Phytotherapy: knowledge, experience and prescription in oral healthcare. A cross-sectional survey of dental practitioners / Conhecimento, experiência e prescrição de fitoterapia em saúde bucal: Um levantamento transversal com dentistas clínicos

ABSTRACT Herbal medicine is widely used as an integrative complementary treatment for common chronic diseases, yet potential risks include adverse effects and coprescription Aim This exploratory survey assessed Brazilian dentists' knowledge, attitudes, and practices regarding phytotherapy Material and Method This study used a consecutive sample of registered dentists who were active in clinical practice and attending advanced training for complex oral rehabilitation at a leading dental school in Latin America. Participants responded to a semi-structured 38-item instrument designed to collect data on sociodemographic, professional and health variables, and on their knowledge, use, prescription and opinions of phytotherapy. Quantitative data were analyzed with descriptive and inferential statistics. Qualitative data were described and analyzed with a thematic approach Results A total 53 dentists responded the survey (88.3% response rate). Six dentists reported formal education in phytotherapy and 33 had informal knowledge. Twenty-one dentists (39.6%) reported using herbal medicine, and 17 (32.1%) prescribed phytotherapy to their patients, mostly traditional medicinal plants. A logistic regression model showed that post-graduate degree and personal use of phytotherapy were associated with phytotherapy prescription. Opinions on how to improve the rational use of phytotherapy included the need for research evidence, specific academic education, and knowledge dissemination to clinicians. As a clinical recommendation, it was proposed that questions on herbal medicine should be asked during the dental patient's anamnesis Conclusions Dentists with post-graduate degrees and personal use of phytotherapy prescribe herbal medicines for their patients in real-world clinics, regardless of formal education on the subject. Qualitative findings indicate the need to implement scientific initiatives.

RESUMO A fitoterapia é amplamente utilizada como um tratamento integrativo e complementar para doenças crônicas comuns, mas os riscos potenciais incluem efeitos adversos e co-prescrição Objetivo Esta pesquisa exploratória avaliou o conhecimento, as atitudes e as práticas de cirurgiões-dentistas brasileiros sobre fitoterapia Materiais e Método Uma amostra consecutiva foi composta por dentistas com registro profissional, que eram ativos em prática clínica e frequentavam treinamento avançado para reabilitação oral complexa em uma das principais escolas de odontologia da América Latina. Os participantes responderam a um instrumento semiestruturado de 38 itens para coletar dados sobre variáveis sociodemográficas, profissionais e de saúde, bem como conhecimento, uso, prescrição e opiniões sobre fitoterapia. Os dados quantitativos foram analisados com estatística descritiva e inferencial. Os dados qualitativos foram descritos e analisados com abordagem temática Resultados Um total de 53 dentistas respondeu à pesquisa (taxa de resposta de 88,3%). Seis cirurgiões-dentistas relataram formação em fitoterapia e 33 possuíam conhecimento informal. Vinte e um dentistas (39,6%) relataram o uso de fitoterápicos e 17 (32,1%) prescreveram fitoterapia para seus pacientes, principalmente plantas medicinais tradicionais. Um modelo de regressão logística mostrou que pós-graduação e uso pessoal de fitoterapia estiveram associados à prescrição de fitoterapia. As opiniões para melhorar o uso racional da fitoterapia incluíram a necessidade de evidências de pesquisa, formação acadêmica específica e disseminação do conhecimento para os clínicos. Como recomendação clínica, foram propostas questões sobre fitoterapia para a anamnese odontológica do paciente Conclusões Cirurgiões-dentistas com pós-graduação e uso pessoal de fitoterapia prescrevem mais medicamentos fitoterápicos para seus pacientes em clínicas do mundo real, independentemente da educação formal sobre o assunto. Os resultados qualitativos indicam a necessidade de iniciativas de implementação científica.

Phytotherapy: knowledge, experience and prescription in oral healthcare. A cross-sectional survey of dental practitioners.

