Difficulties experienced by dentists and orthodontists regarding ethical issues when announcing the diagnosis of a rare oral disease: a qualitative study in Marseille, France.

PURPOSE: It is traditionally considered that breaking bad news to patients does not represent a cause for concern for dental professionals. However, there are situations where they will be confronted with this task, as in the case of rare dental diseases. Little information is available regarding the feelings of healthcare professionals on this subject. There are no qualitative studies that explore how a diagnosis of oligodontia is announced to patients by dentists and orthodontists. The aim of our study is to explore the difficulties and ethical issues experienced by dental health professionals when they have to announce a diagnosis of oligodontia to a patient and their family. METHODS: This study relied on a qualitative research method using focus groups of dentists and orthodontists and a thematic analysis procedure. RESULTS: The difficulties experienced could be summarised within five topics: organisational difficulties, difficulties with the management of dental treatment and with the administrative management associated with this anomaly, difficulties with the content of the announcement, and relational difficulties. These could be grouped in two categories: practical difficulties and ethical difficulties. CONCLUSION: This survey allowed us to understand the difficulties encountered by dentists and orthodontists when announcing oligodontia. The participants felt uncomfortable with this task and were under stress. They reported difficulties in delivering the medical information and in adapting to the message. It is essential that dental professionals develop skills in medical communication.

Integralidade do atendimento odontológico à mulher em situação de violência: revisão narrativa da conduta profissional / Dental care integrality for women in violent situations: a narrative review of professional conduct

O desempenho de atributos profissionais de integralidade do atendimento de mulheres em situação de violência depende de como os cirurgiões-dentistas (CDs)estruturam suas práticas de cuidado e como compreendem a violência. Por isso, o objetivo desta revisão foi acumular evidências da responsabilidade profissional e obrigações sociais do CDe sua imprescindibilidade no enfrentamento da violência contra a mulher. Foram selecionados artigos nas bases de dados PubMed, SciELOe LILACS, a partir de Descritores emCiências da Saúde, para fundamentar e aprofundar as perspectivas sobre a integralidade do atendimento odontológico, considerando os conflitos sociais subentendidos na queixa principal. Constatou-se que a violência contra a mulher é resultante de processoshistóricos-sociais de desigualdade entre os gêneros; a agressão física sobressai-se entre as principais queixas e mulheres agredidas por seu parceiro têm alta prevalência de sofrer injúrias na cabeça e na face. As sequelas da violência vão além dos vestígios físicos e difundem-se a inúmeros problemas orais. Verificou-se pouca aptidão dos cirurgiões-dentistas para identificar, conduzir e propor alternativas de tratamento global à paciente, mesmo com protocolos para naturalização da investigação por meio da anamnese. A ampliação do conhecimento e discussão das políticas de ensino são oportunidades para consolidar a humanização e a integralidade de saúde, evitando exames e tratamentos mecânicos, sem afeto ou respeito. Essa estratégia faz parte da construção coletiva para o estabelecimento e manutenção do compromisso ético e social do Ensino em Odontologia, em que o CD compreende a magnitude de sua profissão e presta seus serviços articulado com a realidade social (AU).

Improving integrality on dental care for women in a violent situation depends on how the dentist conducts the care practices and how to comprehend the violence. For that reason, the goal of this review was to gather evidence and concerns about the role of dentists in addressing violence against women, professional responsibilities, and social obligation. At PubMed, SciELO, and LILACS were selected research and studies to substantiate and deepen perspectives about integrality on dental care attendance considering the social conflicts implied in the main complaint. Violence against women is produced in gender inequality arising from historical and social processes. Physical aggression is the main complaint. Women assaulted by their partners have a high prevalence of suffering head and face injuries. The violence's sequelae spread to countless problems beyond the physical traces. Dentists do not be able to identify, conduct, and purpose alternatives of global treatment even though with protocols of investigationthrough the anamnesis. Multiprofessional discussion expands the knowledge and it is an opportunity to reinforce oral health inclusive criteria avoiding mechanicaltreatment with no respect or affect. Thus, this is a collective construction strategy to establish and maintenance of the ethical and social commitment of Dentistry, on what dentists improve the dental care screening, intervening, and changing behavior according to the real demand of our society (AU).

