Alterações sistêmicas e bucais em pacientes usuários de cocaína: uma revisão integrativa da literatura / Cambios sistémicos y orales em pacientes consumidores de cocaína: una revisión bibliográfica integradora / Systemic and oral changes in cocaína-using patients: an integrative literature review

Introdução: A utilização de cocaína é bastante associada ao surgimento de algumas manifestações sistêmicas e também de algumas alterações orais. Objetivo: Identificaras alterações sistêmicas e bucais mais comuns a pacientes usuários de cocaína. Metodologia: Trata-se de uma revisão sistemática da literatura, considerando artigos com texto completo, com restrição de idioma em Português ou Inglês e que tenham sido publicados entre os anos de 2017 a 2022. Usou-se as bases de dados LiLaCS, MedLine e BBO, por via portal Biblioteca Virtual de Saúde, e SciELO. Os artigos excluídosf oram aqueles que não apresentaram relação explícita do uso de cocaína com alguma manifestação sistêmica e/ou bucal. Resultados: Após o processo de triagem,10 artigos foram salvos para serem analisados e 111 foram descartados por não atenderem aos critérios de inclusão. Dos 10 artigosselecionados,40% deles (n=4) trouxeram informações identificando possíveis riscos de desenvolvimento de doenças cardiovasculares sofridas pelos usuários de cocaína, 10%(n=1) identificou problemas cognitivos associados ao uso da cocaína,30% dos artigos (n=3) mostrou as alterações bucais associadas à utilização abusiva de cocaína. Conclusões: Houve a predominância de algumas manifestações sistêmicas e bucais nos indivíduos usuários de cocaína, como doenças cardiovasculares, xerostomia, perfurações no palato, etc. A partir disso, há algumas alterações sistêmicas e bucais provocadas por esse uso. Mediante o risco considerável, faz-se necessário que o Cirurgião-Dentista se atualize sobre essas alterações em pacientes usuários de cocaína visando promover um trabalho transdisciplinare multiprofissional para atender adequadamente às suas necessidades (AU).

Introduction: The use of cocaine is closely associated with the appearance of some systemic manifestations and also some oral alterations.Objective: To identify the most common systemic and oral alterations in cocaine-using patients.Methodology:This is a systematic review of the literature, considering full-text articles, with a language restriction of "Portuguese" or "English" and published between 2017 and 2022. We used the LiLaCS, MedLine and BBO databases, via the Virtual Health Library (VHL) portal, and SciELO.The articles excluded were those that did not explicitly relate cocaine use to some systemic and/or oral manifestation.Results: After the screening process, 10 articles were saved for analysis and 111 were discarded because they did not meet the inclusion criteria. Of the 10 articles selected, 40% (n=4) provided information identifying possible risks of developing cardiovascular diseases suffered by cocaine users, 10% (n=1)identified cognitive problems associated with cocaine use, 30% of the articles (n=3) showed oral alterations associated with cocaine abuse.Conclusions: There has been a predominance of some systemic and oral manifestations in cocaine users, such as cardiovascular diseases, xerostomia, perforations in the palate, etc. Based on this, there are some systemic and oral alterations caused by this use. Given the considerable risk, it is necessary for dentists to be up-to-date on these alterations in cocaine-using patients in order to promote transdisciplinary and multi-professional work to adequately meet their needs (AU).

Introducción: El consumo de cocaína está estrechamente asociado a la aparición de algunas manifestaciones sistémicas y también de algunas alteraciones orales. Objetivo:Identificar las alteraciones sistémicas y bucales más frecuentes en los consumidores de cocaína. Metodología: Se trata de una revisión sistemática de la literatura, considerando artículos a texto completo, con restricción de idioma en "portugués" o "inglés" y publicados entre 2017 y 2022. Se utilizaron las bases de datos LiLaCS, MedLine y BBO, a través del portal Biblioteca Virtual en Salud (BVS) y SciELO. Los artículos excluidos fueron aquellos que no mostraban una relación explícita entre el consumo de cocaína y alguna manifestación sistémica y/o oral. Resultados: Tras el proceso de cribado, se guardaron10 artículos para el análisis y se descartaron 111 por no cumplir los criterios de inclusión. De los 10 artículos seleccionados, el 40% (n=4) proporcionaba información que identificaba posibles riesgos de desarrollar enfermedades cardiovasculares sufridaspor consumidores de cocaína, el 10% (n=1) identificaba problemas cognitivos asociados al consumo de cocaína, el 30% de los artículos (n=3) mostraban alteraciones orales asociadas al abuso de cocaína.Conclusiones:Ha habido un predominio de algunas manifestaciones sistémicas y orales en los consumidores de cocaína, como enfermedades cardiovasculares, xerostomía, perforaciones en el paladar, etc. De acuerdo con esto, existen algunas alteraciones sistémicas y orales causadas por este uso. Dado el considerable riesgo, es necesario que los odontólogos estén al día sobre estas alteraciones en los pacientes consumidores de cocaína, con el fin de promover el trabajo transdisciplinar y multiprofesional para atender adecuadamente sus necesidades (AU).

Assessing dental surgeons' understanding of bisphosphonates: Implications for patient health in oral surgery.