Herbal medicine is widely used as an integrative complementary treatment for common chronic diseases, yet potential risks include adverse effects and coprescription. Aim: This exploratory survey assessed Brazilian dentists' knowledge, attitudes, and practices regarding phytotherapy. Material and Method: This study used a consecutive sample of registered dentists who were active in clinical practice and attending advanced training for complex oral rehabilitation at a leading dental school in Latin America. Participants responded to a semi-structured 38-item instrument designed to collect data on sociodemographic, professional and health variables, and on their knowledge, use, prescription and opinions of phytotherapy. Quantitative data were analyzed with descriptive and inferential statistics. Qualitative data were described and analyzed with a thematic approach. Results: A total 53 dentists responded the survey (88.3% response rate). Six dentists reported formal education in phytotherapy and 33 had informal knowledge. Twenty-one dentists (39.6%) reported using herbal medicine, and 17 (32.1%) prescribed phytotherapy to their patients, mostly traditional medicinal plants. A logistic regression model showed that post-graduate degree and personal use of phytotherapy were associated with phytotherapy prescription. Opinions on how to improve the rational use of phytotherapy included the need for research evidence, specific academic education, and knowledge dissemination to clinicians. As a clinical recommendation, it was proposed that questions on herbal medicine should be asked during the dental patient's anamnesis. Conclusions: Dentists with post-graduate degrees and personal use of phytotherapy prescribe herbal medicines for their patients in real-world clinics, regardless of formal education on the subject. Qualitative findings indicate the need to implement scientific initiatives.

A fitoterapia é amplamente utilizada como um tratamento integrativo e complementar para doenças crônicas comuns, mas os riscos potenciais incluem efeitos adversos e co-prescrição. Objetivo: Esta pesquisa exploratória avaliou o conhecimento, as atitudes e as práticas de cirurgiões-dentistas brasileiros sobre fitoterapia. Materiais e Método: Uma amostra consecutiva foi composta por dentistas com registro profissional, que eram ativos em prática clínica e frequentavam treinamento avançado para reabilitação oral complexa em uma das principais escolas de odontologia da América Latina. Os participantes responderam a um instrumento semiestruturado de 38 itens para coletar dados sobre variáveis sociodemográficas, profissionais e de saúde, bem como conhecimento, uso, prescrição e opiniões sobre fitoterapia. Os dados quantitativos foram analisados com estatística descritiva e inferencial. Os dados qualitativos foram descritos e analisados com abordagem temática. Resultados: Um total de 53 dentistas respondeu à pesquisa (taxa de resposta de 88,3%). Seis cirurgiões-dentistas relataram formação em fitoterapia e 33 possuíam conhecimento informal. Vinte e um dentistas (39,6%) relataram o uso de fitoterápicos e 17 (32,1%) prescreveram fitoterapia para seus pacientes, principalmente plantas medicinais tradicionais. Um modelo de regressão logística mostrou que pós-graduação e uso pessoal de fitoterapia estiveram associados à prescrição de fitoterapia. As opiniões para melhorar o uso racional da fitoterapia incluíram a necessidade de evidências de pesquisa, formação acadêmica específica e disseminação do conhecimento para os clínicos. Como recomendação clínica, foram propostas questões sobre fitoterapia para a anamnese odontológica do paciente. Conclusões: Cirurgiões-dentistas com pós-graduação e uso pessoal de fitoterapia prescrevem mais medicamentos fitoterápicos para seus pacientes em clínicas do mundo real, independentemente da educação formal sobre o assunto. Os resultados qualitativos indicam a necessidade de iniciativas de implementação científica.

Self-Medication Profile of Adult Patients with Temporomandibular Disorders in Southeast Brazil.

Background: Patients with temporomandibular disorder (TMD) often have orofacial pain and may use medication without professional prescription. Self-medication and inappropriate drug intake may cause serious health problems. This cross-sectional study evaluated the self-medication profile of TMD patients, the most used medications and their effect, and the relation between self-medication and socioeconomic factors. Methods: A non-representative sample (n=358) consisted of consecutive adult patients seeking TMD treatment in specialized referral centers for orofacial pain of two universities in São Paulo city, Brazil. A standardized questionnaire was used to collect the study variables before the TMD treatment: self-medication history, TMD pain intensity, sex, age, ethnicity, marital status, schooling and socioeconomic levels. Data were analyzed by descriptive statistics, chi-square test, and logistic regression models at the 0.05 significance level. Results: Almost 60% of 358 TMD patients reported self-medication. Patients with severe TMD were 4.7 times more likely to self-medicate when compared to patients with low TMD intensity (O=5.7; 95% CI=2.4; 13.3; P=0.043), as well as female patients were 30% more likely to self-medicate compared to male patients (OR=2.3; 95% CI=1.1; 5.1; P<0.001). The other independent variables were not associated with self-medication. The frequencies of moderate and severe TMD in women were larger than in those in men (P<0.001). Analgesics and anti-inflammatory drugs were the most used medications. Regarding medication efficacy, 82% of patients reported some improvement after use, but 9% reported side-effect sickness. Conclusion: Self-medication is common among TMD patients attending specialized clinics, and this inappropriate practice is more likely to occur in women and in patients with severe signs and symptoms of TMD.