Representações cotidianas da prática para o cirurgião-dentista na atenção primária: uma revisão de escopo da literatura / Day-to-day representations about practice by dentists in primary care: a scope review of the literature

Embora se saiba muito sobre os dados mensuráveis da Saúde Bucal na Atenção Primária à Saúde (APS), pouco se sabe sobre os aspectos individuais e subjetivos do profissional da odontologia. No desempenho de suas funções, o cirurgião-dentista entra em contatocom ambientes, tecnologias e pessoas em sua total complexidade, desencadeando, como resposta, uma série de emoções do organismo, as quais se expressam de forma consciente através dos sentimentos.Diante desse cenário, o presente trabalho partiu do pressuposto de que os dentistas têm muito a dizer sobre as representações cotidianas que possuem sobre seu trabalho. O objetivo deste estudo foi identificar -a partir do que se tem produzido na literatura -os sentimentos expressos pelos dentistas na sua práticana APS. Optou-se por conduzir uma revisão de escopo por ser um campo pouco pesquisado. O presente estudo foi elaborado obedecendo os vinte itens essenciais e os dois itens opcionais da Extensão Prisma para revisões de escopo apresentado por Tricco et al.em 2018. As buscas foram realizadas no período de agosto a outubro de 2020, utilizando-se para a construção da pergunta da pesquisa do mnemônico que representa População, Conceito e Contexto, definido assim: P = cirurgiões-dentistas, C = sentimento e C = atenção básica. Por meiodeste estudo percebe-secomo a prática odontológica está sujeita a emoções e sentimentos muitas vezes antagônicos e, assim, necessários de elaboração (AU).

Although much is known about measurable data on Oral Health in Primary Health Care (PHC), little is known about the individual and subjective aspects of the dental professional. In the performance of their functions, dentists keep in touch with some environmental and technological aspects, and with people in their total complexity. In response, these conditions trigger a series of emotions in the [dentist's] body, which are consciously expressed through their feelings. Given this scenario, the present studyarose from the assumption that dentists have a great deal to say about the everyday representations they have about their job. The objective of this study was to identify the feelings expressed by dentists in their practice in PHC, based on the data that has been produced in the. The scope of the review was chosen due to the limited number of researches in this field. The present study was conducted taking into consideration the twenty essential items and the two optional items of the Prisma Extension for scope reviews presented by Tricco et al. in 2018. The search was conducted in the period from August to October 2020, by using the construction of the mnemonic research question that represented Population, Concept and Context, which was defined as follows: P = Dentists, C = feeling and C = primary care. Based on this study, we were able to perceive the extent to which dental practice was subject to emotions and feelings that were frequently antagonistic and, therefore, it was necessary to examine them in greater depth (AU).

Perfil socioeconômico e nível de satisfação dos pacientes atendidos naclínica de endodontia de uma instituição de pós-graduação / Socio-economic profile and level of satisfaction of patients seen at the endodontics clinic of a postgraduate institution

Este estudo objetivou avaliar o perfil socioeconômico e a satisfação dos pacientes em relação aos serviços prestados na Clínica de Endodontia de uma instituição de ensino de pós-graduação. A coleta de dados foi realizada em corte transversal por meio de questionário estruturado e autoaplicável. A amostra foi intencional e aleatória (n=50) para usuários que haviam finalizado o tratamento endodôntico. Para avaliar a satisfação ao final do tratamento foiutilizada escala dimensionale bipolar, com escores atribuídos entre as extremidades. As notas dadas aos diferentes aspectos do tratamento variaram de 0 a 10 com cutoffno valor 7. Os resultados foram catalogados e submetidos às análises descritiva e inferencial com nível de significância fixado em 5%. O perfil socioeconômico dos pacientes atendidos contempla, em sua maioria, mulheres casadas, pardas, acima da terceira década de vida, com vínculo empregatício e baixa renda familiar, com ensino médio completo, residentes na capital e que usam ônibus e carro próprio como meio de transporte. O atendimento foi consideradosatisfatório. Os usuários procuram o atendimento mais por indicação de outros indivíduosdo que pela própria condição financeira, estão satisfeitos com o atendimento do aluno e do professor e consideram a infraestrutura da instituição confortável. Mesmo assim,ainda há aspectos que necessitam ser melhorados, principalmente no que diz respeito ao tempo de espera e de atendimento e àpossibilidade atendimentomais de uma vez na semana (AU).

