Importância da assistência odontológica dentro do ambiente hospitalar / Importance of dental care within the hospital enviroment

A assistência odontológica é imprescindível para a prevenção de doenças infecciosas e para a manutenção da integridade da cavidade oral de pacientes internatos em unidades de terapia intensiva. O objetivo deste estudo foi avaliar o conhecimento e as práticas de higiene oral dos acadêmicos do curso de Enfermagem de uma instituição de ensino superior, que realizam estágio em hospital, no controle de higiene bucal de pacientes internados em ambiente hospitalar. Participaram do estudo 40 alunos, que responderam 14 perguntas com o intuito de avaliar o conhecimento e as práticas no controle de higiene bucal, realizadas por eles, em pacientes internados em ambiente hospitalar. Os resultados demonstraram que os acadêmicos entrevistados tinham idade média de 25,8 anos, sendo 95% do sexo feminino e apenas 5% do sexo masculino. Destes, 42,5% afirmaram não haver presença de um Cirurgião-Dentista em ambiente hospitalar e 82,5% responderam que o responsável pela saúde bucal dos pacientes é do técnico de enfermagem. Quanto aos cuidados em pacientes internados em UTI, 52,5% dos entrevistados relataram que estes pacientes recebem higienização bucal, porém 30% alegaram que esta pratica não era realizada e 17,5% não sabiam responder. Além disso, 47,5% dos entrevistados afirmam ter insegurança ao realizar os procedimentos de higiene bucal dos pacientes. Pode-se concluir que os acadêmicos entrevistados possuem bom conhecimento acerca da importância dos cuidados com a saúde bucal dos pacientes internados em ambiente hospitalar. No entanto, ainda existem muitas dúvidas relacionadas ao manejo clínico de procedimentos de promoção de saúde bucal, que poderiam ser solucionados com a presença de um profissional de Odontologia inserido em uma equipe multidisciplinar(AU)

Oral care is essential for the prevention of infectious diseases and for maintaining the integrity of the oral cavity of patients hospitalized in intensive care units. The objective of this study is to evaluate the knowledge and oral hygiene practices of Nursing students at a higher education institution, who carry out internships in a hospital, in controlling the oral hygiene of patients admitted to a hospital environment. 40 students participated in the study, who answered 14 questions with the aim of evaluating the knowledge and practices in controlling oral hygiene, carried out by them, on patients hospitalized in a hospital environment. The results demonstrated that the academics interviewed had an average age of 25.8 years, with 95% being female and only 5% being male. Of these, 42.5% stated that there was no presence of a Dental Surgeon in a hospital environment and 82.5% responded that the nursing technician is responsible for the patients' oral health. Regarding care for patients admitted to the ICU, 52.5% of those interviewed reported that these patients receive oral hygiene, however 30% claimed that this practice was not performed and 17.5% did not know how to answer. Furthermore, 47.5% of those interviewed say they are insecure when carrying out oral hygiene procedures for patients. It can be concluded that the academics interviewed have good knowledge about the importance of oral health care for patients hospitalized in a hospital environment. However, there are still many doubts related to the clinical management of oral health promotion procedures, which could be resolved with the presence of a dentistry professional within a multidisciplinary team(AU)

Oral Hygiene With Neutral Electrolyzed Water and Systemic Therapy Increases Gastric Helicobacter pylori Eradication and Reduces Recurrence.

OBJECTIVES: Helicobacter pylori gastric infection strongly correlates with gastric diseases such as chronic gastritis, functional dyspepsia, and complications such as peptic ulcers and gastric cancer. In developing countries, systemic therapies are not usually successful due to elevated antibiotic resistance. Additionally, oral H. pylori infection and periodontal disease correlate with gastric treatment failures. This study aimed to explore the effect of an integral therapy, comprising oral hygiene and concomitant systemic treatment, to increase the eradication of gastric infection and recurrences. MATERIALS AND METHODS: A prospective, randomized, four-arm, parallel-group, open-label clinical trial was conducted to investigate the efficacy of integral therapy to eradicate gastric H. pylori infection and avoid recurrences in double-positive (real-time PCR oral and gastric infection) patients. Oral hygiene involved mouthwash with neutral electrolyzed water (NEW), with or without periodontal treatment. One hundred patients were equally distributed into four groups: NS, NS-PT, NEW, and NEW-PT. All patients had concomitant systemic therapy and additionally, the following oral treatments: mouthwash with normal saline (NS), periodontal treatment and mouthwash with normal saline (NS-PT), mouthwash with NEW (NEW), and periodontal treatment and mouthwash with NEW (NEW-PT). Gastric and oral infection and symptoms were evaluated one and four months after treatments. RESULTS: Integral therapy with NEW-PT increased gastric eradication rates compared with NS or NS-PT (84%-96% vs. 20%-56%; p < 0.001). Even more, a protective effect of 81.2% (RR = 0.1877; 95% CI: 0.0658-0.5355; p = 0.0018) against recurrences and 76.6% (RR = 0.2439; 95% CI: 0.1380-0.4310; p < 0.001) against treatment failure (eradication of infection and associated symptoms) was observed in patients from the NEW and NEW-PT groups. CONCLUSIONS: Implementation of oral hygiene and systemic treatment can increase the eradication of gastric infection, associated symptoms, and recurrences. NEW is recommended as an antiseptic mouthwash due to its efficacy and short- and long-term safety.