Objectives: This study aimed to analyze the knowledge of dental surgeons concerning the pharmacological effects of bisphosphonates (BP) and their impact on the health of patients undergoing oral surgery treatment. Materials and methods: A quantitative study was conducted with professionals in the Cariri region of Ceará, Brazil. The data were collected using a semi-structured questionnaire to interview the dental surgeons who met the inclusion criteria. The data were analyzed by Chi-square and Fischer's Exact tests using the SPSS program version 22.0. Results: The results indicated that most interviewed subjects have no experience with the dental treatment of individuals under treatment with bisphosphonates. When a sample of the medication was presented, a significant number of the participants (65.3%) did not recognize the drug. Among those who recognized it, 66.5% did not know how to treat bisphosphonate-using patients in the clinical routine. However, 95.1% of the professionals who recognized the need to discontinue these drugs admitted contacting the prescriber to establish the best dental conduct. Our results also showed that recently graduated professionals better understood the need to stop BP use before invasive treatment, although they did not know the protocol. Conclusion: In conclusion, a better knowledge of the pharmacological effects of BP is crucial for conducting adequate anamnesis, requesting additional tests, and performing medical monitoring, which has a significant impact on the clinical practice of dental surgeons.

Interproximal Reduction Facilitating Orthodontic Teeth Extraction.

Extractions are routinely performed in orthodontics to gain space for teeth alignment. Crowded, malaligned, and overlapped teeth make it difficult for the dental surgeon to engage the beaks of the extraction forceps on the concerned tooth for extraction. An improper grip often leads to complications of instrument slippage, crown fracture, and more commonly, luxation of adjacent teeth. This article aims to help with atraumatic orthodontic extractions and reduce such complications. This case report examines an interproximal reduction technique using standard grit, taper, flat-end diamond bur (Mani TF-20, ISO 171/014, Mani, Inc., Tochigi, Japan) for the tooth to be extracted to create enough space for proper placement of the forceps and to prevent injury to adjacent structures. It can be useful for orthodontic extractions or other cases of tooth extractions with inadequate access.

Atenção odontológica aos pacientes diabéticos no contexto da equipe multiprofissional / Dental care for diabetic patients in the context of the multidisciplinary team

O objetivo deste trabalho é analisar as práticas assistenciais multiprofissionais aos portadores de Diabetes Mellitus nos serviços públicos de saúde, levando-se em consideração a atenção à saúde bucal desses pacientes, com o intuito de propiciar assistência qualificada, melhores condições de saúde e, consequentemente, aliviar a carga econômica sobre o sistema de saúde e a sociedade. Para esse fim, foi realizada uma revisão da literatura de abordagem qualitativa via levantamentos bibliográficos, documental e da literatura cinzenta nas principais bases de dados eletrônicas, tais como: Scielo, PubMed, Portal Regional da Biblioteca Virtual de Saúde, Embase e Oasisbr. Estudos comprovam a importância da atenção multiprofissional aos portadores de diabetes e sugerem dificuldades na integração do cirurgião-dentista nas equipes de saúde apesar da relação definida entre diabetes e manifestações bucais, tornando necessário mais estudos sobre o tema e capacitação dos profissionais envolvidos com vistas a qualificação da assistência aos portadores de Diabetes Mellitus.

The objective of this study is to analyze the multidisciplinary care practices for patients with Diabetes Mellitus in public health services, taking into account the oral health care of these patients, with the aim of providing qualified assistance, better health conditions and, consequently, alleviating the economic burden on the health system and society. Therefore, a qualitative literature review was carried out through bibliographic, documentary and gray literature surveys in the main electronic databases such as: Scielo, PubMed, Regional Portal of the Virtual Health Library, Embase and Oasisbr. Studies prove the importance of multiprofessional care for people with diabetes and suggest difficulties in the integration of dentists into health teams, despite the defined relationship between diabetes and oral manifestations, which makes further studies on the subject and training of professionals involved with a view to the qualification of assistance to patients with Diabetes Mellitus.

A Study on Digit Sucking Among Children Presented to a Tertiary Care Paediatric Clinic in Sri Lanka.

Background Sucking habits are common among children, especially in early childhood. There is, however, controversy about its prevalence probably due to under-reporting. The objective of this study is to analyze the demographic factors, reasons for clinic attendance, and treatment options chosen by parents and health care providers to control digit sucking. Material and methods A retrospective cross-sectional study was conducted including 82 children presented to the paediatric clinic, Teaching Hospital, Batticaloa, with digit sucking over a period of three years from November 2017 to October 2020. The data was analyzed using SPSS version 19.0 (IBM Corp., Armonk, NY, USA). Results Eighty-two children were enrolled in this study. The majority (n=29, 35.4%) of them presented between seven months to two years, and very few (n=3, 3.6%) presented after five years. Female children outnumbered males (50: 32). Only 24 (29.3%) mothers had been working and away from home during the daytime whilst the rest were housewives and were available to their children most of the time of the day. About 70 (85.4%) children had been given exclusive breastfeeding while the rest had either formula alone or formula with breastfeeding during the first six months of their age. Around 62 (75.6%) children had used their right hand for sucking. Sixty-six children (80.5%) had been using the thumb. Most children (n=56, 68.3%) were sucking since birth. The most common reason (n=68, 82.9%) for clinic attendance was that parents were scared about the future occurrence of mal-alignment or malocclusion of teeth. Thirty-one parents (37.8%) did nothing to stop digit sucking while 25 (30.5%) applied bitter oil and the majority tried pacifier without success. All children were referred to the dental surgeon for further management of digit sucking and amongst them, 78 children (95.1%) attended the appointment. All 78 children had been reassured that the habit eventually disappears before permanent teeth will appear and explained that digit fixing therapy would be offered for persisting habitual digit sucking. Four children did not visit the dental department.  Conclusions The majority of children presented to the clinic were below three years and females outnumbered males in all age groups. A greater number of children had been using their right hand and thumb. Most of them had the habit of sucking since birth and most of the parents anticipated mal-alignment of teeth due to consequences of sucking. None of them succeeded in stopping the habit of digital sucking with various remedies performed at home by their parents.