This study aimed to assess the socio-economic profile and patient satisfaction with the services provided at the Endodontics Clinic of a postgraduate teaching institution. Data collection was carried out in cross-section through a structured and self-administered questionnaire. The sample wasintentional and random (n = 50) for users who had completed endodontic treatment. Adimensional and bipolar scale was usedto evaluate satisfaction at the end of the treatmentwith scores attributed between the extremities. The scores given to the different aspects of the treatment ranged from 0 to 10 with a cutoff of 7. The results were cataloged and submitted to descriptive and inferential analysis with a significance level set at 5%. The socio-economic profile of the patients treated includes, in its majority, married, brown women, above the third decade of life, with employment and low family income, with complete high school education, residing in the capital,and who use buses and their own car as a means of transport. The service was considered satisfactory. Users seek care more by referral from other individuals than by their financial condition, are satisfied with the care provided by the student and the teacher,and consider the infrastructure of the institution comfortable. There are still aspectsthat need to be improved, especially concerningwaiting and service times and the possibility of attending more than once a week (AU).

Translation, Cross-cultural Adaptation and Reliability Analysis of the Survey of Anxiety and Information for Dentists (SAID) among Brazilian Adolescents

ABSTRACT Objective: To translate, perform a cross-cultural adaptation and reliability analysis of the Survey of Anxiety and Information for Dentists (SAID) for use with Brazilian adolescents. Material and Methods: The SAID was translated into Brazilian Portuguese and back-translated to English. An expert committee compared both versions and examined their equivalence. Then, a face validation was performed with 10 adolescents. The SAID was applied in printed format with 25 questions. Participants answered and commented on the questions with a researcher to confirm the understanding and provide suggestions. The suggestions were implemented, and the expert committee approved the final version of the SAID in Brazilian Portuguese. The psychometric properties were tested with 60 adolescents aged 10 to 19 years. Participants answered the Brazilian version of the SAID before their first dental appointment and two weeks later to determine test-retest reliability. Reliability was analyzed by internal consistency analysis (Cronbach's alpha) and test-retest (ICC). Results: The instrument presented excellent reliability according to internal consistency (Cronbach's alpha = 0.77) and test-retest coefficients (ICC = 0.88; 95% CI: 0.81-0.93). The Kappa coefficients and the degree of agreement of the dichotomous questions indicated good reproducibility of the new version. Conclusion: The SAID translation, cross-cultural adaptation and reliability analysis were completed successfully. Thus, the Brazilian version of the SAID can be a useful survey tool for dental care of adolescent patients.

Ethical issues and dentists' practices with children with intellectual disability: A qualitative inquiry into a local French health network.

BACKGROUND: The provision of dental care for children with intellectual disability raises many ethical questions. OBJECTIVE: The aim of this qualitative study was to explore approaches to dental treatment in an anxious child with intellectual disability and the ethical dilemmas that ensue. METHODS: Semi-structured interviews were conducted between February and May 2012. A clinical scenario was used to establish a starting point for a discussion of the clinical approach and lead to an ethical reflection. Four topics were discussed: first contact with the patient, information, attitude towards the patient and outcome from the practitioner's viewpoint. The coding procedure used thematic content analysis. RESULTS: Most practitioners fetched the patient from the waiting room personally, greeted them, gave them special attention, and either began the consultation at once, or used distraction to relax the patient. Verbal language and tell-show-do were most often used to provide information. Anxiety and pain were evaluated using parental assessment and standardized scales. A reassuring attitude was adopted. An ethical dilemma arose if the patient refused care or had to be restrained. Practitioners reported sacrificing ethical values (patient autonomy, beneficence and non-maleficence) when making a clinical decision. CONCLUSIONS: There is a wide range of practices but no consensus. This study shed some light on the different perspectives of dentists, most of whom adopted a utilitarianist viewpoint. In this context, ethical reflection is necessary to avoid a detached attitude or, worse, abuse. Further study would enrich this reflection.