Analysis of patients hospitalized by Covid-19 regarding oral care during hospitalization

Oral health interferes with the general condition of the individual, because the oral cavity is a gateway and habitat for pathogens, especially in hospitalized people. There are several diseases that directly interfere in the oral cavity, such as Covid 19. Studies report oral changes in patients infected by SARS-CoV2 and point to the need for satisfactory oral hygiene during hospitalization in order to avoid the occurrence of oral lesions that increase the risk for the individual. The objective of this research is to emphasize the importance of the dentist in hospitals, pointing out the oral diseases that can be caused by poor oral hygiene during hospitalization. For the execution of the work, a questionnaire was carried out with patients who were hospitalized in Covid-19, clarifying if, during the hospitalization period, these patients received help in oral hygiene and if they noticed oral changes. The results achieved are in accordance with the literature, taking into consideration the age range of those affected by covid, over 50 years old, and the length of hospitalization, ran-ging from 10 days. Many hospitals still neglect the dental service and the patient himself performs the oral hygiene. The most common lesions reported by those infected by the virus were taste alteration, xerostomia and thrush, besides caries and dental calculus. We concluded the relevance of the odontologist far beyond the prevention of lesions, but in contributing to the recovery of the individual and the importance of adopting measures for the oral adequacy of hospitalized patients. (AU)

Oral Health Knowledge and Oral Hygiene Habits in a Sample of 12-Year-Old Hispanics: A Cross-sectional Study.

OBJECTIVE: To explore the association between hygiene knowledge and habits and gingivitis in Puerto Rican school children. METHODS: Questionnaires on oral health knowledge and hygiene habits were provided to almost half of the 12-year-olds who participated in an island-wide cross-sectional oral health study. The evaluations included gingival examinations in 2 quadrants. Odds ratios (ORs) (with 95% CIs) were computed using logistic regression models and oral health-related knowledge and hygiene habits to gingivitis. RESULTS: Of the 823 participants who completed the questionnaire 53.43% were female, and 81% had gingivitis. Most reported having received instructions on brushing (98%), flossing (89.5%), and using mouthwash (90%). The majority (75%) rated their gums as healthy, and 44.68% agreed that oral health affects general health. Nearly half (44%) reported brushing their teeth at least 2 times a day, and 80.25%, flossing daily. In multivariate analysis, not having been instructed on how to brush was related to greater odds of having gingivitis (OR: 7.32; 95% CI: 1.5-35.67). Flossing more than once a day was associated with half the odds of gingivitis (OR: 0.50; 95% CI: 0.29-0.88). CONCLUSION: The children had knowledge of oral hygiene methods but were mostly unaware that gingival health could affect systemic health. Fewer than half reported brushing 2 or more times a day. Not having been instructed on how to brush was associated with higher odds of gingivitis.

The Effect of Motivational Interviewing on Oral Hygiene Behavior in Patients With Fixed Orthodontic Appliances: A Randomised Clinical Trial

The aim of this study was to evaluate the effectiveness of motivational interviewing on improving oral hygiene behavior in patients with fixed orthodontics appliances. A parallel-group randomized clinical trial was conducted with 45 patients of the Orthodontic Clinic of Unibe's Postgraduate Unit. A computer-generated list of numbers created with SPSS V21.0 was used to randomly allocate participants into the experimental or the control group. Monthly oral hygiene instructions and an oral hygiene kit from GUM® with special orthodontic hygiene tools were given to the participants. Furthermore, the experimental group underwent motivational interviewing sessions facilitated by a periodontist who received training from two expert psychologists. These psychologists also provided supervision to the interviewer, ensuring the accurate implementation of the intervention. Simplified Oral Hygiene Index (SOHI), Gingival Index (GI), Periodontal Probing Depth (PPD) and Bleeding on Probing (BoP) were recorded at baseline, three and six months after the beginning of the study. The participant and the evaluator (another periodontist who recorded the data) were masked. Repeated-measures mixed- model analysis of variance and chi-squared test were conducted. Mean SOHI, GI, PPD and BoP scores did not differ significantly across the three time points (baseline, three and six months). Nevertheless, a significant interaction on SOHI scores (F (2, 58) = 3.463, p = .038, h2 = .052) was found between the sessions and the treatment conditions (experimental vs control group) at the third and sixth month. Motivational interviewing plus oral hygiene instructions appears to maintain a better control of dental biofilm and calculus in comparison with conventional oral hygiene instructions alone.

El objetivo de este trabajo fue evaluar la efectividad de las entrevistas motivacionales para mejorar el comportamiento de higiene oral en pacientes con aparatos ortodóncicos fijos. Se llevó a cabo un ensayo clínico aleatorizado de grupos paralelos con 45 pacientes de la Clínica de Ortodoncia de la Unidad de Posgrado de Unibe. Se utilizó una lista de números generada por computadora con SPSS V21.0 para asignar aleatoriamente a los participantes al grupo experimental o de control. Se les proporcionó a los participantes instrucciones mensuales de higiene oral y un kit de higiene oral de GUM® con utensilios de higiene especiales para ortodoncia. Además, el grupo experimental recibió sesiones de entrevista motivacional facilitadas por un periodoncista capacitado por dos psicólogas expertas. Estas psicólogas también supervisaron al entrevistador, asegurando la implementación precisa de la intervención. Se registró el Índice Simplificado de Higiene Oral (IHO-S), el Índice Gingival (IG), la Profundidad de Sondaje Periodontal (PS) y el Sangrado al Sondaje (SS) al inicio, a los tres y seis meses después del inicio del estudio. Tanto el participante como el evaluador (otro periodoncista que registró los datos) estaban enmascarados. Se realizaron análisis de varianza de medidas repetidas con modelo mixto y pruebas de chi-cuadrado. Las puntuaciones medias del IHO-S, IG, PS y SS no difirieron significativamente en los tres momentos (inicio, tres y seis meses). Sin embargo, se encontró una interacción significativa en las puntuaciones del IHO-S (F (2, 58) = 3.463, p = .038, h2 = .052) entre las sesiones y las condiciones de tratamiento (grupo experimental vs grupo de control) en el tercer y sexto mes. Las entrevistas motivacionales junto con las instrucciones de higiene oral parecen mantener un mejor control de la biopelícula dental y el cálculo en comparación con las instrucciones convencionales de higiene oral por sí solas.

Autistic spectrum disorder children and adolescents' oral health characteristics - scoping review.