Acupuncture applied at local or distal acupoints reduces pain related to temporomandibular disorders in female patients.

PURPOSE: To evaluate the efficacy of two traditional acupuncture protocols on pain relief in temporomandibular disorder (TMD) patients using either local or distal acupoints for mechanical needle stimulation. MATERIALS AND METHODS: The sample was selected from female TMD patients with chronic pain from a specialized referral center. Clinical charts were retrieved to select patients treated by traditional acupuncture following either a protocol for application of needles in local acupoints (head, neck) or a protocol for application in distal acupoints (hands, legs, feet). Pain intensity was recorded before and after each acupuncture session by using an instrumental question with a 10-point visual analog scale (VAS). A control group consisted of nontreated patients from the waiting list for TMD treatment. Data were analyzed using descriptive statistics, paired t test, analysis of variance, and Tukey test, at a significance level of .05. RESULTS: Out of 102 TMD patients, 32 were treated with acupuncture at local points, 22 were treated with acupuncture at distal points, and 48 were controls. A significant decrease of mean VAS score (approximately 70%) was found after acupuncture treatments in both the local- and distal-point groups. The final VAS of each acupuncture group was lower than the control group, but the acupuncture groups showed no difference. CONCLUSION: It can be concluded that acupuncture treatment reduces chronic pain in TMD patients, and the application of needle stimulation at local or distal acupoints has similar effects.

A multispecies probiotic reduces oral Candida colonization in denture wearers.

PURPOSE: The prevalence of Candida infections has been rising with an increasingly aging population and a larger population of immunocompromised individuals. The use of probiotics may be an alternative approach to antifungal agents in the prevention and treatment of oral candidiasis. This study aimed to evaluate the short-term effect of probiotics in reducing the infection level of oral Candida in candidiasis-asymptomatic elderly denture wearers. MATERIALS AND METHODS: In a double-blind randomized study, 59 denture wearers harboring Candida spp. in the oral cavity with no clinical symptoms were allocated into two groups: probiotic and placebo. All patients were instructed to clean the denture daily. The probiotic group poured a capsule containing lyophilized Lactobacillus rhamnosus HS111, Lactobacillus acidophillus HS101, and Bifidobacterium bifidum daily on the palatal surface of the maxillary denture, whereas the placebo group was submitted to the same regimen using placebo capsules. Candida spp. infection levels were evaluated in palate mucosa samples obtained before and after a 5-week experimental period. RESULTS: All patients harbored Candida in the palate mucosa at baseline. Fifty-five individuals completed the experimental period. The detection rate of Candida spp. was 92.0% in the placebo group after the experimental period, whereas it was reduced to 16.7% in the probiotic group. The reduction promoted by the probiotic regimen was independent of baseline characteristics such as Candida infection level and colonizing species, age of denture, and other variables. CONCLUSION: The probiotic product was effective in reducing the colonization of the oral cavity with Candida in candidiasis-asymptomatic elderly denture wearers, suggesting that this multispecies probiotic could be used to prevent oral candidiasis. CLINICAL IMPLICATIONS: Colonization of oral surfaces by Candida is considered a risk factor for invasive fungal infections. The use of a product with L. rhamnosus, L. acidophilus, and B. bifidum may represent an alternative treatment for reduction of Candida infections in elderly denture wearers.

Three-dimensional readout of flash x-ray images of living sperm in water by atomic-force microscopy.

The imaging of living specimens in water by x-ray microscopy can be greatly enhanced with the use of an intense flash x-ray source and sophisticated technologies for reading x-ray images. A subnanosecond [corrected] x-ray pulse from a laser-produced plasma was used to record the x-ray image of living sea urchin sperm in an x-ray resist. The resist relief was visualized at high resolution by atomic-force microscopy. Internal structure of the sperm head was evident, and the carbon density in a flagellum was estimated from the relief height.