Biosafety in Dental Health Care During the COVID-19 Pandemic: A Longitudinal Study.

Background: The coronavirus disease 2019 (COVID-19) pandemic had quite an impact on dental health care. Concerns about the risk of SARS-CoV-2 transmission through contaminant fluids and droplet formation during several dental procedures highly impacted dental health care, drastically reducing the number of dental practices worldwide. To monitor SARS-CoV-2 contamination in dental clinics, a longitudinal study was carried out during the return of dental practice at university. Methods: Dental health care professionals [(DHCPs); teachers, undergraduate dental students, and dental assistants] and patients were screened for SARS-CoV-2 RNA in a dental school clinic environment from 11th January to 12th March 2021 (9 weeks). Serological testing was performed on DHCPs in two-time points. Additionally, samples with low Ct values were sequenced to identify the circulating SARS-CoV-2 variant and possible transmission clusters. Results: We found a low number of dental staff (5.8%), patients (0.9%), and environment sites (0.8%) positive for SARS-CoV-2. Most positive cases had asymptomatic to mild symptoms, and two asymptomatic DHCPs presented prolonged infection. In the first week after previous exposure to COVID-19, 16.2% of DHCPs had IgM or IgG antibodies against SARS-CoV-2, and 1/3 of them had undetected antibodies in the last weeks. The variant zeta (P.2) could be detected. No cross-infection was observed between participants. Conclusion: Our study suggests that dental practice can be safely executed when adequate control measures and biosafety protocols are applied. DHCP and patient testing, patient telemonitoring, proper use of personal protection equipment, and sanitization of surfaces are essential to avoid SARS-CoV-2 cross-infection in dental practice.

Errors in Antibiotic Therapy: Study with Dentist's Prescriptions in a Large Brazilian City

Objective: To evaluate errors in dental prescriptions of antibiotics for therapeutic purpose. Material and Methods: This was a descriptive study using a random and calculated sample of 366 prescriptions (July1 2011 to June 30 2012), from a total of 31 105 dental prescriptions, was surveyed in an important drugstore chain in a large Brazilian city. Data was validated by double entry in Epi-data (EpiData Assoc, Odense M, Denmark) and then analysed in SPSS (version 19.0, Chicago, IL, USA). Statistical analyses included the calculation of proportions with a 95% confidence interval (CI). Results: We identified 272 prescriptions for therapeutic purpose. Prescription errors involved spelling of the antibiotic name, dose, dosing intervals and duration of treatment. A total of 116 prescriptions (42.6%; 95% CI 36.9%-48.6%) were considered to be totally correct with regard to the generic name, dose, dosing interval and duration of the antibiotic therapy. Most of the antibiotics prescribed by dentists showed errors related to the name, dose, intervals and duration of treatment. Conclusion: These errors may compromise the effectiveness of drug therapy, contribute to microbial resistance and increase the risk of adverse events and costs of treatment.

Factors associated with anterior open bite in children with developmental disabilities.

AIM: To investigate factors associated with anterior open bite in individuals aged from 2 to 33 years with developmental disabilities. DESIGN: This is a cross-sectional study. A total of 271 dental records were examined. The anterior open bite analyzed was determined based on clinic exam. These variables were also analyzed: gender, age, education level of mother, International Code of Diseases (ICD), mouth breathing, use of anticonvulsant drugs, hyperkinesis, pacifier use, thumb sucking, seizure, and involuntary movements. For the purposes of analysis, the individuals were categorized as being with and without anterior open bite. Variables with a p-value of < 0.25 in the bivariate analysis were incorporated into the logistic regression models. RESULTS: Mouth breathers had a 2.60-fold (95% CI: 1.35-5.01) greater chance of exhibiting anterior open bite than nasal breathers. Pacifier users are more likely to have an anterior open bite (3.32-fold, 95% CI: 1.62-6.77). Individuals with reported involuntary movements had a 2.66-fold (95% CI: 1.26-5.63) greater chance of exhibiting anterior open bite. Users of anticonvulsants drugs had a 3.05 (95% CI: 1.57-5.92) greater chance of showing anterior open bite. CONCLUSION: Involuntary movements, mouth breathing, using anticonvulsant drugs, and using pacifier are factors associated with anterior open bite in patients with developmental disabilities.