Workplace violence among dental surgeons - A survey.

BACKGROUND: Workplace violence is a multi-causal, multifaceted, public health, legal and social problem faced by all occupations worldwide. Recently, there has been an increase in the prevalence of workplace violence against doctors. Even though the government has attempted to address these problems in India, doctors are still experiencing violence in their workplaces. AIM: The aim of this survey was to determine the prevalence and awareness of workplace violence among dental surgeons. METHODOLOGY: This cross-sectional study was conducted among the dental surgeons. A self-administered questionnaire containing 15 questions was made and validated. A Web-based questionnaire was developed using Google forms and was circulated. A total of 112 responses were obtained. Questions were answered with "yes" "no" or by marking the correct responses. Frequency analysis and percentage analysis were done with the obtained results. RESULTS: Our study showed that 74.1% of the participants heard about the workplace violence and 30.4% faced violence in their clinic. The nature of the violence was physical in 0.9%, verbal in 39.3%, and sexual in 0.9% among the participants who faced violence. A total of 92.9% of the participants reported that they require policies and guidelines against this workplace violence. CONCLUSION: Dental surgeons should have proper knowledge about the work-related violence and methods to control this violence. Policies, procedures, and intervention strategies should be undertaken to manage this alarming issues.

Conhecimento científico produzido sobre a Síndrome da Ardência Bucal nos últimos cinco anos / Scientific knowledge produced about Bucal Ardence Syndrome in the last five years

Objetivo: realizar revisão integrativa da literatura sobre a Síndrome da Ardência Bucal (SAB). Materiais e Método: trata-se de uma revisão integrativa da literatura sobre a SAB nos últimos cinco anos. Utilizou-se as bases de dados Medline, SciELO e Lilacs para a pesquisa, empregando de forma combinada os descritores relacionados à temática. Como critérios de inclusão, decidiu-se selecionar publicações sobre a temática que estivessem disponíveis para leitura em qualquer idioma dos últimos cinco anos. Foram excluídos os estudos sem relação com o tema. Resultados: após análise, apenas 42 estudos foram selecionados para esta revisão. A maior parte dos artigos era publicada em inglês, porém, foi o Brasil que apresentou o maior número de publicações. As pesquisas avaliadas demonstraram os seguintes resultados: o sexo feminino é o mais acometido; maior prevalência acima dos 60 anos; dor, queimação e xerostomia são os sintomas mais relatados. O laser foi bastante relatado como terapia, além do uso de fármacos. Conclusão: a revisão apresentada neste artigo constatou que a maioria dos artigos, apesar de oriundos do Brasil, foi publicada no idioma inglês. A maioria dos trabalhos destacou que indivíduos do sexo feminino acima dos 60 anos são mais acometidos. Pacientes com SAB apresentam dor e queimação em língua e palato, principalmente. Fatores psicológicos e gastrointestinais podem estar associados ao aparecimento desta síndrome, e os usos do laser e de fármacos fitoterápicos, ou não, parecem melhorar o quadro clínico dos indivíduos acometidos.(AU)

Objective: to perform an integrative review of the literature on Burning Mouth Syndrome (BMS). Materials and Method: This is an integrative review of the literature on Burning Mouth Syndrome over the last five years. The Medline, SciELO, and Lilacs databases were used for the research, using the descriptors related to the topic in combination. The inclusion criteria consisted of publications on the topic that were available for reading in any language over the last five years. Studies unrelated to the topic were excluded. Results: After the analysis, only 42 studies were selected for this review. Most articles were published in English but Brazil had the highest number of publications. The studies evaluated showed the following results: women are the most affected; highest prevalence over 60 years old; and pain, burning, and xerostomia are the most reported symptoms. The laser was extensively reported as therapy, as well as the use of other drugs. Conclusion: The review presented in this article found that most studies were published in Brazil but in the English language. Most studies highlighted that women over 60 years old are more affected. Patients with BMS experience pain and burning especially in the tongue and palate. Psychological and gastrointestinal factors may be associated with the onset of this syndrome, and the use of laser and other drugs, either herbal medicines or not, seems to improve the clinical condition of the individuals affected.(AU)

Knowledge, Attitude and Practice of Oral Biopsy Procedures among Dental Surgeons Registered with Nepal Dental Association.

BACKGROUND: Oral biopsy procedures are rarely practiced by dental surgeons around the world though they should be able to perform the biopsies for the diagnosis of oral lesions. Our objective was to access the knowledge, attitude and practice of oral biopsy procedures among the dental surgeons who are members of Nepal Dental Association. METHODS: A cross sectional study was conducted from December 2018 to March 2019, among the dental surgeons who were registered in Nepal Dental Association till September 2018. A standard pretested questionnaire was prepared using Google forms, was emailed to 374 dental surgeons. Two reminder emails were sent at an interval of 1 month. The non-responding dental surgeons who were reachable through mobile number (N=274) were contacted after the third 3rd email. Out of 274, 10 dental surgeons had completed postgraduation, so 264 of them were included in the study. A reminder call was made after one week. The data was entered in SPSS version 20 software and analyzed using descriptive statistics. RESULTS: There were 160 responses to the emails after the conversation through mobile phone. The response rate was 60.6% with the predominance of female responders (66.9%). Though the majority of dental surgeons (96.2%) had encountered one or the other lesions requiring biopsy, only few of them (7.5%) had performed the biopsy which was mainly due to lack experience and skill (75.6%). CONCLUSIONS: Most of the dental surgeon are not comfortable performing biopsy with majority seem to lack expereice and skill. There is need to organize training to Dental Surgeons to enhance their practical skills.

