Conhecimentos e práticas sobre saúde bucal da equipe de nefrologia, de crianças e adolescente / Oral health knowledge and practices of the nephrology team of children and adolescents

Os objetivos deste estudo foram: (1) avaliar a condição bucal de crianças e adolescentes com IRC e o conhecimento sobre saúde bucal desses pacientes, seus responsáveis e da equipe de nefrologia (Fase 1); elaborar e validar um folheto com instruções de saúde bucal para crianças e adolescentes com IRC (Fase 2); realizar um estudo piloto a fim de observar a influência do folheto no nível de conhecimento e nos índices de placa bacteriana e sangramento gengival desses pacientes (Fase 3). O trabalho foi realizado nos dois centros de referência de Nefrologia Pediátrica da cidade do Rio de Janeiro e na clínica de Odontopediatria da Universidade Federal do Rio de Janeiro (UFRJ). Para a Fase 1, o conhecimento de 30 pacientes pediátricos e dos seus responsáveis foi obtido através de entrevistas com roteiro pré-estruturado. Para 80 profissionais de saúde, um questionário com perguntas abertas e fechadas foi utilizado. Os resultados mostraram que os pacientes apresentam um baixo nível de conhecimento em relação à saúde bucal e elevados índices periodontais (biofilme, sangramento gengival e cálculo). Os profissionais de saúde apresentam um nível de conhecimento suficiente porém não repassam essas informações aos pacientes. Os responsáveis apresentam algum nível conhecimento, porém precisam ser melhores informados sobre saúde bucal. Na Fase 2, o folheto foi elaborado com base na literatura científica e nos resultados obtidos na Fase 1. A validação foi realizada em 4 etapas em que participaram especialistas, mestres e doutores em Odontopediatria, profissionais da área da educação, crianças e adolescentes sem IRC e pacientes pediátricos com IRC e seus responsáveis. As sugestões foram analisadas e aquelas consideradas pertinentes foram incorporadas. A validação foi importante para melhorar o conteúdo e a organização do material informativo. Na fase 3, para a verificar a eficácia do folheto, foram estabelecidos dois parâmetros de avaliação: dados clínicos (índice de biofilme e sangramento) e avaliação do conhecimento (entrevista com questionários pré estruturados). Após a coleta inicial dos dados, 30 pacientes foram convidados a comparecer na UFRJ para realização da raspagem de cálculo e leitura do folheto. Depois de um mês, todos os parâmetros foram reavaliados em 10 pacientes. Os resultados finais mostraram que os índices de biofilme e sangramento diminuíram significativamente (p˂0.05) e o nível de conhecimento sobre saúde bucal aumentou. Conclui-se que crianças e adolescentes com IRC e seus responsáveis precisam ser mais informados sobre os cuidados com a saúde bucal, e que a equipe de nefrologia precisa atuar mais nesse processo de orientação. O folheto pode ser uma opção para informar essa população e estimular o autocuidado em favor da saúde bucal. (AU)