Oral Health Status among Girls with Developmental Disabilities: A Cluster Analysis

Objective: To investigate the factors that influence oral health of girls, with developmental disabilities, attended by a dental service. Material and Methods: A Cross-sectional epidemiological study was carried out using information collected from 171 dental charts of children aged one to 13 years, with developmental disabilities who were treated between 1998 and 2013. Studied variables were: dental caries, gingivitis, bruxism, xerostomia, ingestion of cariogenic food and oral hygiene. Statistical analysis was performed using proportion calculations of each variable and by cluster analysis. Results: Three types of clusters were formed from girls based on three variables (presence of dental caries, gingivitis and bruxism). The choice of two clusters was due to a better understanding of the phenomenon (oral conditions). There was an average of 0.77 of deciduous and 0.21 permanent decayed teeth. Cluster 1 is composed of younger children with lower caries and gingivitis experiences; lower proportion of xerostomia and ingestion of cariogenic food, higher proportion of good oral hygiene and more bruxism experience. Conclusions: Dental caries and gingivitis among girls with developmental disabilities are influenced by factors whose relation of cause and effect has been discussed in the literature. Bruxism is a protective factor against these diseases.Results reinforce the need for early preventive interventions in this population.

Postoperative complications after dental extraction in liver pretransplant patients.

OBJECTIVES: The liver pretransplant phase requires the interaction of -multidisciplinary teams for optimal patient outcomes, including dental -professionals. In this study, we sought to estimate the prevalence of complications related to dental extraction in liver transplant candidates. MATERIAL AND METHODS: This study is a case series of patients eligible for liver transplants referred for dental treatment between 2012 and 2014. Eligible patients for this study underwent at least one tooth extraction, had a complete blood count at the time of the procedure, and were candidates for liver transplantation. RESULTS: Forty-three patients, 12 women (28%) and 31 men (72%), with an -average age of 50.9 ± 11.4 years, had received a total of 116 dental extractions. The prevalence of postoperative complications was 1.7% including two bleeding episodes in the same patient. Seven patients presented a platelet count below 50 × 10³/µL and received platelet transfusions preoperatively. CONCLUSIONS: Postoperative complications following dental extractions in liver transplant candidates are unusual. CLINICAL RELEVANCE: Low postoperative complications prevalence indicates that dental surgical procedures may be safety performed in patients eligible for liver transplantation after careful -preoperative evaluation.

Factors associated with mouth breathing in children with -developmental -disabilities.

OBJECTIVE: To investigate the prevalence and factors associated with mouth breathing among patients with developmental disabilities of a dental service. METHODS: We analyzed 408 dental records. Mouth breathing was reported by the patients' parents and from direct observation. Other variables were as -follows: history of asthma, bronchitis, palate shape, pacifier use, thumb -sucking, nail biting, use of medications, gastroesophageal reflux, bruxism, gender, age, and diagnosis of the patient. Statistical analysis included descriptive analysis with ratio calculation and multiple logistic regression. Variables with p < 0.25 were included in the model to estimate the adjusted OR (95% CI), calculated by the forward stepwise method. Variables with p ​​< 0.05 were kept in the model. RESULTS: Being male (p = 0.016) and use of centrally acting drugs (p = 0.001) were the variables that remained in the model. CONCLUSION: Among patients with -developmental disabilities, boys and psychotropic drug users had a greater chance of being mouth breathers.