Perfil do serviço de terapia periodontal básica na estratégia saúde da família / Profile of the periodontal basic therapy service in the health care strategy

O presente estudo objetivou analisar o perfil do Serviço de Terapia Periodontal Básica (TPB) na Estratégia Saúde da Família (ESF) da Microrregião de Saúde de Acaraú, Ceará, Brasil. Baseado em informações colhidas através de questionário semi-estruturado junto aos Cirurgiões-Dentistas (CDs) das ESF que lá atuam. A maioria dos profissionais relatou realizar o diagnóstico dos pacientes com necessidade de TPB através de exame clínico e sondagem, informação controversa ao verificar-se que 87,5% dos CDS relatam a falta de materiais e instrumentais específicos como sondas periodontais como fator que dificulta a conduta em TPB. As principais necessidades dos pacientes candidatos a TPB são controle de placa e cálculo dental, assim como as condutas de tratamento mais realizadas pelos CDs da ESF são raspagens e instrução de higiene oral. Os encaminhamentos ao Centro de Especialidades Odontológicas são nos casos de doença periodontal e necessidades de cirurgias periodontais. Com relação à capacitação, os CDs se interessaram, por treinamento sobre o uso de antibióticos em periodontia (84%), lesões gengivais não-induzidas por placa bacteriana (78%) e abscessos do periodonto (72%). Na conduta clínica, os profissionais relataram maior dificuldade na prescrição de medicamentos (53%). Na simulação dos casos clínicos, em sua maioria, os CDs demonstraram conhecimento teórico sobre diagnóstico, fatores etiológicos e tratamentos periodontais. (AU)

The aim of this study was to evaluate the profile of Basic Periodontal Therapy (BPT) at "Family Health Strategy (FHS)" in the Acaraú, state of Ceará, Brazil. It was based on the information collected from a questionnaire answered by the dentists that work in the FHS of that region. Most part of the professionals reported that the diagnosis of patients that need Basic Periodontal Therapy (BPT)is made through oral exam and probing. That information disagrees with the fact that 87,5% of the professionals reported lack of specific materials, such as periodontal probe, avoiding a proper diagnosis. The main needs of a patient with BPT are plaque and tartar control as well as dental scaling and oral hygiene instructions are the most common treatments. The patients are screened to "Center of Dental Specialties" when they present periodontal disease or when periodontal surgery are indicated. The dentists have interest on learning about antibiotics that are prescribed to patients with periodontal diseases (84%), gingival lesions that are not caused by bacterial plaque (78%) and abscesses (72%). The professionals also reported that they think is more difficult to prescribed drugs (53%). The dentists also answered questions about a fictitious case. The test revealed that they have more knowledge about diagnosis, etiology e periodontal treatments (AU)

Código de ética de la Asociación Dental Mexicana. Una revisión de nuestros principios: parte 1 / Code of ethics of the Mexican Dental Association. A review of our principles: part 1

Ética, moral y la deontología, se ocupan de un mismo objetivo: la valoración de lo bueno y de lo malo en la conducta humana. Sus enfoques del problema, no son totalmente iguales. La ética utiliza el análisis filosófico, ilumina el problema desde el ángulo axiológico, y a través de la especulación pura trata de establecer un deber ser de valor universal. La moral estudia las acciones humanas desde un punto de vista empírico, histórico, en la realidad de las diferentes culturas y teniendo en cuenta la diversidad de su idiosincrasia, trata de establecer juicios de valor adecuados a tales circunstancias. La deontología, fluctuando entre la ética y la moral y basándose en las conclusiones de ambas, se propone establecer las normas concretas que deben regir la conducta en situaciones determinadas, como puede ser el ejercicio de una profesión. La bioética establece los conceptos morales, éticos y racionales derivados en la interdisciplina de la ciencia y la biomedicina (AU)

Ethics, Moral and deontology, deal with the same objective: The assessment of good and evil in human behavior. Their approaches to the problem are not totally the same. Ethics uses philosophical analysis, illuminates the problem from the axiological angle, and through pure speculation tries to establish a duty of universal value. Morality studies human actions from an empirical, historical point of view, in the reality of different cultures and taking into account the diversity of their idiosyncrasy, tries to establish value judgments appropriate to such circumstances. Deontology, fluctuating between ethics and morals and based on the conclusions of both, it is proposed to establish the specific rules that should govern behavior in certain situations, such as the exercise of a profession. Bioethics establishes the moral, ethical and rational concepts derived in the interdiscipline of science and biomedicine (AU)

Toothache as the initial symptom of plasma cell myeloma.

