Prevalência e fatores associados à sintomatologia dolorosa e a qualidade de vida de odontólogos da cidade de Teresina-PI

Objective: Identify the factors associated to the painful symptomatology and the quality of life and in dentists in the city of Teresina-PI. Brazil. Methods It was accomplished a cross-sectional study with 175 dentists registered with the Regional Council of Dentistry-PI from March to May, 2007. For characterization of the dentists we used a multidimensional questionnaire containing sociodemographic (age, sex) and professional information (time of service, journey to work). The evaluation of the presence of pain was performed by the Protocol of Painful Symptoms of McGILL. The WHOQOL-Bref was used to assess quality of life through physical, psychological, social and environmental domains. Results / Conclusions The painful symptomatology was reported in 69,7% of individuals, being observed in 77.3% of women and 60.3% of men. Body regions where pain was prevalent was the regions of neck (69,2%) lower back (69,7%). The dentists had high levels of self-perception of quality of life satisfaction and health. 96,0% of the individuals reported quality of life as very good, and only 16.6% reported dissatisfied with health. The Physical and Environmental domains showed values higher than the psychological and social domains. The painful symptomatology of studied dentists is associated with female sex (RP=1.28; IC95% 1.04-1.58; p<0.01). A multivariate analysis by logistic regression was performed and only the painful symptoms (OR = 2.51, IC95% 1,21-5,21) remained associated with the quality of life of these professionals when adjusted for other variables studied

A influência do sorriso gengival no vedamentos labial

Ideally the smile should expose minimal gingival, therefore patients with gummy smile and passive eruption altered or excessive marginal gingivae, usually excessive gingival display because incomplete anatomical crown exposure is present. If the maxillary incisor show at rest is optimal, active upper incisor intrusion should not be iniciated. To achieve a smile with minimal gingival exposure, the anatomic crown should be fully exposed by surgical crown lengthening. Precise determination of the location of cementoenamel junction prior to surgery, precise placement of incisions and correct establish of biological width are necessary in order to achive this goal. One protocol is decribed and clinical results from 15 brazilian subjects, after three years post surgery are showed

A influência do tempo de diálise e do paratormônio sobre as condições clínico-radiográficas bucais de indivíduos com insuficiência renal crônica em diálise

Universidade Estadual do Rio Grande do Norte

Ansiedade em indivíduos bruxômanos e suas principais implicações na vida social

Neste trabalho procuramos estudar o fenômeno do bruxismo, definido como o ato de apertar e/ou ranger os dentes, hábito prejudicial à região orofacial relacionado a varáveis psicossociais. O bruxismo é frequentemente associado aos aspectos emocionais, entre os mais ressaltados, a ansiedade e o estresse, podendo implicar em alterações das estruturas orofaciais, modificações funcionais e inclusive com repercussões sociais. Deste modo, torna-se relevante evidenciar que a pesquisa foi desenvolvida, visando o contexto multidisciplinar, abrangendo a Fonoaudiologia, Odontologia e Psicologia. Objetivo: verificar associação entre bruxismo, ansiedade e as principais queixas referentes à função mastigatória. Método: participaram oitenta voluntários, divididos entre grupo com bruxismo (N=40) e sem bruxismo (N=40), do sexo masculino e feminino. O diagnóstico do bruxismo foi realizado através do exame clínico. Para avaliar os níveis de ansiedade empregou-se o Inventário de Ansiedade Traço e Estado e para os aspectos psicossociais um questionário com questões estruturadas referentes às atividades diárias, focando a função mastigatória (para o grupo com bruxismo). Resultados:: Os resultados permitem evidenciar diferenças significativas entre os grupos analisados, a média e desvio padrão de ansiedade estado no grupo com bruxismo, 42,7±9,6 e sem bruxismo 38,6±8,2 (p ≤0,04) e de ansiedade traço respectivamente 44,5±11,0 e controle 40,7±9,5 (p ≤0,11). O relato dos participantes com bruxismo evidenciou como principais queixas durante a mastigação, dor na face ao mastigar, cansaço muscular na face, cefaleia ao mastigar e presença de ruídos articulares. Conclusões: Evidenciamos uma associação dos fatores emocionais como a ansiedade e o bruxismo, e como resultante os pacientes apontam que a função mastigatória encontra-se depreciada

