ABSTRACT
CONTEXT: It is not clear if an oral hygiene protocol to control biofilm applied before cardiac surgery can reduce infection rates. OBJECTIVE: We aim to verify the effectiveness of an oral hygiene protocol in reducing postoperative infections when compared to usual practices, in patients admitted to a cardiology unit, prior to cardiac surgery. DESIGN, SETTING AND PARTICIPANTS: Randomized, blind, controlled clinical trial, with 107 participants who expected to undergo cardiac surgery, randomized into two groups: Experimental Group (EG) standardized oral hygiene protocol (54) and Control Group (CG), usual practices performed in patients admitted (53). INTERVENTION: a standardized oral hygiene protocol, 1 day before surgery: professional prophylaxis with a portable ultrasound device, tooth brushing and flossing plus a 0.12% chlorhexidine gluconate solution (0.12% CHX) mouth rinsing. When applicable, removable prostheses cleaning. PRIMARY OUTCOME: the presence of infection. RESULTS: The occurrence of postoperative infection was higher in CG = 7 (13.2%) than in EG = 5 (9.3%); but no statistical difference was found between protocols (p = 0.518). The length of stayed from surgery to discharge presented a statistical difference (p = 0.047; RR = 4.9; CI = 1.01-24.33); the percentage of postoperative infection was almost five times higher in those participants who stayed 11 or more days. CONCLUSION: The standardized oral hygiene protocol with mechanical and chemical cleaning, 1 day before cardiac surgery, was not more effective than the usual practices performed regarding the reduction of postoperative infections. Other interventions regarding oral hygiene procedures before cardiac surgery must be studied to contribute to the reduction of adverse post-surgical events. CLINICAL TRIAL REGISTRATION: Site Ensaclinicos.gov.br number U1111-1214-2862. DESCRIPTORS: Healthcare Associated Infections, Cardiovascular Diseases, Periodontal Diseases, Dental Biofilm, Cardiovascular Surgery.
ABSTRACT
Abstract Objective: to analyze the teaching of geriatric dentistry from the perspective of the National Curricular Guidelines (NCG) for undergraduate courses in dentistry in South American countries. Method: an exploratory and descriptive study with a qualitative approach was carried out, covering the dental schools of public universities in five South American countries which included a geriatric dentistry module in their curriculums. Twenty intentionally selected participants were included. Semi-structured open interviews were recorded using digital media and the content was analyzed using the Thematic Analysis technique with Atlas-Ti® software, based on the current NCG in each country. Results: the NCG evaluated in the five countries were similar in terms of the norms that guide the education of the dental surgeon. Three categories of analysis were identified: professional profile, skill development and the geriatric dentistry teaching-learning process for the undergraduate student. Conclusions: dentistry teaching has sought to connect with the NCG. However, the simple insertion of a geriatric dentistry module in the curriculum is not sufficient to promote a teaching-learning process that allows the student to develop skills to provide better care for the elderly.
Resumo Objetivo: Analisar o ensino da odontogeriatria sob a perspectiva das Diretrizes/Normas Curriculares Nacionais (DCN) para cursos de graduação em odontologia em países da América do Sul. Método: Trata-se de um estudo de caráter exploratório, descritivo com abordagem qualitativa. O universo do estudo abrangeu os cursos de odontologia de universidades públicas de cinco países da América do Sul, os quais incluíam a disciplina de odontogeriatria em sua matriz curricular. Participaram 20 docentes que ministram a disciplina, selecionados intencionalmente. Foram realizadas entrevistas abertas semiestruturadas, gravadas em meio digital e analisadas por meio da técnica de Análise Temática, com o auxílio do software Atlas-Ti®, à luz das DCN vigentes nos países. Resultados: As DCN dos cursos de odontologia dos cinco países estudados apresentam similitudes com relação às normas que direcionam a formação do futuro cirurgião-dentista. Foram identificadas três categorias de análise: Perfil do formando egresso/profissional, Desenvolvimento de competências e Ensino-aprendizagem em odontogeriatria para a formação do aluno de graduação em odontologia. Conclusões: O ensino da odontogeriatria tem procurado estabelecer uma ligação com as orientações das DCN. Entretanto, somente a inserção da disciplina de odontogeriatria na matriz curricular dos cursos de graduação não é suficiente para promover um processo de ensino-aprendizagem que permita ao aluno desenvolver competências para uma melhor atenção à saúde bucal dos idosos.
