Dental Pain Medication Prescriptions in Minas Gerais, Brazil (2011-2021): A Time-Series Analysis.

To describe trends of dentist-prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics, from January 2011 to December 2021, as well as to examine the relationship between these trends and characteristics of public oral health services in Minas Gerais, Brazil. In this time-series analysis, all drugs were classified according to the Anatomical Therapeutic Chemical classification system. Drugs categorized as NSAIDs (M01A), and other analgesics and antipyretics (N02B) were included for analysis. The outcome was the number of Defined Daily Doses (DDDs)/1000 inhabitants/year for NSAIDs and analgesics in each town. Covariates referred to characteristics of public oral health services, such as coverage, estimates of dental procedures, and frequency of toothache. Linear time-series regression models were used to determine the influence of covariates on the outcome. Overall, there were 58,482 prescriptions of NSAIDs recorded in thirty-eight towns, while 47,499 prescriptions of analgesics in forty-three towns. For each year, there was a 0.38 (p < 0.001), and 0.28 (p < 0.001) increase in the average log of DDD/1000 inhabitants/year for NSAIDs and analgesics, respectively. A positive association was detected between toothache (p < 0.001) and the prescription of NSAIDs. Over the eleven years, there was a general rising trend in the prescriptions. Toothache was the only characteristic of public oral health services associated with the prescription rates of NSAIDs, implying that as the frequency of toothaches increase, so do the prescriptions of NSAIDs in the studied towns.

High prevalence of potential psychotropic drugs interactions among Brazilian dental patients.

OBJECTIVE: To determine the prevalence of potential drug-drug interactions involving psychotropics prescribed by dentists, and dispensed by the public healthcare system, as well as to describe the severity and level of evidence of those interactions in the state of Minas Gerais, Brazil. MATERIALS AND METHODS: We conducted data analysis from pharmaceutical claims in which dental patients received systemic psychotropics in 2017. Data from the Pharmaceutical Management System provided the drug dispensing history of the patients, allowing the identification of those on concomitant medication use. The outcome was the occurrence of potential drug-drug interactions, which were detected according to IBM Micromedex®. Independent variables were the patient's sex, age, and the number of drugs used. Descriptive statistics was performed using SPSS v. 26. RESULTS: Overall, 1480 individuals were prescribed psychotropic drugs. The prevalence of potential drug-drug interactions was 24.8% (n = 366). The total of 648 interactions was observed and, most of which were of major severity (n = 438, 67.6%). Most interactions occurred in female individuals (n = 235; 64.2%), with 46.0 (±17.3) years-old, concurrently taking 3.7 (±1.9) drugs. CONCLUSION: A substantial proportion of dental patients presented potential drug-drug interactions, mostly of major severity, which might be life-threatening.

Association of sociodemographic factors with the prescription pattern of opioids for dental patients: a systematic review.

Aim To evaluate the association of patients' sociodemographic factors (sex, age, ethnicity, income, educational level, living environment and health insurance) with the prescription pattern of opioids provided by oral health practitioners.Methods Observational studies that evaluated the association of patients' sociodemographic factors and the likelihood of receiving an opioid prescription provided by an oral health practitioner were eligible. Electronic searches were conducted in Medline (PubMed), Embase, Scopus, Web of Science, LILACS, SciELO, Google Scholar, and OpenGrey up to March 2021. Two authors independently screened the studies, performed data extraction, and assessed the risk-of-bias using the critical appraisal tools developed by the Joanna Briggs Institute (JBI). Certainty of the evidence was assessed with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).Results Eight studies were included in this systematic review. Publication year ranged from 2011 to 2021. Narrative synthesis showed with very low certainty of evidence that younger individuals were more likely to receive a prescription of opioids than older individuals. Regarding the other sociodemographic factors and the prescriptions of opioids in dentistry, the evidence is controversial. Risk of bias was low for most items assessed in the included studies.Conclusion The available evidence suggests that there is an association between patients' sociodemographic factors and the prescription patterns of opioids provided by oral health practitioners.

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.

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.

Oral hygiene protocols in intensive care units in a large Brazilian city.

This study investigated oral hygiene protocols for patients in intensive care units (ICUs) in 25 of 30 hospitals in Belo Horizonte, Brazil, using a questionnaire. Although all hospital representatives said there was a protocol for the maintenance of patients' oral hygiene, it was observed that there was no standardization. Only 2 hospitals had dentists on the ICU staff. Cetylpyridinium chloride was the most frequently used antiseptic, even in patients under mechanical ventilation.

Perceptions of adolescents and young people regarding endemic dental fluorosis in a rural area of Brazil: psychosocial suffering.

Severe dental fluorosis is endemic in some rural areas of Brazil. This paper describes the psychosocial consequences of this condition and how it has affected the self-esteem of adolescents and young people in a rural area in Brazil. Semi-structured, face-to-face interviews were carried out with 23 adolescents and young people affected by severe dental fluorosis and 14 of their teachers. The study revealed the affected individuals were embarrassed to smile at strangers due to a presumed association between fluorosis and a lack of dental hygiene. Further findings include conflicts between affected and non-affected students at school, problems in pursuing a romantic relationship and uncertainties regarding a professional future. Disbelief and scepticism were observed regarding the ethical position that science can offer a solution to the problems stemming from the disease. Lesions from severe dental fluorosis appear to be a stigmatizing factor and have contributed toward suffering and self-exclusion among an entire generation of adolescents and young people.