Oral health-related knowledge and practices among a cohort of pregnant Portuguese women

Objectives: To assess the level of knowledge and attitudes regarding prenatal and infant oral health in a sample of pregnant women from Coimbra, Portugal. Methods: A self-applied questionnaire was administered to randomly selected pregnant women who attended prenatal check-ups at two public health institutions in Coimbra. Collected data included sociodemographic information, oral health knowledge and practices in pregnancy, and knowledge on oral health in children. All ethical requirements were met. Statistical analysis was conducted using descriptive and inferential methods. Variables were tested for independence using a chi-square test with a 95% confidence interval. Results: A total of 120 women enrolled in the study. Although 68.9% of participants brushed their teeth twice daily, 36.4% reported not using floss, with a statistically significant association with age (p=0.004). Half of the respondents had not attended a dental appointment before pregnancy, and 59.2% believed pregnancy could be harmful to oral health. Findings showed limited knowledge of the possible consequences of gingivitis and periodontitis to the course of pregnancy and the importance of diet in oral health. Moreover, a low level of understanding was noted regarding the existence and prevention of early childhood caries. Conclusions: Oral health-related knowledge and practices of surveyed women were in general deficient. Considering pregnancy is a period of particular interest for acquiring knowledge and good oral health practices, which are decisive for both the expectant mother and the child, our results highlight an urgent need to implement prenatal oral health care programs in this study population.

Indicators for dental appointment scheduling in primary health care: a national cross-sectional study

Background Integrated dental services within the Health System, particularly at primary health care, are crucial to reverse the current impact of oral diseases, which are among the most prevalent diseases worldwide. However, the use of dental services is determined by complex phenomena related to the individual, the environment and practices in which care is offered. Therefore, factors associated with dental appointments scheduling can affect positively or negatively the use of dental services. The aim of the present study was to evaluate the indicators for dental appointment scheduling in Primary Health Care (PHC). Methods The present is a cross-sectional analytical study that used data from the external assessment of the third cycle of the National Program for Improving Access and Quality in Primary Care (PMAQ-AB), carried out between 2017 and 2018, in Brazil. The final sample consisted of 85,231 patients and 22,475 Oral Health teams (OHTs). The outcome variable was the fact that the user sought for a dental appointment at the Primary Health Care Unit. A multilevel analysis was carried out to verify the association between individual variables (related to users) and contextual variables (related to the OHTs) in relation to the outcome. Results Only 58.1% of the users interviewed at these Primary Health Care Units seek the available dental care. The variables with the greatest effect on the outcome were the patient’s age up to 42 years old (OR = 2.03, 95% CI: 1.96–2.10), at individual level, and ‘oral health teams that assisted no more than a single family health team (FHT)’ (OR = 1.29, 95% CI: 1.23–1.36) at contextual level. Other variables were also associated with the outcome, but with a smaller effect size. Conclusion In conclusion, users’ age and work process of OHT were indicators for dental appointment scheduling. Our results suggest that when OHT put the National Oral Health Policy guidelines into practice, by assisting only one FHT, the chance for PHC users seeking dental appointments is higher than OHTs that assist more than one FHT. Regarding age, patients aged up to 42 years are more likely to seek an appointment with a dentist.

Diagnosis of hypertonicity of the masticatory muscles at a dental appointment

Summary. The purpose of the study. Hypertonus of the masticatory muscles is a fairly common pathology that leads to the development of parafunctional masticatory activity. At the same time, the nature of the course of the pathology becomes long-lasting, leading to irreversible consequences. Patients often do not pay attention to minor pain in the area of the masticatory muscles, so hypertonus of the masticatory muscles is diagnosed randomly. In view of the variety of clinical symptoms from headaches to the phenomena of oral stomalgia, the diagnosis of hypertension is extremely difficult. Also, there is currently no single algorithm for the management of such patients.Materials and methods. In the presented scientific study, a survey of 189 patients who applied to a dental clinic for the treatment of dental caries and its complications, a professional examination was conducted. All patients were examined according to the method of diagnosis of muscle hypertonus developed by us. The methodology includes a thorough collection of anamnesis, questionnaires (PSM-25, VAS, MAS, author's methods), the use of objective research methods, including: OPTG, CT, ultrasound, the author's method of determining the degree of mouth opening.Results. Muscle hypertonus of varying severity was diagnosed in 80% of cases, high stress level on the PSM-25 scale in 71% (135), the presence of morning pain in the area of the masticatory muscles in 55%(104). An assessment of muscle tone on the MAS scale confirmed a significant increase in masticatory muscle hypertonicity in 34% of cases. These additional methods of investigation confirmed the presence of hypertonicity of the masticatory muscles in patients with an objective clinical picture. In the study of this area, the main role is played by the clinician, only if all the diagnostically valuable information is available, it is possible to formulate an optimal treatment plan and avoid aggravation of the patient's condition due to incorrect diagnosis and treatment.Conclusions. The application of the developed diagnostic method contributes to the random detection of parafunctional activity of the masticatory muscles at a dental appointment, as well as to the final diagnosis of masticatory muscle hypertonus.