Percepción de estomatólogos sobre atención estomatológica a pacientes sordos. La Habana, 2016 / Dentists´ perception of dental care of deaf patients. Havana, 2016

Introducción: La sordera es una discapacidad neurosensorial que provoca un problema de salud pública que afecta no solo al individuo que la padece sino también a su entorno familiar y social. Objetivo: Identificar la percepción de los estomatólogos sobre la atención estomatológica a los pacientes sordos. Material y Método: Se realizó un estudio descriptivo de corte transversal, con una muestra de 42 estomatólogos, entre 29 y 69 años de edad, de ambos sexos, pertenecientes a las Clínicas Estomatológicas de los Policlínicos Docentes del Municipio Marianao en La Habana, en los meses de junio y julio de 2016. Se realizó encuesta. Las variables estudiadas fueron: edad, sexo, conocimientos sobre las reglas de comunicación con el paciente sordo, conocimiento de las posibles causas de insatisfacción de los pacientes sordos durante la atención estomatológica, reconocimiento de los elementos a considerar durante la atención estomatológica al paciente sordo y conocimiento de factores capaces de generar estímulos negativos durante la atención estomatológica al paciente sordo.Resultados: El sexo femenino fue el de mayor predominio con 73.8 por ciento. El 66.7 por ciento de los Estomatólogos no conoce las reglas de comunicación de los pacientes sordos y 78.6 por ciento no conoce los aspectos a tener en cuenta durante la atención al paciente sordo. El 100 por ciento de los encuestados no reconoce los estímulos negativos ni las posibles causas que provocan insatisfacción en dicha población. Conclusiones: La mayoría de los estomatólogos encuestados son del sexo femenino, no reconocen las reglas de comunicación ni los aspectos a tener en cuenta durante la atención al paciente sordo; mientras que la totalidad de ellos desconoce los factores capaces de generar estímulos negativos o las posibles causas que provocan insatisfacción en la atención a estos pacientes(AU)

Introduction: Deafness is a neurosensorial disability which causes a public health problem that affects not only the individual who suffers from it, but also his social and family environment. Objective:To identify the dentists´ perception of dental care they deliver to deaf patients. Material and methods:A descriptive cross-sectional study was conducted, which comprised a sample of 42 dentists aged from 29 to 69 years, of both sexes, who work in the Dental Clinics of the Teaching Polyclinics located in Marianao Municipality, Havana, in June-July, 2016. A survey was made. The variables studied were: age, sex, knowledge about the rules for communication with the deaf patient, knowledge of the possible causes of dissatisfaction of the deaf patients with dental care, recognition of the elements to consider during dental care of the deaf patient, and knowledge of the factors which are capable to generate negative stimuli during the dental care of the deaf patient. Results:The highest predominance was observed in females (73.8 percent). The 66.7 percent of dentists do not know the rules for communication with deaf patients, and the 78.6 percent of them are unaware of the aspects to keep in mind during the care of the deaf patient. The 100 percent of the surveyed dentists do not recognize neither the negative stimuli nor the possible causes that lead to dissatisfaction in this population. Conclusions: Most of the surveyed dentists are female, they do not know neither the communication rules nor the aspects to keep in mind during the care of the deaf patient; whereas the totality of them are unaware of the factors that are capable to generate negative stimuli or the possible causes which lead to dissatisfaction in the attention to these patients(AU)