Estudo psicossocial das perdas dentárias na terceira idade

The present study seeks to understand tooth loss by investigating the social representations in the daily life of elderly individuals, thus characterizing itself as a comparative and analytic research. It is known that tooth loss is a common occurrence in elderly individuals, interfering at the psychosocial and biological levels, through its functional, esthetical and social implications. The area of oral health in Brazil is lacking studies on this topic, especially with respect to the psychosocial aspects of the elderly. The Theory of Social Representations and the Central Nucleus Theory were selected for theoretical-methodological support. The Free Association of Words Test was used, whose inducing stimulus were the words tooth loss , in which each subject was asked to associate 3 words, to respond to a questionnaire related to socio-economic conditions and containing an investigation of tooth loss, access to odontological services and the need for dental treatment, and to undergo a focus group interview. The study sample consisted of 120 individuals 60 years of age or over, resident in Natal, RN, Brazil and participants of the Live Together to Live Better group of the Basic Health Unit of Felipe Camarão Residential District and Unati (Open University of the Elderly); an interview was performed with 36 subjects. Data analysis was performed by Evoc 2000, SPSS/99, Graph Pad and Alceste softwares. The results demonstrate that the central nucleus of the social representations of tooth loss for the Live Together group emerged from the difficulty in eating categories, showing a relation between physiologic necessity, desire and pleasure from eating, not to mention the pain that resulted from justifying the tooth loss. Besides the central discourses, the following peripheral elements were gathered: difficulty in adapting to the prosthesis, treatment and difficulty in speaking. All of these categories, except the last, also comprised the class themes of the group interview. For the Unati group the central nucleus emerged from the socio-economic difficulties categories, demonstrating a narrow relation between poverty, access to health and education and esthetics, confirming in the discourse of common sense, the association between tooth loss and aging. At the margin of the central discourses was collected the peripheral element difficulty in adapting to the prosthesis, found both in the Live Together and Unati groups, which expresses the resistance of the subject to this new situation and the failure of the rehabilitation treatment in the sense of reviving the memory of their natural teeth. All of these categories also constitute the class themes of the of the group interview. Thus, through the study of the social representations, we can reveal a reality in the perspective of the social subjects, contemplating the multiple facets of the social-cultural reality experienced by these individuals

Eficácia do bochecho de quitosana a 0,4% sobre o biofilme e bactérias orais

The purpose of this study was evaluate the effectiveness of the chitosan at 0.4 with high molecular weight and high deacetylation degree mouthrinse over the total decrease of the streptococci, Streptococcus mutans, lactobaci/li and over the perceptible bacterial film and gingival bleeding indices. For that, a total of 68 healthy students between 11 and 13 years old, not allergic to crustacean and not users of antibiotics or antimicrobial agent for the last three months or during the treatment, was selected. From those, thirty two individuaIs used the mouthrinse test, and thirty six, the control one. The participants rinsed 10 mL of the solutions twice a day, one during the moming (which was supervised), and another one during the aftemoon (which was not supervised), for fifteen days. The saliva collect for the microbiological analysis, as well as the perceptible bacterial film and gingival bleeding indices check, were made before the use ofthe mouthrinses (base line), immediately after the last mouthrinse on the day (zero time) and fifteen days after (fifteen time). These data were collected at school and the saliva was carried inside the ice to the laboratory. The samples were diluted, and 0.1 mL ofthe 10 -1 dilution was seeded in Rogosa SL agar, for further analysis of the total of lactobaci/lus~ 0.1 mL of the 10-4 dilution in Mitis Salivarius with bacitracin, for S. mutans analysis; and 0.1 mL of the 10-6 dilution in Mitis Salivarius for the analysis ofthe total of streptococcus. The Rogosa SL agar plates were incubated in aerobic at 37°C for 72 hours and the MSB and the MS were incubated in anaerobic in Gaspak@ jars at 37°C for 48 hours for further count ofColonies Former Units (CFUs). The assay was made in duplicate for each bacterial group analyzed. The number of CFUs transformed in LOGlO was analyzed according to the following tests: ANOV A, t of Paired and Not Paired Student, Friedman, Man-Whitney and square-qui test. On the base line, alI the variables analyzed were similar on both tested groups. On both groups, for the total of streptococcus there was no significant difference along the time and for S. mutans there was a statistic significant increase of the CFUs from the base line to the zero time. For the total of lactobaccilus there was no significant difference on the test group along the time, and on the control there was a significant increase ofthe CFUs ITom the base line to the zero time. For both groups, there was significant decrease ofthe perceptible bacterial film index along the time, and that can be explained by the mechanic effect of the mouthrinse over the bacterial film and by the participation of the students on the research which could have motivated him to a better toothbrushing (Hawthome effect). The gingival bleeding index also showed a decrease along the time, even though it was not significant. Therefore, the conclusion of this study was that the chitosan at 0.4 % mouthrinse was not effective on the CFUs reduction of the three bacterial groups analyzed, as well as on the reduction of the perceptible bacterial film and gingival bleeding indices

