution of aesthetic impairment caused by the developmental defect of enamel (DDE) and the use of behavioral adaptation techniques. Case report: female patient, three years old, born premature, presented DDE in the upper left central incisor and, when smiling, covered it with her hands. The profile of the child was evaluated and, based on her characteristics, the techniques of tell-show-do, voice control, positive reinforcement, distraction, and repetition were chosen and used in association for better results, considering the need for repeat visits to the dental office. After five consultations, it was possible to perform the restoration with light-curing resin, restoring the aesthetics and comfort of the child. Final considerations: for the dental care of children, it is essential to know child management techniques and use them according to the individual needs, with the purpose of promoting the participation of the children in the process, decreasing their anxiety, fear, and reactions that may hinder or prevent the treatment. (AU)

Percepção de responsáveis sobre medo odontológico e técnica alternativa para remoção de cárie / The caregivers’ perception of dental fear and alternative technique for caries removal

O objetivo deste estudo foi avaliar a percepção de responsáveis sobre os fatores preditores de medo odontológico infantil e aceitação de uma técnica alternativa (abrasão ultrassônica) para a remoção de cárie. Cento e sessenta e dois responsáveis por crianças atendidas em uma instituição pública responderam a um questionário semiestruturado. A média de idade das crianças foi de 9 anos, sendo 52,5% meninos. Resultados mostraram que, gostavam de ir ao dentista 73,5% e 34% apresentavam-se nervosas/ansiosas antes de serem atendidas. A maioria dos responsáveis julgou importante a realização de estudos para descoberta de novos métodos para substituição do motor (p> 0,05) e autorizariam a utilização da abrasão ultrassônica (p > 0,05). Conclui-se que, aproximadamente, metade das crianças tinha medo ou ficavam ansiosas durante o atendimento, e que os responsáveis são receptivos à utilização de técnicas alternativas de remoção de cárie.

Dental esthetic satisfaction, received and desired dental treatments for improvement of esthetics.

Aim: The purposes of this research were to investigate factors influencing patients' satisfaction with their present dental esthetic, received previous dental treatments on anterior teeth and basic treatments that they wanted to undergo to improve their dental appearance. Materials and Methods: A total of 1014 patients who attended a dental school in a major city in Turkey participated in the study. The participants were surveyed with a questionnaire containing questions about gender, age, education level, self-reported tooth appearance, received previous dental treatments on anterior teeth and desired basic esthetic dental treatments. Statistical analysis of the verifying data was made with descriptive statistics, χ2 test and multiple logistic regression analyses. Results: According to the analyses of the verifying data, 55.1% of the patients were dissatisfied with the color of their teeth, 42.7% with dental appearance, 29.9% with crowding of anterior teeth, 23.3% were hiding teeth while smiling, 16.1% had non-esthetic restorations and 11.9% thought that their anterior teeth were protruding. Esthetic restoration was found to be the most-performed treatment recently (29.0%) and whitening of teeth was the most-desired dental treatment (49.0%). Gender, age and education level had an effect on satisfaction and received previous and desired dental treatments for improvement of esthetics. Conclusion: Many of the Turkish patients surveyed in the study were dissatisfied and desired the improvement of dental esthetics. Therefore, dentists should consider this as an important dimension in their practice.

A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients.

Pain is not the sole reason for fear of dentistry. Anxiety or the fear of unknown during dental treatment is a major factor and it has been the major concern for dentists for a long time. Therefore, the main aim of this study was to evaluate and compare the two distraction techniques, viz, audio distraction and audiovisual distraction, in management of anxious pediatric dental patients. Sixty children aged between 4-8 years were divided into three groups. Each child had four dental visits--screening visit, prophylaxis visit, cavity preparation and restoration visit, and extraction visit. Child's anxiety level in each visit was assessed using a combination of four measures: Venham's picture test, Venham's rating of clinical anxiety, pulse rate, and oxygen saturation. The values obtained were tabulated and subjected to statistical analysis. It was concluded that audiovisual distraction technique was more effective in managing anxious pediatric dental patient as compared to audio distraction technique.

