Odontogenic Infection and dental Pain negatively impact Schoolchildrens Quality of Life / Infecção odontogênica e odontalgia impactam negativamente a qualidade de vida de crianças escolares

ABSTRACT The aim of this study is to assess the prevalence of odontogenic infection in lowincome Brazilian schoolchildren and evaluate its association with the subjective variables of oral healthrelated quality of life and dental pain. In this crosssectional study, 230 schoolchildren aged eight to ten years old underwent a clinical oral survey in which the DMFT/dmft and PUFA/pufa indexes were measured. Afterward, children responded individually to the Child Perceptions Questionnaire (CPQ810) and selfreports of dental pain were collected. Data were statistically analyzed using MannWhitney or KruskalWallis test with a posttest by Dunn's and Pearson correlation. Of the children evaluated, 42.6% had odontogenic infection and 80% reported experiencing dental pain. Children's age (p = 0.034) and past experience of dental pain (p < 0.002) were associated with odontogenic sepsis, in addition to impairment of their emotional wellbeing (p = 0.008), social welfare (p = 0.009) and overall impact on quality of life (p = 0.019). Toothache intensity (p < 0.001), frequency (p < 0.001) and duration (p < 0.001) were correlated to the overall impact on children's quality of life. The prevalence of odontogenic infection remains high among lowincome Brazilian schoolchildren. Pediatric infection and its related pain induce not only various biological disorders but also impair children's selfperception of quality of life.

RESUMO O objetivo deste estudo foi avaliar a prevalência de infecção odontogênica em crianças escolares brasileiras de baixa renda e analisar a sua associação com as variáveis subjetivas da autopercepção de qualidade de vida relacionada à saúde bucal e dor dentária. Neste estudo transversal, 230 crianças escolares com 8 a 10 anos de idade realizaram exame clínico bucal no qual os índices CPOD/ ceod e PUFA/pufa foram mensurados. Com isso, as crianças responderam individualmente ao Child Perceptions Questionnaire (CPQ810) e relatos de dor dentária foram coletados. Os dados foram estatisticamente analisados utilizandose o teste MannWhitney ou KruskalWallis, com posterior teste da correlação de Dunn e Pearson. Dentre as crianças examinadas, 42,6% apresentavam infecção odontogênica e 80% reportou experiência de dor dentária. A idade (p=0,034) e experiência de dor dentária (p<0,002) das crianças foram associadas à infecção odontogênica, bem como o seu bemestar emocional (p=0,008) e social (p=0,009) e impacto geral na qualidade de vida (p=0,019). Além disso, a intensidade (p<0,001), frequência (p<0,001) e duração (p<0,001) da odontalgia foram correlacionadas com o impacto geral na qualidade de vida da criança. A prevalência de infecção odontogênica permanece elevada em crianças escolares brasileiras. Infecção pediátrica e sua dor relacionada induzem não apenas diversas desordens biológicas, mas também afetam negativamente a autopercepção de qualidade de vida das crianças.

Assessment of the impact of toothache, untreated caries and its consequences on the quality of life among poor Brazilian children / Avaliação do impacto da dor de dente, da cárie não tratada e suas consequências na qualidade de vida de crianças brasileiras

Purpose: to evaluate the impact of dental pain and the consequences of untreated dental caries on the quality of life in children of low social-economic status aged from 8 to 10 years old. Materials and Methods: in this cross-sectional study, 230 children were submitted to a clinical examination in which the caries-pufa ratio was measured, afterward, they answered to two questionnaires: one about their quality of life (CPQ8-10) and the other about dental pain. Data were statistically analyzed through Chi-square, Mann-Whitney or Kruskal-Wallis tests to evaluate the association between the variables with impact on children's OHRQoL. To establish the existence of risk factors among variables and impact on OHRQoL a Poisson Regression model was applied. Results: dental caries (p = 0.003; PR 2.39; 95% CI 1.04­1.56), severity of untreated caries (p = 0.008; PR 2.86; 95% CI 1.13­2.00), toothache (p < 0.001; PR 2.31; 95% CI 1.64­3.27) and PUFA + pufa index (p < 0.023; PR 2.68; 95% CI 1.10­1.87) were associated with and were a predictor factor for impact on overall OHRQoL. All of these variables also had an effect over the social welfare subscale (p ≤ 0.001), whereas caries presence was also statistically linked with the emotional wellbeing subscale (p = 0.008) and dental pain with all four subscales (p ≤ 0.001). Conclusion: untreated dental caries' clinical consequences and dental pain exerted a negative influence on the quality of life of schoolchildren analyzed.(AU)