Factors Associated with Gingivitis in Children with Developmental Disabilities

Objective: To investigate factors associated with gingivitis in children aged one to 13 years with developmental disabilities. Material and Methods: A total of 408 dental records were used to recover the data. Gingivitis was measured based on the Modified Gingival Index. Other variables were also analysed: gender, age, International Classification of Diseases (ICD) code, mouth breathing, history of gastroesophageal reflux, use of psychotropic drugs, reports of dry mouth, history of asthma, use of medications to treat asthma, oral hygiene, dental caries, and filled or missing teeth in deciduous or permanent dentition. For the purposes of this analysis, the individuals were categorized as with and without gingivitis. Variables with a p-value < 0.25 in the bivariate analysis were incorporated into the logistic regression models (ICD, reflux, oral hygiene, primary tooth decay or filling, mouth breathing, dry mouth and use of psychotropic drugs). Results: We found a 14.67% prevalence of gingivitis. Individuals with mouth breathing had a 2.574-fold (95% CI: (1.113-5.950) greater chance of exhibiting gingivitis. Individuals with moderate oral hygiene had a 2.763-fold (95% CI: 1.066 to 7.160) greater chance of exhibiting gingivitis, and individuals with poor oral hygiene had a 15.029-fold (95% CI: 3.705-60.965) greater chance of exhibiting gingivitis than those with good oral hygiene. Conclusion: Moderate or poor oral hygiene and mouth breathing are factors associated with gingivitis in a group of patients with developmental disabilities at a dental service in Belo Horizonte.

Prescribing errors in antibiotic prophylaxis by dentists in a large Brazilian city.

Prescribing errors may contribute to antibiotic resistance and other drug-related problems. To investigate the quality of prescriptions involving antibiotic prophylaxis by dentists in a large Brazilian city, 366 dental prescriptions were randomly selected from 31,105. A prophylaxis indication represented 24.9% of the prescriptions, and only 12 (13.2%; 95% confidence interval, 7.7%-21.7%) were correct regarding the generic name, dose, and length of antibiotic use. Prescriptions for antibiotic prophylaxis by dentists are mostly inadequate in this city.

Complete removable prostheses: from expectation to (dis)satisfaction.

OBJECTIVE: The purpose of this survey was to increase our knowledge on the experience and feelings of edentulous people, 6 months after having acquired and worn a pair of complete removable prostheses. BACKGROUND: The incorporation of conventional, complete removable prostheses may be an appropriate treatment which can result in an improvement in the quality of life of people who have lost their teeth. METHODS: The 12 patients of the sample were interviewed individually according to a semi-structured questionnaire so as to create an atmosphere for open conversation regarding the subject matter. For each participant, photographs, before dental treatment and after the use of the prostheses, were taken. The images of the prostheses were reviewed and impressions were collected. RESULTS: The analysis of participant's statements allowed one to verify if the complete removable prostheses improved the quality of life; however, difficulties encountered could lead users to abandon their prostheses. CONCLUSION: Appropriate investment on the part of health professionals, together with the clarification of information and the monitoring of patients, may well minimise these difficulties.

A importância do ensino danotificação de doenças / The importance of teaching disease notification

Notificação é a comunicação da ocorrência dedeterminada doença ou agravo à saúde, feita à autoridadesanitária por profissionais de saúde ouqualquer cidadão, desencadeando o processo deinformação-decisão-ação. A Notificação é o principalmecanismo através do qual o Ministério da Saúderecebe os dados epidemiológicos necessáriospara a adoção de medidas de intervenção cabíveis.No Brasil, são de notificação compulsória os casosde doenças que podem implicar em medidas deisolamento ou quarentenas, e aquelas que constamde uma lista elaborada pelo Ministério da Saúde,adaptada para cada Unidade da Federação e atualizadaperiodicamente. Apesar da importância e daobrigatoriedade, a notificação tem sido precária,sendo a subnotificação um problema para o sistemade saúde. Existe pouca literatura sobre o assunto,resumindo-se a publicações oficiais como leis, portariasetc. Faz-se necessária uma maior divulgaçãodo assunto em revistas de grande circulação, entreos profissionais de saúde e os futuros profissionais,e até para a população em geral, que é parte importanteda informação sobre ocorrência de doenças.Este artigo tem como objetivo divulgar as doençasde notificação compulsória aos profissionaisde saúde, e refletir sobre a importância da conscientizaçãodo futuro profissional de Odontologiasobre seu papel na manutenção do Sistema de VigilânciaEpidemiológica.