Psychological assessment of the attitude to oral diseases of patients of older age groups who have applied for dental care

Aim. Determination of the psychological type of attitude to the patient's illness, depending on gender and age group, which will further improve communication between the patient and the dentist.Materials and methods. This article provides a psychological assessment of patients in relation to diseases of the oral cavity at a dental appointment using the adapted TOBOL technique. This technique is based on typing patients according to certain cognitive characteristics described in the article. For this study, 65 people of older age groups were interviewed.Results. The frst group of attitudes towards the disease included 27 patients (41.5%), the second – 24 (37%), the third – 14 (21.5%). 11 (45.8%) men were assigned to the frst group, 8 (33.3%) men – to the second and 5 (20.9%) – to the third group. Women showed a distribution: 16 (39%) women belonged to the frst group, 16 (39%) – to the second and 9 (22%) – to the third group, respectively. Negative attitude towards dental diseases, reluctance to treat them sharply increases in centenarians.Conclusions. With increasing age, there is a growing tendency towards pessimization and aggression. Sensitized attitudes toward illness, depression, refusal of treatment, or blame-shifting complicate diagnosis and subsequent treatment. To prevent unwanted emotions and improve the quality of communication, the dentist should be guided by an individual approach to these patients, which should be based on the basic principles of ethics and deontology. Only then will dental treatment be effective and complete.

Fear and dental anxiety in children: a study of the contributing factors.

Introduction: Dental fear and anxiety are an important issue affecting children’s oral health and clinical management, and also an insufficiently studied subject in dentistry. Aim of the study: The aim of this study was to better understand the child patient - dentist versus dentist - child patient relationship and study the dental fear and anxiety of children in order to improve the dental office practice. Material and methods: In this study a personalized questionnaire was created and applied on a number of 333 children, in 4 schools from Mures county, Romania, on girls and boys between the ages of 8 and 13. The questionnaires used emoticons alongside words in order to better determine the state of anxiety created by the dental appointment and everything that it entails. All data and results obtained were analyzed using Excel and Graph Pad Prism 5.0 software. Results: Out of 333 patients, 133 subjects (40%) were 8-10-year-old, 143 subjects (42.9%) 11 - 13 years and 57 subjects (17.1%) were over 14 years. 175 girls (52.6%) and 158 boys (47.4%) demonstrated their courage and desire in participating in our study. It was determined that fear of dental appointments was caused in children over 14 years of age. The state of relaxation is generally enjoyed by urban children (45%) and those aged 11-13 years (37.1%); the percentage of boys in this category is an interesting aspect (40.5%). Conclusion: Dental anxiety is multifactorial and is far more complex than can be explained by a single contributing factor. The direct involvement of the child from the perspective of maintaining dental health, leads to the elimination of the state of fear and anxiety. Regular visits to the dental office, on the initiative of the child patient itself can reduce the anguish.

Predictors of the Demand for Dental Appointments in Primary Health Care: A National Cross-Sectional Study

Background Aiming to reverse the current impact of oral diseases, which are among the most prevalent diseases worldwide, it is necessary that public dental services act in an integrated manner within the Health System, particularly with the primary care services. However, even inside availability scenarios in health care, the use of dental services is determined by complex phenomena related to the individual, the environment and practices in which care is offered. The aim of the present study was to evaluate the predictors of the demand for dental care in Primary Health Care Units (PHC) with Oral Health Teams (OHTs). Methods The present is a cross-sectional analytical study that used data from the external assessment of the third cycle of the National Program for Improving Access and Quality in Primary Care (PMAQ-AB, Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica), carried out between 2017 and 2018, in Brazil. The final sample consisted of 85,231 patients and 22,475 Oral Health teams (OHTs). The outcome variable was the fact that the user requested a dental appointment at the Health Unit. A multilevel analysis was carried out to verify the association between individual variables (related to users) and contextual variables (related to the OHTs) in relation to the outcome. Results In the final model, of the variables at the individual level, the patient's age over 43 years (OR = 2.03, 95% CI: 1.96–2.10) was the one that had the greatest effect on the outcome. In turn, among the contextual variables related to the teams, the ones with the greatest effect on the outcome were 'oral health teams that assisted no more than a single family health team' (OR = 1.29, 95% CI: 1.23–1.36) or 'those in which the dental form constitutes the user's medical record' (OR = 1.21, 95% CI: 1.15–1.26) were predictors of the demand for a dental appointment in Primary Health Care. Conclusion It can be concluded that individual and contextual issues interfere in the demand for dental care. Oral health planning must consider an active search for patients with profiles that do not favor the spontaneous demand for oral health care, such as being older, male gender and non-white ethnicity. It is also concluded that the oral health teams that worked in line with the Brasil Sorridente guidelines are the teams most often sought after by the users.