Patients with plasma cell myeloma may initially present to their dentists or dental surgeons with toothache, loose teeth, or gingival masses. An X-ray of the jaw can reveal osteolyses. In addition, accumulation of monoclonal light chains in AL-amyloidosis can lead to macroglossia. It is prudent that the dentist or dental surgeon recognizes the underlying disease and refers the patient to the oncologist or hematologist for further workup to prevent the complications of plasma cell myeloma such as renal impairment, fractures, bone pain, infections, hypercalcemia, anemia, or heart failure. Another area where the dentist or dental surgeon is involved with patients suffering from plasma cell myeloma is prevention and therapy of osteonecrosis of the jaw, occurring after administration of bisphosphonates or denosumab for osteolytic bone disease. The case report presented here shows a patient complaining of toothache for whom recognition of a systemic disease by the dentist led to the diagnosis of plasma cell myeloma, highlighting the need for interdisciplinary cooperation. As recent years have seen many changes in the management of patients with plasma cell myeloma, an update for dentists and dental surgeons is warranted.

High-fidelity simulation in training dental students for medical life-threatening emergency.

INTRODUCTION: Any dental surgeon may be faced with a critical life-threatening emergency situation. In our university, all students in dentistry receive a standard course on emergency first aid. The aim of this prospective, comparative, single-centre study was to determine whether additional training on a high-fidelity patient simulator would improve student performance. METHODS: After approval by an Ethical Committee and written informed consent, the students of the Simulation group (n=42) had full-scale high-fidelity training on a patient simulator SimMan 3G™ (3 hours by six students). They participated in pairs in two scenarios (airway obstruction, seizures, allergies, vasovagal syncope, asthma, chest pain). The first scenario was simple, and the second was a progression to cardiac arrest. Three months later, the Simulation group and the Control group (n=42) participated in a test session with two scenarios. The primary end point was the score at the test session (with a standardised scoring grill, direct observation and audio-video recording). Data were median and 25%-75% percentiles. RESULTS: High-fidelity training strongly improved the score on the test obtained by the students of the Simulation group (146 [134-154]) which was much higher (P<.0001) than in the Control group (77 [67-85]). Technical as well as non-technical skills components of the scores were improved. In addition, performances of the Simulation group were increased between the training and the test. Simulation session was very positively assessed by the students. CONCLUSIONS: The results support the systematic introduction of training to critical life-threatening emergency situations on high-fidelity patient simulators the dentistry curriculum. The impact on clinical practice in the dental office remains to be assessed.

Comportamentos e conhecimentos de cirurgiões-dentistas da atenção primária à saúde quanto ao câncer bucal / Behaviors and knowledge of dentists of the Primary Health Care regarding oral cancer

Resumo Introdução Considerando a importância da prevenção e do diagnóstico precoce do câncer bucal, a atenção primária à saúde é uma ambiência apropriada para o desenvolvimento dessas ações, e a atenção odontológica exerce papel estratégico nesse enfrentamento. Portanto, objetivou-se identificar os comportamentos e os conhecimentos dos cirurgiões-dentistas inseridos na atenção primária à saúde quanto ao câncer bucal. Métodos: Tratou-se de um estudo transversal conduzido a partir de entrevistas com cirurgiões-dentistas da Estratégia de Saúde da Família. O teste de Mann-Whitney comparou as variáveis independentes às dependentes. Resultados: Dos 70 cirurgiões-dentistas avaliados, a maioria foi identificada com conhecimento satisfatório (82,6%), porém diferindo em relação à capacidade de fornecer informações preventivas (p<0,001), de realizar citologia esfoliativa (p=0,011) e na classificação do nível de ensino que obteve na graduação sobre câncer bucal (p<0,001). Quanto aos comportamentos, a maioria foi identificada com comportamento insatisfatório (52,2%), diferindo em relação à importância dada ao exame dos tecidos moles nas consultas iniciais (p=0,005), investigação de fatores de risco (p=0,002), fornecimento de informações sobre autoexame da boca (p<0,001) e realização de atividades preventivas (p=0,029). Conclusão: A maior parte dos cirurgiões-dentistas avaliados possui conhecimentos satisfatórios relacionados ao câncer bucal. Entretanto, o conhecimento demonstrado não tem sido colocado em prática em suas atividades laborais.

Abstract Introduction Considering the importance of prevention and early diagnosis of oral cancer, the Primary Health Care is an ambience suitable for the development of these actions, and dental attention plays a strategic role in this confrontation. Therefore, this study aimed to identify the knowledge and behaviors of dental surgeons of the Primary Health Care on oral cancer. Methods: This is a cross-sectional study conducted using interviews with dentists of the Family Health Strategy. The Mann-Whitney test was used for comparison between independent and dependent variables. Results: Most of the 70 dentists evaluated were identified with satisfactory knowledge (82.6%) on oral cancer; however, differences were observed with respect to the ability to provide preventive information (p<0.001); perform exfoliative cytology (p=0.011), and the level of education on oral cancer obtained at graduation (p<0.001). Most of the professionals were identified with unsatisfactory behavior (52.2%), with differences with regard to the importance given to the examination of soft tissues in the initial queries (p=0.005); the investigation of risk factors (p=0.002); providing information on self-examination of the mouth (p<0.001), and preventive activities (p=0.029). Conclusion: Most of the dentists evaluated present satisfactory knowledge on oral cancer, but this knowledge has not been put into practice in their activities.

Have Smartphones Contributed in the Clinical Progress of Oral and Maxillofacial Surgery?