This study aimed to conduct a scoping review to know children and adolescents' main oral health concerns with Autism Spectrum Disorder (ASD) and thus identify any oral characteristic that stands out, aiming at preventive and interceptive clinical conduct. A search was performed in the three electronic databases and the gray literature; in September 2021. A total of 562 studies were identified, and after applying the eligibility criteria, 73 articles were included in the synthesis of this scoping review. The mean decayed, lost, and restored teeth index (DMFT/dfmt) ranged from 0 to 12.37; the mean DMFT index (permanent dentition) from 0.06 to 6.2; and the average dmft index (deciduous dentition) ranged from 0.29 to 9.91. The mean simplified oral hygiene index (OHIS) ranged from 0 to 3.4; gingival index (GI) from 0.29 to 2; and plaque index (PI) from 0.005 to 3.15. Plaque prevalence was 25.9% to 90%; dental calculus from 4.7% to 59.41%; gingivitis from 36.7% to 100%. Bruxism was 10.3% to 73%, and dental trauma was 4.7% to 100%. This disparity in the results shows the heterogeneity of this population, with different degrees of socio-behavioral impairment, which can directly influence oral hygiene and the consequent accumulation of biofilm.

Effectiveness of dental floss in the management of gingival health: A 6-month follow-up of a randomized controlled clinical trial.

OBJECTIVES: To evaluate, (i) if subjects submitted to a structured oral hygiene training program (OHt) maintain adopted habits over 180 days without professional guidance; and (ii) in perspective whether flossing provides additional benefits to toothbrushing on gingival health. MATERIALS AND METHODS: Seventy-five adult subjects showing approximately 40% proximal gingival bleeding were randomized to receive OHt (1 session weekly over 8 weeks) using toothbrush and dental floss or toothbrush alone. The subjects were then followed over 180 days without professional guidance. Primary outcomes were mean interproximal Gingival Index (GI) and GI = 2 (gingival bleeding). Mixed linear models were used for the comparison between groups (p < 0.05). RESULTS: 68 subjects received OHt, 48 subjects completed the 180-day follow-up. Subjects maintained adequate oral hygiene routines. Besides a reduction in gingival inflammation, no alterations in gingival status were observed among groups, subjects additionally instructed to use dental floss showing a mean interproximal GI = 2 of 12.8 ± 2.5 compared with 19.8 ± 2.2 for subjects limited to tooth brushing alone. CONCLUSIONS: OHt intensive training promotes gingival health and maintenance lasting at least 6 months without professional supervision reinforcing important principles: (i) dental health professionals should dedicate time training and motivating their patients to reach adequate self-performed plaque control; and (ii) the adjunctive use of dental floss appears essential to reduce interproximal gingival inflammation in subjects with intact interdental papillae. CLINICAL RELEVANCE: Dentists need to invest time in training/motivating/engage their patients to achieve adequate OH; adjunct flossing in subjects with papilla filling the interdental space appears essential to reach and maintain gingival health. CLINICALTRIALS: GOV : (53831716.5.0000.5346). TRIAL REGISTRATION: The protocol registration was filed May 9, 2018 (# 538,311,716.5.0000.5346) on ClinicalTrials.gov. An NCT number (NCT04909840) was generated upon completed registration.

Analysis of primary caregivers' knowledge concerning the cariogenic risk associated with the use of pediatric liquid medications / Análisis del conocimiento de los cuidadores principales sobre el riesgo cariogénico implicado en la ingesta de medicamentos líquidos pediátricos

Introduction: Pediatric liquid medications (PLM) are frequently administered to children, yet their usage may contribute to the onset of dental caries. Despite its prevalence, there is a notable scarcity of scientific research regarding caregivers' knowledge of this potential cariogenic risk. Objective: This study aims to assess the knowledge of the main caregivers of children aged 5 to 12 years concerning the cariogenic potential associated with the use of PLM. Materials and Methods: A cross-sectional analytical obser-vational study involving 152 primary caregivers of children aged 5 to 12 was conducted. Data were collected on caregivers' perceptions of the cariogenic risk associated with PLMs and their consumption habits. The study also assessed oral hygiene routines and evaluated the level of information provided by healthcare professionals. Results: Research findings indicated a significant lack of awa-reness among primary caregivers regarding the cariogenic risks of PLMs, with 78.95% being unaware of these risks and 47.37% unaware of the sugars present in such medications. Additionally, a high rate of PLM consumption was observed, with 63% of caregivers using them in the last year. The study underscored a notable absence of guidance from healthcare professionals, as 91.45% of the caregivers stated that they had not received instructions on tooth brushing after the administration of the PLM. Conclusions: The study highlights a significant lack of awa-reness among primary caregivers regarding the cariogenic risks associated with the ingestion of pediatric liquid medications. This deficit in information and preventive measures presents a substantial obstacle to children's oral health. To address this issue, it is crucial for healthcare professionals to offer comprehensive guidance and promote preventive measures.

Introducción: La administración de medicamentos líquidos pediátricos (MLP) es una práctica común en la población infantil y puede estar vinculada al desarrollo de lesiones de caries dental. Sin embargo, la evidencia científica que aborda el conocimiento de los cuidadores acerca de este riesgo cariogénico es escasa. Objetivo: Este estudio busca determinar el conocimiento de los cuidadores principales de niños de 5 a 12 años sobre el potencial cariogénico asociado al consumo de MLP. Materiales y Métodos: Se llevó a cabo un estudio observacional analítico transversal que incluyó a 152 cuidadores principales de niños en el rango de edad de 5 a 12 años. Se recopiló información sobre la percepción de los cuidadores acerca del riesgo cariogénico de los MLP, así como sobre sus patrones de consumo. Además, se registraron las prácticas de higiene oral y se evaluó el nivel de información proporcionado por los profesionales de la salud. Resultado: Los hallazgos de la investigación revelaron que un 78,95% de los cuidadores principales desconocen el riesgo cariogénico asociado al consumo de medicamentos líquidos pediátricos (MLP), y un 47,37% de ellos no eran conscientes de la presencia de azúcares en dichos medicamentos. Además, se observó un elevado índice de consumo de MLP, con un 63% de los cuidadores que los utilizaron en el último año. Se destacó la falta de orientaciones por parte de los profesionales de la salud, ya que, un 91,45% de los tutores afirmaron no haber recibido instrucciones sobre el cepillado dental posterior a la administración de los MLP. Conclusión: Este estudio evidencia un relevante porcentaje de desconocimiento entre los cuidadores principales acerca del riesgo cariogénico asociado a la ingesta de medicamentos líquidos pediátricos. La falta de información y medidas preventivas constituye un desafío significativo para la salud oral de los niños. Es imperativo que los profesionales de la salud proporcionen información detallada y fomenten prácticas de prevención.