Objetivo: avaliar o impacto da dor de dente e das consequências da cárie não tratada na qualidade de vida de crianças entre 8 e 10 anos com baixos indicadores socioeconômicos. Métodos: neste estudo transversal, 230 crianças escolares foram submetidas a um exame clínico, no qual foram avaliados seus CPO/ceo (Dentes cariados, perdidos e obturados) e PUFA/pufa (Envolvimento pulpar, ulceração, fístula e abscesso). Em um segundo momento, elas responderam a dois questionários: um sobre a qualidade de vida (CPQ8-10) e outro sobre odontalgia. Os dados foram analisados estatisticamente por meio dos testes de Chi-quadrado, Mann-Whitney ou Kruskal-Wallis, para avaliar a associação entre as variáveis e o impacto na qualidade de vida relacionada à saúde oral (QdVRSO) da criança. Para estabelecer a existência de fatores de risco para impacto na QdVRSO entre as variáveis, um modelo de regressão de Poisson foi aplicado. Resultados: a presença de cárie (p = 0,003; RP 2,39; 95% IC 1,04-1,56), a severidade da cárie não tratada (p = 0,008; RP 2,86; 95% IC 1,13-2,00), dor de dente (p < 0,001; RP 2,31; 95% IC 1,64-3,27) e PUFA/pufa (p < 0,023; RP 2,68; 95% IC 1,10- 1,87) foram associados com impacto na QdVRSO, assim como também foram fatores preditores para o impacto na qualidade de vida relacionada à saúde oral. Todas as então citadas variáveis também exerceram efeito sobre a subescala do bem-estar social (p ≤ 0,001), enquanto a presença de cárie esteve estatisticamente conectada com a subescala do bem-estar emocional (p = 0,008) e a dor dentária com todas as subescalas da QdVRSO (p ≤ 0,001). Conclusão: as consequências clínicas da cárie não tratada e a dor dentária exercem uma influência negativa na qualidade de vida das crianças analisadas.(AU)

Evaluation of pain perception during orthodontic debonding of metallic brackets with four different techniques

Abstract Objective The aim of this study was to evaluate patients' pain levels during four different debonding procedures. The null hypothesis was that the pain perception of the patients undergoing four different debonding applications was not statistically significant different. Material and Methods One hundred and twenty orthodontic patients who underwent orthodontic debonding were included in this study. The patients were randomly divided into 4 groups according to technique used in the patients. Debonding groups were as follows: Group 1) Conventional debonding group, Group 2) Medication group (acetaminophen was given 1 hour before debonding), Group 3) Soft bite wax group, and Group 4) Soft acrylic bite wafer group. The patients' levels of anxiety and fear of pain were evaluated before debonding, and Numerical Rating Scale (NRS) was applied to evaluate their pain perception during debonding. Mann-Whitney U and Kruskal-Wallis tests were used to evaluate non-normally distributed data. Categorical data analysis were carried by chi-square and McNemar tests. The significance level was set at p<0.05. Results Anxiety scores of the patients were not statistically significant between both genders and debonding groups. In the quadrants in which the patients were perceived, the highest pain level was in the left side of the mandible. The teeth in which the highest pain level was perceived were the lower left and upper right lateral incisors. Although there was no statistically significant difference among the pain scores of the patients in each group, quadrant scores of female patients showed significant differences, being the lowest scores in the soft bite wax group. Conclusions Majority of the patients had no fear of pain before debonding. Pain levels of the patients in the conventional debonding group were not significantly different from those of the other groups, except quadrant scores of females in the soft bite wax group. The null hypothesis was accepted.

Dental pain as a determinant of expressed need for dental care among 12-year-old school children in India.