BACKGROUND: Dental surgeons who encounter complex situations, such as those in unscheduled care, often have limited resources to provide a structured and specialty care. Therefore, there is always a need for cost-effective, easy to handle, easy to carry "Smartphones". OBJECTIVE: The purpose of this paper was to undertake a review of literature on "Smartphone in Oral and Maxillofacial Surgery" online data-base and discuss the case series with emphasis on the role of attending dental surgeon and the maxillofacial surgeon. MATERIALS AND METHODS: The available literature relevant to oral and maxillofacial surgery in online data-base of the United States National Library of Medicine: PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) was searched. The inclusion criterion was to review the published clinical papers, abstracts and evidence based reviews on 'Uses of Smartphone in Oral and Maxillofacial Surgery'. RESULTS: Six articles were found with the search term "Smartphone in Oral and Maxillofacial Surgery" in the literature searched. Five articles met the inclusion criteria for the study. The relevant data was extracted, tabulated, and reviewed to draw evidence-based conclusions for uses of smartphone in oral and maxillofacial surgery. CONCLUSION: Utilization of smartphones in oral and maxillofacial surgery facilitate in differential diagnosis, treatment, follow up, prevention of the disease further and thereby improve the quality of patient care without requiring the presence of the maxillofacial surgeon in remote areas.

Responsabilidade civil: análise estatística da sua inter-relação com profissionais atuantes na Periodontia / Civil liability: statistical analysis of interrelationship with your professional active in Periodontics

Objetivo: analisar o nível de conhecimento de 200 cirurgiões- -dentistas atuantes na área de Periodontia, sobre sua responsabilidade civil. Material e métodos: uma amostra estabelecida por conveniência, composta por 200 cirurgiões-dentistas atuantes na área de Periodontia, de todas as regiões do Brasil. Esses profissionais responderam um questionário autoaplicável, constituído por 25 perguntas objetivas, com o intuito de obter algumas informações sobre o conhecimento destes a respeito de responsabilidade civil. Foram excluídos os profissionais que não estavam atuando na Odontologia, embora possuíssem titulação. Resultados: a pesquisa buscou analisar de forma estatística o conhecimento dos profissionais quanto à sua responsabilidade civil, análise esta feita com base nos dados obtidos em pesquisa de campo, por meio de levantamento de questionários. Os resultados mostraram, na maioria dos assuntos, que mais da metade dos profissionais respondeu de forma incorreta, demonstrando a necessidade de conhecerem mais o assunto. A pesquisa também mostrou que o número de profissionais que conhecem e possuem seguro de responsabilidade civil é significativamente superior no grupo que já concluiu curso de pós-graduação. Conclusão: os resultados demonstraram a necessidade de um melhor conhecimento por parte dos profissionais com prática em Periodontia, referente ao assunto responsabilidade civil, fato reconhecido por 89% dos profissionais pesquisados ao responderem positivamente quando questionados se sentem necessidade de um programa de atualização sobre responsabilidade civil. A necessidade de conhecimento do assunto pode prevenir eventuais problemas judiciais, pois o profissional, sabendo o que pode ocorrer, tomará os cuidados necessários.

Objective: this study aimed to analyze the level of knowledge of two hundred dentists working in the area of periodontics, about their civil liability. Materials and methods: a sample established for convenience, consisting of two hundred dentists working in the area of periodontics, from all regions of Brazil. These professionals answered a self-administered questionnaire, consisting of twenty-five objective questions, in order to obtain some information about the knowledge of these regarding civil liability. Were excluded the professionals who were not working in dentistry, although possessed titration. Results: the research sought to analyze statistical form the knowledge of professionals as to its civil liability, this analysis is made on the basis of the data obtained in field research, through survey questionnaires. The results showed, in most subjects, more than half of the professionals answered incorrectly, demonstrating the need for professionals more aware of the issue. The survey also showed that the number of professionals who know and have civil liability insurance is significantly higher in the group that has already completed graduate course. Conclusion: the results showed the need for a better knowledge on the part of professionals with practice in periodontics, referring to the civil liability issue, a fact recognized by 89% of professionals surveyed to respond positively when asked if they feel the need of an upgrade program on civil liability. The need for knowledge of the subject can prevent any legal problems, because the professional, knowing what may occur, it shall take the necessary care.

Domestic violence and the role of the dentist from the public health perspective: a review of scientific literature / Violencia doméstica y el papel del dentista desde la perspectiva de salud pública: una revisión de literatura científica / Violência doméstica e a atuação do cirurgião-dentista sob a perspectiva da saúde coletiva: uma revisão sistemática da literatura

This study systematically reviewed the systematic production about domestic violence, based on the professional practice of the dentist in a multidisciplinary and interdisciplinary context, from the perspective of public health. The goal was to verify how this issue has been addressed, identify which is the most explored focus, and point out possible gaps. The search was conducted in the Virtual Health Library (BVS Brazil), by selecting 40 articles: 37 on Lilacs, 2 in BBO and only 1 in SciELO, from 2000 to 2011. Of the total scientific production analyzed, 20 percent references have cited the dentist along the paper, among these 50 percent pointed for the practice of the dentist in a multidisciplinary and interdisciplinary context, from the perspective of public health. The health professional role in a multidisciplinary and interdisciplinary context, from the perspective of public health corresponded to 72.5 percent studies. In this way, the need for studies on the performance of professional dentist in interdisciplinary and multidisciplinary team is necessary before the Brazilian context, being an open and wide field to be explored, from the perspective of public health.