Should We Wait to Brush Our Teeth? A Scoping Review Regarding Dental Caries and Erosive Tooth Wear.

BACKGROUND: Tooth brushing is a universal recommendation. However, the recommendations related to the time of its execution are conflicting, especially when dealing with patients at risk of erosive tooth wear (ETW) or dental caries. SUMMARY: Our objective was to summarize the evidence on the timing of brushing with fluoridated toothpaste in relation to ETW and cariogenic dietary challenges. We conducted a scoping review following the PRISMA-ScR checklist, using three databases searching for in vivo, in situ, or in vitro studies involving human teeth exposed to either a cariogenic or an erosive challenge. Only models including human saliva and fluoride were assessed. Data selection, extraction, and risk of bias analysis were done in duplicate and independently. From 1,545 identified studies, 17 (16 related to ETW and 1 to dental caries) were included. Most evidence (n = 10) supported that brushing with a fluoride-containing product does not increase ETW, independent of the moment of brushing. Delaying tooth brushing up to 1 h (n = 4) or individualized recommendations based on the patient's problem (n = 2) were less frequent. Only one study reported that brushing pre- or post-meal does not affect Streptococcus mutans counts. Most data were in situ (n = 13), and the overall study quality was judged as sufficient/low risk of bias. KEY MESSAGES: Although the available evidence lacked robust clinical studies, tooth brushing using fluoridated products immediately after an erosive challenge does not increase the risk of ETW and can be recommended, which is in line with recommendations for dental caries prevention. Furthermore, we suggest updating the international guidelines to promote individualized recommendations based on risk factors to prevent either ETW or dental caries.

Orientações de manutenção e higienização de prótese fixa total implantossuportada: revisão de literatura / Guidelines for maintenance and cleaning of implantssupported total fixed prosthesis: literature review

A evolução dos tratamentos em implantodontia possibilitou uma mudança nos tratamentos reabilitadores para pacientes edêntulos, tornando possível a colocação de próteses fixas, que proporcionam maior qualidade de vida para estes pacientes. Para que estas próteses tenham bom desempenho e longevidade satisfatórios é essencial que se mantenha um padrão adequado de higienização bucal e manutenção profissional. Assim, o objetivo deste trabalho foi realizar uma revisão de literatura a respeito dos principais recursos disponíveis para higienização e manutenção das próteses totais fixas sobre implante (protocolo de Branemark), tanto nos cuidados domiciliares dos pacientes quanto no atendimento profissional do cirurgião dentista. Foi realizada uma busca eletrônica, não sistemática, nas bases de dados Lilacs, Pubmed/Medline, Scielo e ScienceDirect, cruzando-se os seguintes descritores: "Higiene Oral"; "Implantes Dentários"; "Implantação Dentária"; "Manutenção"; "Prótese Dentária Fixada por Implante" e "Prótese Dentária". Foram consultados artigos de revisão de literatura, revisão sistemática, meta-análise, estudos clínicos randomizados, além de livros pertinentes ao assunto, publicados no período de 1995 a 2022.Verificou-se na literatura disponível que os principais instrumentos indicados para uso domiciliar são escova dental, fio dental, escova interdental, irrigador oral, dentifrício e enxaguatório. No atendimento profissional em consultório odontológico deve ser dispendida atenção especial às instruções passadas ao paciente e também fazer o possível para motivar e encorajar o seu engajamento na rotina de higienização, além do acompanhamento periodontal, possíveis substituições de parafusos e instalação de placa oclusal estabilizadora, quando necessário. Manter uma higiene oral adequada é essencial para o sucesso das próteses fixas sobre implantes e o cirurgião dentista desempenha um papel crucial não apenas ao realizar o acompanhamento periódico do paciente, mas também ao sugerir os instrumentos mais apropriados, instruir sobre a higiene oral adequada e motivar o paciente a manter a saúde bucal satisfatória(AU)

The evolution of treatments in implantology has enable a change in rehabilitation treatments for edentulous patients, making it possible to place fixed prostheses that provide a better quality of life for these patients. In order to ensure good performance and satisfactory longevity, it is essential to maintain an appropriate standard of oral hygiene and professional maintenance. Thus, the objective of this work was to conduct a literature review on the main resources available for cleaning and maintenance of complete fixed prostheses on implants (Branemark protocol), both in the patients' home care and in the professional care provided by the dentist. A nonsystematic electronic search was carried out in the Lilacs, Pubmed/Medline, Scielo, and ScienceDirect databases, crossing the following descriptors: "Oral Hygiene"; "Dental Implants"; "Dental Implantation"; "Maintenance"; "Dental Prosthesis, ImplantSupported"; and "Prosthodontics". Literature review articles, systematic reviews, meta-analyses, randomized clinical studies, and relevant books on the subject published from 1995 to 2022 were consulted. The literature available indicates that the main instruments recommended for home care are toothbrush, dental floss, interdental brush, oral irrigator, toothpaste, and mouthwash. In the professional dental office, special attention should be given to the instructions given to the patient, as well as to motivate and encourage their engagement in the hygiene routine, in addition to periodontal monitoring, possible screw replacements, and installation of an occlusal splint when necessary. Maintaining adequate oral hygiene is essential for the success of fixed prostheses on implants, and the dentist plays a crucial role, not only in providing periodic patient follow-up, but also in suggesting the most appropriate instruments, instructing on adequate oral hygiene, and motivating the patient to maintain satisfactory oral health(AU)

Effect of coffee staining and simulated oral hygiene methods on the color and translucency of a nanoceramic resin.