Key dental challenges during the COVID-19 pandemic: an interdisciplinary platform

Relevance. The article presents an analysis of the key dental problems during the pandemic of the novel coronavirus infection (COVID-19), discussed on the platform of the interdisciplinary all-Russian online conference „Prevention of cross-infection at dental appointments in the context of the COVID-19 pandemic”. The high professional interest of dentists in the problems of high risk of transmission of infection at a dental appointment, the role of dental manifestations in the general symptom complex of COVID-19, the possibilities of testing saliva for SARS-CoV-2, the peculiarities of providing specific types of dental care in different periods of a pandemic, dental (hygienic) accompanying patients in outpatient and inpatient treatment, including in intensive care units. Based on the analysis of existing data on the immunopathogenesis of the disease, the main risk factors and routes of infection, the principles of systematization of COVID-associated diseases (conditions) of the oral cavity, the proposed approaches to their correction and treatment were discussed. Based on the results of our own observations and analysis of foreign publications, clinical variants of the manifestation of the disease (or its medication support) in the oral cavity have been analyzed. The important role of interdisciplinary approaches (dentists, healthcare organizers, epidemiologists, microbiologists, immunologists, etc.) to solving dental problems during a pandemic is emphasized. The role of modern IT-technologies, telemedicine and teledentistry in the implementation of educational and scientific-practical activities for the medical and dental community during a pandemic is highlighted.

The relationship between parenting styles and children’s behavior at a dental appointment

Aim. To identify the relationship between the parenting style and the child’s behavior during a dental appointment. Materials and methods. This study involved 110 children and their parents. The children met the following requirements: age from 4 to 6 years, no history of systemic and mental illnesses, primary admission. We used the search methods, questionnaires, and statistical calculations. Information from parents was collected using Stepanov’s questionnaire “Styles of parenting behavior” and Frankl’s behavioral scale. Results. Analysis of the results showed that 60% of parents correctly predicted the behavior of their child, namely families that adhere to authoritative, liberal and indifferent styles. The most positive behavior at a dental appointment was observed in children growing up in a family with an authoritative parenting style. Conclusion. The data confirms the connection between the parenting style and the behavior of children in dentistry. The definition of parenting style is important for the interaction of the child and the pediatric dentist, and should be taken into account when choosing an effective method of behavioral guidance.

CONHECIMENTO DE GRADUANDOS EM ODONTOLOGIA SOBRE A CONSULTA ODONTOLÓGICA DE PACIENTES HIPERTENSOS, DIABÉTICOS E GESTANTES

Introdução: Os pacientes, diabéticos é um público comum no consultório. Os cirurgiões dentistas fazem uso e prescrevem medicamentos que auxiliam na prevenção e cura de doenças orais, tornando necessário um conhecimento apropriado para a correta indicação de uma determinada doença. Dessa forma, o objetivo do presente estudo é descrever a compreensão dos acadêmicos do Curso de Odontologia do Unifunec sobre seus conhecimentos e o manejo de pacientes com hipertensão, diabetes e gestantes em relação aos anestésicos locais utilizados e à terapêutica medicamentosa. Material e Métodos: Os alunos matriculados no quinto ano do curso de odontologia foram convidados a responder 22 questões sobre perfil pessoal e a prática clínica de atendimento odontológico dos pacientes especiais. Os dados obtidos foram divididos em certos e errados e registrados no Software Microsoft Excelem tabelas elaboradas. Resultados: As tabelas e os gráficos estão exemplificados nos resultados e na discussão. Participaram da pesquisa 68 alunos, sendo que a maioria era do sexo feminino, atendem em clínica escola 100% dos alunos entrevistados. A maioria das questões obteve uma porcentagem de acertos favorável ao da literatura com algumas questões chegando a 90%. Do total de perguntas, as que apresentaram um percentual de acerto menor de 50% foram as questões sobre a anestesia local no paciente diabético e gestante. Conclusão: A compreensão dos graduandos sobre a consulta odontológica de pacientes hipertensos, diabéticos e gestantes encontrou-se em torno de 56%. UNDERGRADUATE STUDENT’S KNOWLEDGE ABOUT DENTAL APPOINTMENT FOR HYPERTENSIVE, DIABETIC AND PREGNANT PATIENTS ABSTRACT Introduction: Hypertensive and diabetic patients are frequent in dental offices. Dental surgeons make use and prescribe medications which help in the prevention and cure of oral diseases; it requires appropriate knowledge in order to properly write prescriptions to certain diseases. Consequently, this paper aims at describing the understanding of the undergraduate students’ Dentistry School at Unifunec about their knowledge and management of hypertensive, diabetic, and pregnant patients regarding the use of local anesthetic and drug therapy. Material and methods: Undergraduate students who were enrolled in the fifth year of Dental School were invited to answer 22 questions about personal profile and clinical practice for those particular patients’ dental care. The obtained data was classified as right and wrong and recorded at the Software Microsoft Excel spreadsheets. Results: Spreadsheets and graphics are exemplified in results and discussion. Sixty-eight undergraduate students participated in the study, most of them were female, 100% of them assisting patients at a dental school clinic. Most of the questions obtained a favorable percentage of correctness in accordance to the literature with some questions hitting 90% correctness. From the total of the questions, questions about local anesthetics for diabetic and pregnant patients obtained less than 50% correctness. Conclusion: The understanding of the undergraduate students about dental appointment for hypertensive, diabetic, and pregnant patients was found to be around 56%. Keywords: Hypertension. Diabetes Mellitus. Pregnant women.