Avaliação clínica da técnica de tratamento restaurador atraumático associada ao Carisolv® em pacientes com deficiência mental / Clinical evaluation of the atraumatic restorative technique associated with Carisolv® in patients with mental impairment

Este estudo teve o objetivo de analisar a durabilidade de restaurações confeccionadas pela técnica de Tratamento Restaurador Atraumático (ART), realizadas em associação ou não ao emprego do Carisolv® em pacientes com deficiência mental. O protocolo foi aprovado pelo Comitê de Ética local e obteve-se o consentimento livre e esclarecido dos responsáveis. Dos 26 pacientes com deficiência mental que participaram desta pesquisa, 14 eram do sexo masculino e 12 do feminino; tinham entre oito a dezesseis anos (mediana e semi-amplitude interquartílica de 12 anos ± 1,50). As condições dentais e de higiene bucal puderam ser avaliadas pelos índices CPO-D, que foi igual a 6,27 (desvio padrão de 3,26); e IPV (índice de placa gengival) com resultado de 57,30 (desvio padrão de 25,79). Cada paciente selecionado recebeu pelo menos uma restauração da técnica ART (controle) e outra modificada em associação com Carisolv®, aleatoriamente escolhidas para tratamento. O número de dentes tratados foi 52 sendo 26 com a técnica ART (T1) e 26 com a técnica ART associada a Carisolv® (T2). Este grupo de pacientes com deficiência mental precisou de uma média de duas sessões de condicionamento cada. Quanto à profundidade cavitária, apenas dois dentes do total analisado foram considerados com cavidades profundas, os quais foram restaurados coincidentemente com a mesma técnica (T1), as outras cavidades se distribuíram igualmente entre rasas e médias. Quanto à dificuldade encontrada pelo operador no momento da remoção do tecido cariado, considerando-se as duas técnicas (T1 e T2) os registros foram muito próximos, isto é, a técnica de remoção mecânica do tecido cariado (T1) e a técnica de remoção química-mecânica (T2) apresentaram o mesmo grau de dificuldade. Como cada paciente foi submetido às duas técnicas, foi possível avaliar o grau de dificuldade sentida pela profissional...

This study analyzes the durability of restorations accomplished by the Atraumatic Restorative Technique (ART), with or without utilization of Carisolv® in patients with mental impairment. The study design was approved by the local Institutional Review Board and the caretakers of patients signed an informed consent term. Among the 26 patients with mental impairment included in this study, 14 were males and 12 were females; patients were aged 8 to 16 years (median and interquartile semi-amplitude 12 years ± 1.50). The dental and oral hygiene status were evaluated by the DMFT index, which revealed a mean value of 6.27 (standard deviation 3.26); and GPI (gingival plaque index) with a mean value of 57.30 (standard deviation 25.79). Each patient received at least one restoration by the ART technique (control) and another restoration by the modified technique associated with Carisolv®, randomly selected for treatment. Overall, 52 teeth were treated, being 26 by the ART technique (T1) and 26 by the ART technique associated with Carisolv® (T2). ...

Eficacia de la técnica de modelado con video preoperatorio en pacientes de 4 a 6 años de edad / Efficacy of the modeling technique with preoperative video in 4- to 6-year-old patients

Este estudio se realizó para evaluar el comportamiento de niños de difícil manejo utilizando la técnica de modelado con video. La muestra consistió en 15 niños con experiencia odontológica previa, cuyo comportamiento fue clasificado como definitiva o levemente negativo de acuerdo a la escala de Frankl. Cada niño se atendió en dos citas: en la primera se sometió a un tratamiento restaurador convencional; previo a la segunda cita, los pacientes observaron un video donde se mostró la atención de un niño de buen comportamiento. Inmediatamente después, recibió tratamiento similar al de la primera cita. Todos los procedimientos fueron grabados y editados para ser evaluados por un juez, previamente estandarizado, quien clasificó el comportamiento de los niños en cada momento operativo y en forma global para cada cita. Al comparar el comportamiento de las dos citas, se encontró que hubo una mejoría del 53.3 por ciento (p=0.25 por ciento) durante la aplicación de la anestesia, 73.3 por ciento (p=0.02) durante el tallado de la cavidad y 60 por ciento (p=0.001) al momento de la restauración. En la evaluación global, la técnica de mostró ser efectiva en el 80 por ciento de los pacientes (p=0.008). Se concluyó que la técnica puede ser efectiva cuando es utilizada en niños de 4 a 6 años con comportamientos levemente negativos, logrando éxito en el mejoramiento del comportamiento disruptivo

Estética: a polêmica da beleza / Esthetics: the polemic for good look

Modismo, exploraçäo comercial ou futuro? As discussöes sobre a estética estäo esquentando. Apesar de polêmicos e, às vezes, pouco firmes, os argumentos, tanto pró como contra, deixam a impressäo bastante favorável de que, no final, quem sai ganhando é a odontologia