OBJECTIVE: Evaluate the color and translucency of a nanoceramic resin subjected to hygiene practices and immersion in coffee over time. MATERIALS AND METHODS: Specimens (n = 80, HT and LT, 0.5-mm thick) of a nanoceramic resin were obtained and were divided in groups according to the simulated oral hygiene: no intervention (NT), brushing with an electric brush and water (BN), brushing with an electric brush and toothpaste for 10 s (BT), and immersion in mouthwash for 30 s (MW). Oral hygiene practices were repeated after staining in coffee solution for 15, 48, 336, 1440, 8640, and 35,040 min. Spectral wavelengths were recorded with a spectrophotometer at each time. ∆E00, ∆L', ∆C', ∆H', and TP00 were calculated by CIEDE2000 and were evaluated by 2-way ANOVA, repeated measures ANOVA, and Tukey's HSD test (α = 0.05). RESULTS: ANOVA showed significance among factors for ΔE00 (p < 0.05), with higher ΔE00 for NT-HT (11.7) and NT-LT (11.2). After T6 (2-year simulation), the lowest values were found for BT-HT (5.3) and BT-LT (4.9). All groups showed a reduction in lightness and translucency and increased chroma and hue. However, the smallest variations were found in the BT groups (p < 0.05). CONCLUSIONS: Brushing with toothpaste effectively minimized the color change of NCRs caused by coffee staining. CLINICAL SIGNIFICANCE: Oral hygiene practices, such as brushing with toothpaste, might be important to minimize staining of nanoceramic resin restorations, especially in patients who frequently consume coffee.

Strategies for Preventing and Treating Oral Mucosal Infections Associated with Removable Dentures: A Scoping Review.

Oral infections occur due to contact between biofilm rich in Candida albicans formed on the inner surface of complete dentures and the mucosa. This study investigated historical advances in the prevention and treatment of oral mucosal infection and identified gaps in the literature. Bibliographic research was conducted, looking at PubMed, Embase, Web of Science, and Scopus, where 935 articles were found. After removing duplicates and excluding articles by reading the title and abstract, 131 articles were selected for full reading and 104 articles were included. Another 38 articles were added from the gray literature. This review followed the PRISMA-ScR guidelines. The historical period described ranges from 1969 to 2023, in which, during the 21st century, in vitro and in vivo studies became more common and, from 2010 to 2023, the number of randomized controlled trials increased. Among the various approaches tested are the incorporation of antimicrobial products into prosthetic materials, the improvement of oral and denture hygiene protocols, the development of synthetic and natural products for the chemical control of microorganisms, and intervention with local or systemic antimicrobial agents. Studies report good results with brushing combined with sodium hypochlorite, and new disinfectant solutions and products incorporated into prosthetic materials are promising.

The Role of the Dental Surgeon in the Pediatric Intensive Care Unit / O Papel do Cirurgião-Dentista na Unidade de Terapia Intensiva Pediátrica

Dentistry plays a significant role in the supportive care of hospitalized children in Pediatric Intensive Care Units (PICUs) as these patients arrive in this environment with altered immune systems and compromised oral health. This paper aims to present an integrative literature review on the role of dentists in the hospital setting, particularly in the PICU, and discuss the challenges encountered in this environment. A free search was conducted on the electronic platforms PubMed, Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Sciences (Lilacs), and Virtual Health Library (BVS) from January to February 2023, with no defined publication period and including all types of studies. Health Science descriptors (DeCS/MeSH) were used in English and Portuguese, applying Boolean operators. According to the data collected, among the conditions requiring admission to the PICU, respiratory disorders, heart and kidney failure, neurological disorders, severe metabolic diseases, infections, injuries, traumas, near-drowning incidents, and post-operative care after complex surgeries stand out. Dental care in this environment reduce hospitalization time, costs, and improve the quality of life of pediatric patients. However, the integration of these professionals into the PICU is still limited. Dentists in the hospital setting optimize multidisciplinary work through protocol-based measures derived from studies conducted in adult patients in intensive care units. Due to the lack of robust evidence related to oral care practices in pediatric intensive care settings, further research is mandatory. (AU)

A Odontologia tem um papel importante na assistência de crianças hospitalizadas nas Unidades de Terapia Intensiva Pediátricas (UTIP), pois esses pacientes chegam neste ambiente com o sistema imunológico alterado e a saúde bucal comprometida. Apresentar uma revisão integrativa da literatura sobre o papel do cirurgião-dentista no hospital, em especial, na UTIP, além de discutir os desafios encontrados nesse ambiente. Uma busca foi conduzida nas plataformas eletrônicas PubMed, Scientific Eletronic Library Online (SciElo), Latin American and Caribbean Literature in Sciences (Lilacs) e Biblioteca Virtual da Saúde (BVS), entre janeiro a fevereiro/2023, sem período definido de publicação e sob a inclusão de todos os tipos de estudos. Os descritores em Ciências da saúde (DeCS/MeSH) foram utilizados em inglês e português, sob aplicação dos operadoress booleanos. Segundo dados coletados, dentre as condições que necessitam de internação na UTIP, destaca-se as alterações respiratórias, insuficiência cardíaca e renal, alterações do sistema nervoso, doenças metabólicas graves, infecções, ferimentos, traumatismos, quase afogamentos e pós-operatório de cirurgias complexas. O cirurgião-dentista neste ambiente reduz o tempo de internação, os custos e aumenta a qualidade de vida dos pacientes pediátricos. Todavia, ainda é escassa a inserção deste profissional em UTIP. O cirurgião-dentista em ambiente hospitalar otimiza o trabalho multidisciplinar através de medidas baseadas em protocolos obtidos a partir de estudos em pacientes adultos em unidades de terapia intensivas. Devido a falta de evidências robustas relacionadas à prática de cuidados bucais no ambiente de cuidados intensivos pediátricos, a realização de pesquisas futuras torna-se mandatória. (AU)