The objectives of this study are: (1) assess the oral status of pediatric patients undergoing hemodialysis and their level of knowledge, of their caregivers and of the health care team about the relationship between oral health and Chronic Kidney Disease (CKD) (Stage 1); (2) develop and validate a pamphlet with oral health instruction for children and adolescents with CKD (Stage 2); (3) and perform a pilot study in order to observe the influence of the pamphlet at the level of knowledge and periodontal plaque and gingival bleeding of these patients (Stage 3). The study was conducted in reference centers of pediatric nephrology in the city of Rio de Janeiro, Brazil. On Stage 1, the knowledge of caregivers and pediatric patients was obtained using a pre-prepared interview, while for the health professionals, a self-administered questionnaire was used. The results showed that children and adolescents had a low level of knowledge and increased periodontal indexes. The health professionals had a sufficient level of knowledge in relation to oral health; however, they did not pass this information on to patients. The caregivers had a certain level of knowledge; however, they need to be better informed. At Stage 2, the elaboration of the pamphlet was based on specific scientific literature of the area and based on the results of Stage 1. Validation was carried out in 4 steps which involved professors and researchers in the field of Pediatric Dentistry and renal diseases, educational professionals, children/adolescents without CKD and children/adolescents with CKD and their caregivers. The suggestions were analyzed and those considered relevant to the study were incorporated. The validation process was considered important to enhance the content and organization of the pamphlet. At Stage 3, to verify the effectiveness of the pamphlet were established two evaluation parameters: clinical data (biofilm and gingival bleeding indexes) and level of oral health knowledge (interview with pre-structured questionnaires). After the initial data collection, 30 patients were invited to go to a dentist appointment in UFRJ to perform the dental calculus removal and read the pamphlet. After a month, all parameters were assessed in 10 patients. The final results show that the biofilm and gingival bleeding indexes rates decreased significantly (p˂0.05) and the level of knowledge about oral health has increased. We conclude that children and adolescents with CKD and their parents need to be more informed about the oral care, and the nephrology team needs to work more in this orientation process. The pamphlet can be an option to report this population and encourage their self-care in favor of oral health. (AU)

Quality of Life related to Eruption Hematoma in a Twenty Months Old Infant.

AIM: This paper describes a case of an eruption hematoma in a 20-month-old boy and the impact of this hematoma on the quality of life (QoL) related to oral health of this infant and his family. BACKGROUND: Eruption hematoma is a soft benign cyst that contains blood and overlie a tooth that are about to erupt. Oral health conditions can affect the QoL and bring psychological impacts. CASE REPORT: The proposed treatment was based on oral hygiene instruction, normal diet and massage on the lesion area. A weekly follow-up visits up to the spontaneous regression at the 6 weeks of the lesion was conducted. The impact on QoL was assessed though the Brazilian version of the early childhood Oral Health Impact Scale (B-ECOHIS) questionnaire before and after 2 months of the hematoma regression. CONCLUSION: The presence of eruption hematoma impacted, physically and emotionally, the QoL related to oral health of the child and his family, and this impact decreased when the eruption hematoma disappeared. CLINICAL SIGNIFICANCE: It is important the knowledge of the dentists about eruption cyst/hematoma to make the correct decisions to improve the QoL of their patients and families.

Left-right judgment of haptic stimuli representing the human hand

The handedness recognition of visually perceived body parts engages motor representations that are constrained by the same biomechanical factors that limit the execution of real movements. In the present study, we used small plastic cutouts that represented the human hand to investigate the properties of mental images generated during their haptic exploration. Our working hypothesis was that any handedness recognition task that involves body parts depends on motor imagery. Forty-four blindfolded, right-handed volunteers participated in a handedness evaluation experiment using their index finger to explore either the back or palm view of a haptic stimulus that represented the human hand. The stimuli were presented in four different orientations, and we measured the subjects' response times. Our results showed that stimulus configurations that resemble awkward positions of the human hand are associated with longer response times (p < .006), indicating that the haptic exploration of stimuli that represent body parts also leads to motor imagery that is constrained by biomechanical factors

Left-right judgment of haptic stimuli representing the human hand

The handedness recognition of visually perceived body parts engages motor representations that are constrained by the same biomechanical factors that limit the execution of real movements. In the present study, we used small plastic cutouts that represented the human hand to investigate the properties of mental images generated during their haptic exploration. Our working hypothesis was that any handedness recognition task that involves body parts depends on motor imagery. Forty-four blindfolded, right-handed volunteers participated in a handedness evaluation experiment using their index finger to explore either the back or palm view of a haptic stimulus that represented the human hand. The stimuli were presented in four different orientations, and we measured the subjects' response times. Our results showed that stimulus configurations that resemble awkward positions of the human hand are associated with longer response times (p < .006), indicating that the haptic exploration of stimuli that represent body parts also leads to motor imagery that is constrained by biomechanical factors.(AU)