Periodontal and Microbiological Profile of Intensive Care Unit Inpatients.

INTRODUCTION: The bidirectional relationship between the periodontal diseases and systemic diseases was attributed to the focal infection concept. The aims of this study were to assess the periodontal and microbiological profile of intensive care unit (ICU) inpatients submitted to orotracheal intubation, and classify them regarding gender, age group, ethnic, hospitalization reason and period, nosocomial infection occurrence, and death. MATERIALS AND METHODS: Inpatients were assessed, distributed into toothed and toothless groups. The periodontal clinical condition was assessed 24 hours after the ICU admission through plaque index, gum index, probing depth, and clinical level of insertion. All microbiological samples were collected on the 6th day of admission. These samples were collected from different intraoral sites, depending on the group: In the toothed group, samples were collected from gingival sulcus and in the toothless group, from buccal mucosa and tongue. Identification for Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Tannerella forsythia (Tf) was accomplished and analyzed, using absolute quantification and specific primer pairs through an amplification system with probes. RESULTS: Forty subjects composed the sample: Gender characterized by 60% of male, 27.5% of all patients were older than 60, and 22.5% were hospitalized due to cerebrovascular accident. Regarding hospitalization period, 55% of patients were hospitalized for 6 days and 70% of them died during the period of hospitalization. Of inpatients, 40% presented periodontal disease and 100% presented dental biofilm on assessed sites. When assessing the microbiota, statistical significance was observed between Aa, Pg, and Tf, for both toothed and toothless group (p < 0.0001). CONCLUSION: Large quantities of Aa were found in samples of toothless inpatients, a fact that suggests that the oral environment, even without teeth, presents favorable conditions for bacterial biofilm formation with a related pathogenic potential. CLINICAL SIGNIFICANCE: The dental biofilm may comprise pulmonary pathogen colonies, promoting a perfect environment for their growth and development, facilitating the colonization of the lower airways, as well as colonization by bacteria originally from the oral cavity.

Avaliação do conhecimento dos alunos de graduação em odontologia x cirurgião dentista no diagnóstico de maus-tratos a crianças / Assessment of knowledge of undergraduate students x dentist in diagnosis of child maltreatment

Os maus-tratos em crianças e adolescentes ocorrem quando um indivíduo comete um ato capaz de causar dano físico, psicológico ou sexual, contrariamente à vontade da vítima, podendo gerar consequências graves como injúrias permanentes e problemas psicossociais. O envolvimento frequente de áreas como a estrutura da face e a cavidade bucal torna o cirurgião dentista apto a diagnosticar a ocorrência de tais fatos. Segundo o Ministério da Saúde, a notificação é compulsória dos casos de violência pelos profissionais da saúde que atendem pelo SUS. Muitas vezes, o cirurgião dentista não tem capacitação para realizar o correto diagnóstico e fazer o encaminhamento necessário. Assim, o objetivo do presente estudo foi avaliar o conhecimento dos alunos de graduação e do profissional de Odontologia em relação aos maus-tratos na infância e adolescência.

Maltreatment in children and adolescents occur when an individual commits an act capable of causing physical harm, psychological or sexual, against the wishes of the victim, and may cause serious consequences such as permanent injury and psychosocial problems. The frequent involvement of areas such as the structure of the face and oral cavity makes the dentist able to diagnose the occurrence of such events. According to the Ministry of Health, it is required mandatory reporting of cases of violence by health professionals that work in the public service (SUS). Often the dentist does not have capacity to make a correct diagnosis and make the necessary referral. The objective of this study was to evaluate and compare the knowledge of undergraduate students and professional dentistry in relation to abuse in childhood and adolescence.