Controle profissional de biofilme dentário como estratégia para manutenção da saúde periodontal de pacientes com aparelho ortodôntico fixo: análise comparativa entre diferentes períodos

The presence of fixed orthodontics appliances interfere on sanitation, allowing periodontal diseases to appear, despite the fact patients keep on visiting the dentist every month. This research aims to determine a protocol for the mechanical control of the dental biofilm performed by the professional. A protocol that was able to maintain the periodontal health of the patients under orthodontic treatment with fixed appliances, and in order to do so, it used a non-controlled, randomized and blind clinical essay. The sample involved 40 adolescents who were under the installation of fixed orthodontics appliances and it was divided in three groups, as follows: monthly controlled group (group 1) composed of 11 patients, the quarterly controlled group (group 2) with 16 patients and the semestrial controlled group (group 3) with 13 patients. For data collection, an interview and clinical exams with probing depth measurement, quantity of keratinized mucosa, Gingival Index and the Plaque Index were used. On the initial exam all patients received brushing guidelines as well as the professional control of dental biofilm, with periodontal scaler, Robinson s brush and prophylactic paste. However, Group 1 returned every month for control procedures; Group 2 every three months and Group 3 after six months. The intervention had a six-month duration (for all the three groups), when all the exams were repeated by another examiner who did not know which group each patient was inserted in. Finally, the research concluded that despite the fact there is no statistically significant difference among the three groups, clinically the patients from the monthly group presented a better response to professional control, with less accumulation of dental biofilm and less rate of gingival inflammation. Thus, the mechanical control of the dental biofilm performed by the professional could not avoid gingival increase, characterized by the raise of probing depth measurement, neither the quantity of keratinized mucosa

Avaliação da eficácia de selante ionomérico modificado por resina e escovação dentária na preservação de cárie oclusal

The purpose of this study was to evaluate the effectiveness during a twelve-month period, of resin-modified glass ionomer (Vitremer@) used as fissure sealants compared to supervised teeth brushing in the prevention of oclusal caries in permarient molars of pubIlc school children from 5 to 7 years of age. A total of 91 children participated in the study, being randomly divided up into three groups of investigation: group with sealant (n=31), group of supervised brushing (m=30), and control gorup (n=30). After 12 months, a total of 28.5% of tosses in the sample of 26 children was registered, and although there wasn t a significant diference between these losses and the groups studles (p = 0.6355), there was a considerable reduction in the sample. The results showed that none of the independentIy studied variables (present caries experience, biofilm, bleeding, sealant retention, position of the tooth in the arch, and sex) interfered in the final results, and that there was no significant difference between applying the sealant in question, perfornling supervised dental brushing, or not intervening at alI (p=0.542). These results could have been a consequence of the limitations found alI through the study, especially relating to the losses occurred because of school evasion, transfer, or because of the accident in the Marise Paiva Municipal School, Keeping students away for approximately one semester, so tht a new reseach had to be developed sos as to better clarify the effects among the treatments done there

Os Centros de Especialidades Odontológicas como suporte da atenção básica: uma avaliação na perspectiva da integralidade

The public dental services in Brazil were limited, practically, to the basic care, so that the specialized services acted, up to 2002, no more than 3,5% of the total of clinical procedures. That lower offer reveals the difficulty of continuity of the attention, that is, the comprehensiveness in the assistance, particulary, the reference and counter-reference system. Brasil Sorridente search to supply those needs when proposing Speciality Dental's Centers(CEOs Centros de Especialidades Odontológicas, Brazil) to compose the services of average complexity. In 2005, Ministry of Health enabled the three CEOs of Natal, located in the North II, East and West Sanitary Districts. This investigation evaluated the implantation of these CEOs, as support of the family health care teams, in the perspective of organization of the services in assistencial nets in Natal/RN. It was a study of evaluation, with qualitative approach and some quantitative data as contribution. Dentists, users and managers were interviewed to identify and to understand their perceptions, relationships and experiences in the daily of the services. The conceptual base that orientated the investigation was the principle of comprehensiveness, in its operational sense of the hierarchization in health attention levels. The collection of data was done with documental research, direct observation and semi-structured interview. The analysis was accomplished by triangulation of the extracted content from the used techniques and sources of interviewed groups depositions, looking for theoretical-conceptual support in specific bibliography. The results pointed aspects that go away from the comprehensiveness like: low resolution of problems in the basic net; little valorization of the space in the health units; traditional models of access to health services, insufficient offer for some specialties, compromising the reference and counter-reference system; practices centered in procedures in the CEO; bureaucratic directions from basic care to the specialized service; disintegrated and disjointed system among levels of attention; disrespect to the municipal protocol. On the other hand, there is an approach of compreensiveness in situations like: increase of the access and covering in the Family Health Strategy (ESF Estratégia Saúde da Família, Brazil); larger approach between professional and user; tendency to the quantitative and qualitative growth of specialized actions; punctual initiatives of relationships among levels; existence of protocol to guide professionals