Este estudio revisa sistemáticamente lo publicado sobre violencia doméstica, basado en la práctica profesional del dentista en un contexto multidisciplinario e interdisciplinario, desde la perspectiva de salud pública. El objetivo consiste en verificar cómo ha sido abordado este tema, identificar cuál es el foco más explorado y señalar posibles vacíos. Se realizó la investigación usando la Biblioteca Virtual de Salud (BVS Brasil), seleccionando 40 artículos: 37 en Lilacs, 2 en BBO y solamente 1 en SciELO, del 2000 al 2011. Del total de la producción científica analizada, 20 por ciento de la referencias han citado al dentista en el artículo; entre estos, 50 por ciento señalan la práctica del dentista en un contexto multidisciplinario e interdisciplinario, desde la perspectiva de salud pública. El papel del profesional de la salud en un contexto multidisciplinario e interdisciplinario desde la perspectiva de salud púbica correspondía al 72,5 por ciento de los estudios. De esta forma, se necesitan estudios sobre el comportamiento de dentistas profesionales en equipos multidisciplinarios e interdisciplinarios en el contexto de Brasil, siendo un campo abierto y amplio para ser explorado, desde la perspectiva de salud pública.

Este estudo é uma revisão da produção sistemática sobre violência doméstica, baseado na prática profissional do dentista num contexto multidisciplinar e interdisciplinar, sob a perspectiva da saúde pública. O objetivo foi verificar como este tema tem sido abordado, identificar qual é o foco mais explorado, e apontar as possíveis lacunas. A pesquisa foi realizada na Biblioteca Virtual de Saúde (BVS Brazil), por seleção de 40 artigos: 37 do Lilacs, 2 do BBO e somente 1 do SciELO, no período de 2000 a 2011. Do total da produção científica analisada, 20 por cento citaram referências de dentistas no texto, destes 50 por cento apontaram para a prática do dentista num contexto multi e interdisciplinar, sob a perspectiva da saúde pública. O papel do profissional de saúde no contexto multi e interdisciplinar, sob a perspectiva da saúde pública, correspondeu a 72.5 por cento estudos. Daí a necessidade para estudos da atividade do profissional dentista na inter e multidisciplinar é importante no contexto brasileiro, abrindo um amplo campo a ser explorado sob o ponto de vista da saúde pública.

Responsabilidade civil do cirurgião-dentista / Civil responsibility of the dentist

A responsabilidade civil profissional é definida como o dever de reparar o dano causado à outra pessoa, dano este provocado por um ato ilícito ou pela falta de observação das normas que regem a vida em sociedade. Na Responsabilidade Civil Subjetiva, os fundamentos são a culpa (imprudência, negligência ou imperícia) e o dolo, ao passo que na Objetiva os fundamentos são a lei e o risco da atividade. A responsabilidade do cirurgião-dentista é regulamentada pelo Código Civil e pelo Código de Defesa do Consumidor. O objetivo deste trabalho é discutir a responsabilidade civil, ressaltando a importância da manutenção de uma documentação odontológica estruturada e devidamente arquivada que, além de poder ser usada como prova na eventualidade de processos civis, penais e éticos, também pode servir de instrumento para consulta nos casos de identificação humana.

The professional civil liability is defined as the obligation to repair the damage caused to another person, either by an unlawful act or failure to observe the rules governing life in society. The foundations of Subjective Civil Liability are guilt (imprudence, recklessness or ineptitude) and deceit, whereas the Objective Civil Liability is based on law and the risk of the activity. The responsibility of the dentist is regulated by the Civil Code and the Consumer Protection Code. The aim of this paper is to discuss the civil liability of the dentist, emphasizing the importance of maintaining the dental records structured and properly filed to be used as evidence in civil, criminal and ethical processes, and also serve as instrument for consultation in cases of human identification.

Levantamento epidemiológico em portadores de patologias de língua atendidos no Serviço de Estomatologia e Prevenção do Câncer Bucomaxilofacial do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS): estudo retrospectivo / Epidemiological profile of patients with lesions affecting tongue treated at the Oral Medicine and Preventionof Oral Cancer Service of São Lucas Hospital at the Pontifical Catholic University of Rio Grande do Sul (PUCRS) - Porto Alegre, Brazil: retrospective study

Foi feito um levantamento epidemiológico buscando identificar, classificar e quantificar as patologias presentes na estrutura da língua dos pacientes atendidos no Serviço de Estomatologia e Prevenção do Câncer do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), contemplando um período de 35 anos. Método: estudo retrospectivo, executado a partir da análise de 5928 prontuários onde constavam lesões de língua. Resultados: encontrou-se uma gama variada de patologias, totalizando 7862 lesões localizadas na região, sendo estas classificadas em 14 grupos distintos. As lesões específicas da língua foram as mais frequentes, sendo a língua saburrosa a enfermidade com a maior casuística. A hiperplasia da mucosa, glossite rômbica mediana, hemangioma e carcinoma espinocelular somaram o maior número de casos respectivamente nos grupos de lesões traumáticas, infecções fúngicas, neoplasias benignas e malignas. O carcinoma espinocelular, tumor maligno mais prevalente na boca, comprometeu principalmente o bordo posterior da língua, preferentemente acometendo homens acima de 40 anos. Conclusão: a identificação de diversas lesões favorece o estabelecimento do diagnóstico precoce bem como o tratamento das enfermidades presentes e reforça a importância do exame sistemático desta área anatômica, no dia a dia do cirurgião-dentista.