Control de la biopelícula con materiales bioactivos en pacientes adolescentes: reporte de caso / Biofilm control with bioactive materials in adolescents' patients: case report

El objetivo del artículo es reportar el desempeño clínico en el control y disminución de la placa bacteriana en pacientes adolescentes mediante un gel y barniz con partículas S-PRG. Se realizaron tratamientos con materiales bioactivos con tecnología GIOMER en 2 pacientes. En el primer caso se realizó una profilaxis con Pro Care Gel (S-PRG) en un paciente de 15 años con problemas neuromotores para eliminar la placa y posteriormente, se aplicó un barniz con partículas de S-PRG para prevenir la formación de biofilm. En el segundo caso, un adolescente de 15 años normoreactivo con inflamación gingival recibió el tratamiento profilaxis con PRG Pro Care Gel.Se observó una disminución de placa bacteriana tras la profilaxis con el gel Pro Care y la aplicación del barniz en el primer caso. Además, existió una baja incidencia de biofilm incluso después de 11 meses de la aplicación del barniz. En el segundo caso, a las 2 horas de aplicación, se observó una disminución total de la placa. Clínicamente se observó el bueno desempeño clínico de los materiales con partículas de S-PRG, como lo demuestra la literatura científica en cuanto a la reducción de la formación de placa bacteriana en las estructuras dentarias, la desinflamación gingival, proporciona bienestar a los pacientes y restaura la salud bucal de forma menos invasiva.

The objective of the article is to report the clinical performance in the control and reduction of bacterial plaque in adolescent patients using a gel and varnish with S-PRG particles. Treatments with bioactive materials with GIOMER technology were performed in two patients. In the first case, prophylaxis was performed with Pro Care Gel (S-PRG) in a 15-year-old patient with neuromotor problems to eliminate plaque and subsequently, a varnish with S-PRG particles was applied to prevent biofilm formation. In the second case, a normal 15-year-old adolescent with gingival inflammation received prophylaxis treatment with PRG Pro Care Gel. A decrease in bacterial plaque was observed after prophylaxis with the Pro Care gel and the application of the varnish in the first case. Furthermore, there was a low incidence of biofilm even after 11 months of varnish application. In the second case, after 2 hours of application, a total decrease in plaque was observed. The good clinical performance of materials with S-PRG particles was clinically perceived, as demonstrated by the scientific literature in terms of reducing the formation of bacterial plaque in dental structures, gingival disinflammation, providing well-being to patients and restoring oral health in a less invasive way.

Evaluation of brushing efficiency in reducing oral microbiota in mechanically ventilated patients admitted to an intensive care unit.

Background: Patients admitted to the Intensive Care Unit (ICU) are at greater risk of developing nosocomial infections due to their investigations, treatment and changes in the immune system. One of the most prevalent nosocomial infections is respiratory tract infection, such as hospital acquired pneumonia and ventilator-associated pneumonia (VAP). The bacteria commonly found in the oral cavity in the hospital environment are Streptococcus viridians, Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus spp., and Klebsiella pneumoniae. There is a need to test and define appropriate standard protocols for oral hygiene in patients undergoing mechanical ventilation in ICUs through the intervention of a dental specialist, preventing the proliferation of microorganisms into the respiratory tract, thus reducing hospitalization time, the use of antibiotics, and increased morbidity/mortality. Objective: This study aimed to evaluate the effectiveness of dental brushing in the reduction of the pathogenic buccal microbiota associated with mechanical ventilation in patients admitted to the Evangelical Hospital from Londrina, Paraná, Brazil. Methodology: The sample consisted of 90 patients (of both sexes), mean age of 65 years, under mechanical ventilation by orotracheal tube and tracheostomized patients, without suspected or confirmed diagnosis of pneumonia. Patients were randomized ∗∗∗. Results: Results showed that oral hygiene using a toothbrush by suction, with chlorhexidine gel 0.12% (Group B), was more effective than conventional hygiene using gauze soaked with chlorhexidine 0.12% (Group A) in reducing pathogenic buccal microbiota. Conclusions: There was a reduction of the pathogenic buccal microbiota in mechanically ventilated patients receiving oral hygiene using a toothbrush by suction with chlorhexidine gel 0.12% (Group B).

Desenvolvimento de aplicativo móvel para cuidadores sobre higiene bucal em demência e disfagia / Desarrollo de aplicación móvil para cuidadores sobre higiene bucal en demencia y disfagia / Development of a mobile application for caregivers on oral hygiene in dementia and dysphagia

Os autores relatam a experiência do processo de desenvolvimento do protótipo de um aplicativo sobre higiene bucal de idosos com demência, com atenção especial aos que apresentam disfagia, voltado à orientação dos seus cuidadores. Objetivou, também, descrever o papel desta experiência como estratégia de ensino interprofissional e de inovação social a estudantes de Odontologia e Fonoaudiologia. Realizou-se estudo qualitativo do tiporelato de experiência, com informações originadas de narrativas verbais e registro escrito e iconográfico dos autores dessa pesquisa, bem como de relatos escritos de duas revisoras do protótipo do aplicativo ­ambas especialistas em Gerontologia. Para o protótipo, utilizou-se o site SeuApp.com, sem necessidade de programação, gerando formato de aplicativo e site para desktop e celular. O produto foi desenvolvido em três fases, concluído com êxito, e avaliado positivamente pelas pareceristas. Seu conteúdo incluiu informações escritas e iconográficas, estáticas e dinâmicas, referentes à importância e "passo a passo" da higiene bucal, suas relações com saúde e disfagia, e cuidados específicos diante dessa, além de um "Guia do Aplicativo" e "Feedback". A experiência relatada demonstrou que a construção do aplicativo se deu com êxito e avaliação positiva por pareceristas, com contribuição social almejada. Os discentes e docentes de Odontologia e de Fonoaudiologia envolvidos ampliaram suas habilidades na inovação e nas competências interprofissionais. Mais estudos sobre a inovação na graduação em saúde são requeridos, por se tratar de uma área em expansão no mercado, tendo grande contribuição para atualização dos profissionais da saúde (AU).