Objective: We have undertaken a cross-sectional study to assess factors associated with dental pain that determine the expressed needs for dental care among 12-year-old school children in India. Materials and Methods: A total of 2 250 school children were surveyed after being drawn through stratified cluster random sampling. The simultaneous effects of sociodemographic characteristics, pain characteristics, and the impact of pain on the quality of life were studied in association with the expressed needs for dental treatment. Results: Among the studied school children, 71.4% suffered from dental pain, only 27.7% expressed need for dental healthcare. Socioeconomic status (SES) was a statistically significant determinant. Pain characteristics like the severity of pain and pain on eating hot and cold foods were significantly associated with expressed needs. Impact characteristics associated with expressed needs were embarrassment in showing teeth, brushing teeth, and difficulty in eating and drinking. Logistic regression analysis yielded a Nagelkerke R 2 value of 0.106. Conclusion: Important determinants of expressed needs for dental care among the studied population were SES, pain intensity, pain on thermal stimuli, impact characteristics like eating/drinking and embarrassment in showing teeth.

The relationship between dental anxiety and dental pain in children aged 18 to 59 months: a study in Recife, Pernambuco State, Brazil / A relação entre ansiedade odontológica e a dor de dente em crianças com idade entre 18 e 59 meses: estudo em Recife, Pernambuco, Brasil

The aim of this study was to evaluate anxiety and pain related to dental treatment in children under the age of five years. This cross sectional study was carried out with 2,735 children of both sexes. Socioeconomic data, dental anxiety and dental pain experience, as well as the assessment of the child's oral health status, were obtained through a questionnaire answered by the child's parent or guardian. Dental anxiety was measured using the Dental Anxiety Question (DAQ). The prevalence of dental anxiety was 34.7 percent and that of dental pain was 9.1 percent. There was an association between these two variables (p < 0.0001). There was also an association between dental pain, age, family income and assessment of oral health status. The poorest rating of the child's oral health and the lowest family income were correlated with the highest percentages of a history of dental pain. Dental anxiety was related to a history of dental pain in children under the age of five years.

Este estudo teve como objetivo avaliar a ansiedade e a dor relacionadas ao tratamento odontológico em crianças menores de 5 anos de idade. Este estudo transversal foi realizado com uma amostra de 2.735 crianças, de ambos os sexos. Por meio da aplicação de um questionário em forma de entrevista com os pais ou responsáveis foram obtidas as seguintes informações: dados sócio-econômicos, ansiedade relacionada ao tratamento odontológico e a experiência de dor de dente, assim como a avaliação dos pais em relação à saúde bucal das crianças. A prevalência de ansiedade odontológica foi de 34,7 por cento e o histórico de dor de dente foi 9,1 por cento. Verificou-se associação entre essas duas variáveis (p < 0,0001). Observou-se também associação entre dor de dente, idade, renda familiar e a avaliação dos pais em relação à saúde bucal das crianças. Saúde bucal comprometida, assim como baixa renda familiar, foram correlacionadas com alta prevalência de histórico de dor de dente. A ansiedade odontológica estava associada ao histórico de dor de dente em crianças menores de 5 anos de idade.

Psicoprofilaxis quirúrgica. Una disciplina que interdisciplina: un trabajo para no quedarnos en silencio / Surgical psychoprophylaxis: A discipline that interdisciplinates: a job done not to remain in silence

A lo largo de este escrito intentaremos destacar la importancia de la relación cirujano/a-paciente en el momento de una intervención quirúrgica. Indagaremos el lugar del dolor desde la precepción tanto del profesional de la salud como así también desde quien en dicha situación oficia de paciente. Utilizaremos frases dichas en los primeros encuentros entre el profesional de la salud y quienes consultan y/o solicitan la intervención para poder reflexionar sobre aquellas significaciones que circulan en el Imaginario Social sobre conceptos tales como: angustia, ansiedad, miedo, vínculo cirujano/a-paciente y dolor. Entendiendo la importancia de la psicoprofilaxis quirúrgica como una herramienta que habilita y posibilita una mejor calidad y ejercicio de la práctica profesional, en tanto tiene en cuenta las posiciones propiamente subjetivas del paciente.

Diferencia entre demanda de alivio y demanda de sufrimiento: un problema clínico / Difference between request of relief and request of pain: a clinical problem

El presente artículo aborda el concepto de dolor discriminando su dimensión orgánica de su dimensión psíquica, para estudiar, a partir de allí, el lugar que este fenómeno tiene en la instauración del lazo social entre odontólogo y paciente. Se definen los conceptos de demanda de alivio y demanda de curación, analizando las consecuencias de cada una en la práctica clínica en odontología. Por último, se indica el rol del odontólogo en la operación de transformación de la demanda de alivio en demanda de curación, con el fin de optimizar las estrategias clínicas en la práctica odontológica