Epidemiological data were obtained on tongue diseases of patients treated at the Oral Medicine and Maxilofacial Cancer Prevention Centre of São Lucas Hospital at the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil, for a period of 35 years. Methods: a retrospective study was performed, assessing 5928 patients' folders which tongue lesions were observed. Results: a myriad of lesions, totalizing 7862 lesions could be found in the tongue, being classified into 14 distinct groups. Lesions that occur specifically in the tongue were the most frequent. Coated tongue was the lesion with most cases. Mucosal hyperplasia, median rombic glossitis, hemangioma and spindle cell carcinoma were, respectively, found to be the most frequent in cases of trauma, fungal infections, benign and malign tumors. Spindle cell carcinoma, the most prevalent malign tumor of the mouth, compromised mostly the posterior tongue border, being most occurrent in men aging over 40 years. Conclusion: the identification of various lesions allows the early diagnosis and proper treatment of diseases. It is important that the dental surgeon systematically proceeds with the examination of this important anatomic site.

Hepatitis-B vaccination status among dental surgeons in benin city, Nigeria.

BACKGROUND: The development of success-oriented hepatitis-B vaccine uptake approach among dental surgeons is dependent on the availability of comprehensive baseline data. OBJECTIVE: To determine the hepatitis-B vaccination status among dental surgeons in Benin City. MATERIALS AND METHODS: This questionnaire-based cross-sectional study of dental surgeons in Benin City was conducted in May 2011. The questionnaire elicited information on demography, occupational risk rating of contracting hepatitis-B infection, hepatitis-B vaccination status, barriers to uptake of hepatitis vaccine, and suggestions on how to improve hepatitis-B vaccination rates among dental surgeons. RESULTS: Participation rate in the study was 93.3%. More than half (51.4%) of the respondents were 20-30 years old and 52 (74.3%) were males. The occupational risk of contracting hepatitis-B infection among dental surgeons was rated as either high or very high by 51 (72.9%) of the respondents. Amongst the respondents, 14 (20.0%) had received three doses of the hepatitis-B vaccine, 34 (48.6%) either two doses or a single dose, and 22 (31.4%) were not vaccinated. The major barriers reported among the respondents who were not vaccinated were lack of opportunity and the fear of side effects of the vaccines. The suggested ways to increase the vaccination rate among the respondents in descending order include: Making the vaccine available at no cost (51.4%), educating dentists on the merits of vaccination (17.1%), and using the evidence of vaccination as a requirement for annual practicing license renewal (14.3%) and for the employment of dental surgeons (11.4%) and others (2.9%). CONCLUSION: This study revealed low prevalence of complete hepatitis-B vaccination among the respondents. Improvement in uptake following the respondents' recommendations will serve as a template in developing success-oriented strategies among stakeholders.

A contribuição do acolhimento e do vínculo na humanização da prática do cirurgião-dentista no programa saúde da família / The contribution of receptivity and bonding towards humanization of dental surgeons' practice within the family health program / La contribución de la acogida y del vínculo de humanización de la práctica del cirujano dentista en el programa salud de la familia

Objetiva-se compreender como são empregadas as tecnologias leves do acolhimento e vínculo na prática do dentista, no Programa Saúde da Família do município de Fortaleza, Ceará, no sentido da construção do cuidado humanizado. Trata-se de pesquisa qualitativa realizada com 16 cirurgiões-dentistas, utilizando-se, para coleta de dados, entrevista semiestruturada e observação simples e, para análise dos dados, a análise de conteúdo. Os resultados mostram o dentista fazendo maior uso dessas tecnologias em sua prática, porém o acolhimento é mais identificado como primeira etapa de organização da demanda do que como atitude de escuta, postura esta mais associada ao vínculo. A grande demanda tem contribuído com linhas de tensão entre dentista e usuário e forçado o odontólogo a uma prática ainda presa ao consultório. Novos espaços seriam importantes na utilização dessas tecnologias, já que estas consideram, para além da doença, o indivíduo.

This study aimed to ascertain how the soft technologies of receptivity and bonding are used in dentists' practice within the Family Health Program in the municipality of Fortaleza, Ceará, towards constructing humanized care. This was a qualitative investigation conducted among 16 dental surgeons using semi-structured interviews and simple observation to gather data. The data were evaluated using content analysis. The results showed that the dentists were making greater use of these technologies in their practice, but receptivity was identified more as a first stage in organizing the demand than as an attitude of listening. The latter stance was more associated with bonding. The great demand has contributed towards tension lines between dentists and users and has forced dental practitioners towards practices that are still tied to the office. New spaces would be important for using these technologies, given that these look beyond the disease, to the individual.

Se objetiva comprender como se emplean las tecnologías leves de la acogida y vínculo en la práctica del dentista, en el Programa Salud de la Familia del municipio de Fortaleza, del estado de Ceará, Brasil, en el sentido de la construcción del cuidado humanizado. Se trata de investigación cualitativa realizada con 16 cirujanos dentistas utilizando, para la colecta de datos, entrevista semi-estructurada y observación simple y, para análisis de los datos, un análisis de contenido. Los resultados muestran al dentista haciendo mayor uso de tales tecnologías en su práctica; la acogida, sin embargo, se identifica como primera etapa de organización de la demanda más que como actitud de escucha, una postura más asociada al vínculo. La gran demanda ha contribuido con líneas de tensión entre dentista y usuario, forzando al odontólogo a una práctica todavía sujeta al consultorio. Nuevos espacios serían importantes en la utilización de estas tecnologías ya que consideran, más allá de la enfermedad, al indivíduo.