Los autores relatan la experiencia del proceso de desarrollo del prototipo de una aplicación sobre higiene bucal para personas mayores con demencia, con especial atención a aquellas con disfagia, con el objetivo de orientar a sus cuidadores. También tuvo como objetivo describir el papel de esta experiencia como estrategia de enseñanza interprofesional e innovación social para estudiantes de Odontología y Logopedia. Se realizó un estudio cualitativo del tipo relato de experiencia, con informaciones provenientes de relatos verbales y registros escritos e iconográficos de los autores de esta investigación, así como relatos escritos de dos revisores del prototipo de la aplicación, ambos especialistas en Gerontología. Para el prototipo se utilizó el sitioweb SeuApp.com, sin necesidad de programación, generando un formato de aplicación y sitio web para escritorio y celular. El producto fue desarrollado en tres fases, completado con éxito y evaluado positivamente por los revisores. Su contenido incluía información escrita e iconográfica, estática y dinámica, referente a la importancia y el "paso a paso" de la higiene bucal, sus relaciones con la salud y la disfagia, y los cuidados específicos ante esta, además de una "Guía de Aplicación" y "Comentarios". La experiencia relatada demostró que la construcción de la aplicación fue exitosa y fue evaluada positivamente por los revisores, con la contribución social deseada. Los estudiantes y profesores de Odontología y Logopedia involucrados ampliaron sus habilidades en innovación y competencias interprofesionales. Se requiere más estudios en innovación en la graduación en salud, ya que es un área en expansión en el mercado, con un gran aporte para la actualización de los profesionales de la salud (AU).

The authors report the experience of developing the prototype of an application on oral hygiene for elderly individuals with dementia, with special attention to those with dysphagia, aimed at guiding their caregivers. The purpose was also to describe the role of this experience as a strategy for interprofessional education and social innovation for dentistry and speech-language pathology students. A qualitative study of the experience was conducted, gathering information from verbal narratives and written and iconographic records of the researchers, as well as written reports from two reviewers of the application prototype­both experts in Gerontology. The website SeuApp.com website was used for the prototype, which required no programming, generating an application format and a website for desktop and mobile. The product was developed in three phases, successfully completed, and positively evaluated by the reviewers. Its content included written and iconographic information, static and dynamic, regarding the importance and step-by-step process of oral hygiene, its relationships with health and dysphagia, and specific care in the face of the latter, along with an "App Guide" and "Feedback." The reported experience demonstrated that the application's construction was successful and positively evaluated by reviewers, thus achieving the intended social contribution. Dentistry and speech-language pathology students and faculty involved expanded their skills in innovation and interprofessional competencies. Given itsexpanding presence in the market and significant contribution to the ongoing education of healthcare professionals, further studies on innovation in health education are required (AU).

Perfil de saúde bucal dos pacientes pediátricos internados no Hospital e Pronto Socorro da Criança Zona Sul (PSC) / Oral health profile of pediatric patients admitted to the South Zone Children's Hospital and First Aid Station

A pesquisa propõe conhecer a saúde bucal, analisando o perfil epidemiológico, identificando a prevalência e necessidade de tratamento dos pacientes pediátricos internados na enfermaria do Hospital e Pronto Socorro da Criança Zona Sul em Manaus (PSC), no Amazonas. Este estudo transversal e observacional descritivo foi realizado com pacientes internados atendidos no PSC no período de setembro de 2022 a fevereiro de 2023. A coleta de dados foi realizada presencialmente nos dias semanais através análise dos prontuários, utilização de uma ficha odontológica e avaliação clínica. Observou-se a presença de pacientes do gênero masculino, superior ao gênero feminino e com faixa etária maior entre 2 a 9 anos de idade. Obteve-se resultados positivos acerca da condição bucal dos pacientes, sendo 44,26% considerada no critério Boa. A doença mais prevalente entre os pacientes internados nas enfermarias, corresponde à Síndrome Nefrótica com 25,35%. Conclui-se que a condição bucal mais prevalente entre os pacientes que se encontram internados na enfermaria é a condição bucal Boa. Isto justifica-se devido a presença de um projeto de extensão completado no hospital, que evidencia que a presença do cirurgião dentista na equipe multidisciplinar nas enfermarias dos hospitais é indispensável, pois ele é o profissional capacitado a manter e restabelecer a saúde bucal.

The research aims to investigate oral health by analyzing the epidemiological profile, identifying the prevalence and treatment needs of pediatric patients admitted to the ward of the South Zone Children's Hospital and First Aid Station in the city of Manaus, in the state of Amazonas. This cross-sectional and descriptive observational study was conducted with admitted patients treated at the South Zone Children's Hospital and First Aid Station between September 2022 and February 2023. The data collection was conducted in person on weekly days through the analysis of medical records, the use of a dental form, and clinical evaluation. It was observed that male patients were more numerous than female patients, and that the age range of 2 to 9 years old had a higher representation. Positive results were obtained regarding the oral condition of the patients, with 44.26% considered to be in the Good category. The most prevalent disease among the patients admitted to the wards is Nephrotic Syndrome, accounting for 25.35%. It is concluded that the most prevalent oral condition among patients admitted to the ward is the Good oral condition. This is justified by the presence of an extension project conducted in the hospital, which shows that the presence of the dental surgeon in the multidisciplinary team in the hospital wards is essential, as they are the professionals capable of maintaining and restoring oral health.

Chemical Profile and Biological Activities Of Piper mikanianum (Kunth) Steud Essential Oil for Development and Improvement of Oral Rinse.

INTRODUCTION: Studies prove that the use of medicinal plants is a custom carried out by man since ancient times, the evolution of the pharmaceutical industry makes more people consume more natural products. Currently, we can observe that mouthwashes containing natural compounds have shown a growth in demand in the markets and in the professional community. OBJECTIVE: The present study aims to carry out the chemical characterization and microbiological potential of Piper mikanianum (Kunth) Steud essential oil (EOPm), providing data that allows the development of a low-cost mouthwash formulation aimed at vulnerable communities. METHODS: The evaluation of the antibacterial activity and modulator of bacterial resistance was performed by the microdilution method to determine the minimum inhibitory concentration (MIC). The chemical components were characterized by gas chromatography coupled to mass spectrometry, identified 28 constituents, in which Safrole Phenylpropanoid is the major compound, representing 72.6 % of the total composition, followed by α-pinene (10.7 %), Limonene (2 %), ß-caryophyllene (2 %), E-nerolidol (1.9 %), spathulenol (1.3 %) and camphene (1.1 %). RESULTS: The EOPm showed a MIC minimum inhibitory concentration≥1024 µg/mL for all bacterial strains used in the tests. When the EOPm modulating activity combined with chlorhexidine, mouthwash, ampicillin, gentamicin and penicillin G was evaluated against bacterial resistance, the oil showed significant synergistic activity, reducing the MIC of the products tested in combination, in percentage between 20.6 % to 98 .4 %. CONCLUSIONS: We recommend the expansion of tests with greater variation of EOPm concentration combinations and the products used in this study, as well as toxicity evaluation and in vivo tests, seeking the development of a possible low-cost mouthwash formulation accessible to the most vulnerable population.

A Saúde Bucal e a Prevenção da Pneumonia na UTI: Revisão Literatura / Bucal Health and Prevention of Pneumonia in the ICU: Literature Review / Salud Bucodental y Neumonía en la UCI: Revisión Bibliográfica

Objetivo: Analisar os fatores que interferem na saúde bucal na prevenção da pneumonia, cujos procedimentos metodológicos se fundamentaram a partir da literatura na modalidade integrativa. Método: Estudo do tipo Revisão de literatura nas bases de dados Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de dados de Enfermagem (BDENF), Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELo). Resultados:Foram encontrados resultados mais relevantes que apesar dos profissionais de enfermagem afirmarem que possuem conhecimento suficiente sobre como realizar a higiene oral em pacientes, a aplicação do protocolo adequado diminui drasticamente nos casos de pneumonia associado a ventilação mecânica. Conclusão: Conclui-se que os protocolos de atividades voltadas para assistência à saúde dos pacientes com pneumonia precisam ser intensificados, sobretudo pelos profissionais de enfermagem

Objective: To analyze the factors that interfere with oralhealth in the prevention of pneumonia, whose methodological procedures were based on the literature in the integrative modality. Method:Literature review study in the Latin American and Caribbean Health Sciences databases (LILACS), Nursing Database (BDENF), Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELo). Results:More relevant results were found that although nursing professionals claim to have sufficient knowledge about how to perform oralhygiene in patients, the application of the appropriate protocol drastically decreases in cases of pneumonia associated with mechanical ventilation. Conclusion:It is concluded that the protocols of activities aimed at health care for patients with pneumonia need to be intensified, especially by nursing professionals.

Objetivo: Analizar los factores que interfieren en la salud bucal en la prevención de la neumonía, cuyos procedimientos metodológicos se basaron en la literatura en la modalidad integrativa. Método:Revisión de la literatura en las bases de datos de Ciencias de la Salud de América Latina y el Caribe (LILACS), Base de Datos de Enfermería (BDENF), Sistema de Análisis y Recuperación de Literatura Médica en Línea (MEDLINE), Scientific Electronic Library Online (SciELo). Resultados: Se encontraron resultados más relevantes que aunque los profesionales de enfermería afirman tener conocimientos suficientes sobre cómo realizar la higiene bucal en los pacientes, la aplicación del protocolo adecuado disminuye drásticamente en los casos de neumonía asociada al ventilador. Conclusión:Se concluye que los protocolos de actividades dirigidas al cuidado de la salud de pacientes con neumonía necesitan ser intensificados, especialmente por los profesionales de enfermería

Halitosis: a conceptual, etiologic and therapeutic approach / Halitose: uma abordagem conceitual, etiológica e terapêutica

Objective: Halitosis is the offensive odor emanated by the oral and nasal cavities and perceived by the individual and/or by other people. Halitosis is a symptom that directly impacts on the social aspects of an individual's life and may be a sign for a systemic disorder in some cases. Material and Methods: A search was conducted on the literature in order to gather the main aspects about halitosis and make a review about the main features necessary to the clinical practice when a professional deals with a patient with halitosis. Results: The information was summarized and discussed with a focus on what clinicians should be aware of when dealing with a patient with halitosis. Conclusion: Halitosis is a prevalent symptom that affects approximately 25% of the individuals. Its classification takes into consideration the origin of the compounds producing the malodor. The diagnosis must take into consideration the various etiological possibilities before defining the treatment. The treatment must be focused on the cause and since there is a wide range of possible causes, halitosis needs a multidisciplinary approach (AU)

Objetivo: Halitose é um cheiro ofensivo expelido pela cavidade bucal e pela cavidade nasal e percebido pelo indivíduo e/ou pelas outras pessoas. A halitose é um sintoma que impacta diretamente aspectos sociais da vida de um indivíduo e pode ser um sinal de alguma desordem sistêmica em alguns casos. Material e Métodos: Uma busca foi feita na literatura para reunir os principais aspectos da halitose e conduzir uma revisão sobre as principais características necessárias à prática clínica quando um profissional lida com um paciente com a queixa de halitose. Resultados: A informação disponível foi sumarizada e discutida com foco naquilo que um clínico deve estar atento quando lida com um paciente com a queixa de halitose presente. Conclusão: A halitose é um sintoma prevalente que afeta aproximadamente 25% dos indivíduos. Sua classificação leva em consideração a origem dos compostos que produzem o mau hálito. O diagnóstico deve levar em conta as várias etiologias possíveis antes de definir um tratamento. O tratamento deve ser focado na causa e, como há uma ampla variedade de possíveis causas, a halitose é um sintoma que precisa de uma abordagem multidisciplina (AU)