O programa Saúde da Família pelo olhar do Cirurgião-Dentista

This study tried to know the social representation of dentists surgeons about the Family Health Program (FHP). Where used as methodological instruments a semi-structured interview and direct observation of work process in tive towns that are part of the metropolis region ofNatal city. During the interview some aspects where broached, such as the reasons of dentists surgeons join the FHP, what are the implications ofthe introduction of this program in the everyday practice, what kind of activities are they practicing and what are those professional missing the most in the FHP. In the direct observation where take in account some aspects related to the physic structure of health units, its service organization and demand, relationship amongst dentist and other member of the team, and about patient receptiveness, when they arrives at health unit. This study also identifY the researches subject showing their age, sex, for how they are graduates, what are them specialty and for how long they work for the FHP. The data had been analyzed through the analysis of content of Bardin5. The dentists depict the FHP for the change in assistance model through the preventive proposal of social work that makes possible to work with an ample concept of health. However what makes the FHP more attractive to dentists is the salary questiono The creation of bonds whit the community and the work whit groups and in team had been the main occurred changes in the daily one of the pratices ones of these professionals. The principal activities executed for these professionals inside of the new strategy of assistance in oral health are the carried trough preventive activities achieved in health units and social area. To them, the absence of institutional support and the employment of only one dentist for each team it is one the main point of strangling. There is no doubt that FHP is new strategy and that it is need a better integration amongst the professional, the institution

Fatores associados à condição de saúde bucal de pacientes internados em hospitais públicos do município de Natal-RN

The hospitalization is an event that can attack any person, independent of gender, race, social and economical condition. Last year, the prevalence of hospitalization was 8.1 for 100 inhabitants and the average time of hospitalization was 8.5 days for each patient one in Natal city. Therefore, an important point is whether the attention to the patients during the permanence in these health establishments incorporates the health integral model suggested by the principles proposed by the National Health System in Brazil (SUS), with actions of promotion and protection by different kinds of professionals, beside those called convalescence. Then, the aim of this study was to evaluate the patient s oral health conditions hosted in public hospitals of the Natal city, looking for to establish its relationship with several risk factors by two dimensions: the characteristics of the hospitalization and the patient s general and economical conditions. We accomplished a cross-sectional study with 205 patients distributed among the hospitals Onofre Lopes, Giselda Trigueiro and Monsenhor Walfredo Gurgel, looking for to know the socio-demographic characteristics, the food habits and of oral hygiene and the conditions of oral health, through the Visible Plaque Index and Gingival Bleeding Index. We observed that the conditions of the patient s oral health interned at public hospitals of reference of the municipal district of Natal is bad, existing accumulation of dental plaque and, consequently, a great number of patients with gingival bleeding. However, the time of hospitalization and its reason, the type of medicine used in this time and the toothbrush frequency were not configured as risk factors for this oral health condition

Avaliação clínica do efeito da irradiação pós-opratória do laser de baixa intensidade na cicatrização de gengivoplastias em humanos

Many studies have been made to understand the process of tissular cicatrization, as well as the possible effects of laser therapy in the wound healing. However, the influence of low frequency laser irradiation in the repairing process is not completely understood. Our study has the purpose to assess clinically the effect of postoperative irradiation of the low frequency laser in humans, and the gingival repairing process postgingivoplasty performed with the extern bevel technique. Twenty-four patients with inflammatory gingival hyperplasia were enrolled in this study, which did not reduce with basic periodontal procedures, and patients with melanin pigmentation, with esthetic indications. After surgery the test group, randomly selected by a drawing, received laser application with energy density of 4 J/cm2, immediately after surgery and each 48 hours, during a week, with a total of 4 sections. The control group did not receive irradiation. The visual clinical analyses were performed by a single blind examiner, in the 2nd, 4th, 6th, 8th, 15th and 21st days post surgery. For statistic analyses of the data was used a Q-square test. Concerning the color, the results showed a better wound healing during days 6 to 8. when assessed the degree of progress of surgical wound, the results showed that the test group had a better cicatrization compared with the control group in the 2nd, 6th, 8th and 15th days post surgery, and at the 21st day both groups had the same results. Our results confirm that the laser had clinical influence in the repairing process after gingivoplasty surgery during days 2 to 15 post surgery

Perspectivados cirurgiões-dentistas sobre a inserção da fisioterapia na atenção básica de saúde

This work aims at investigating the surgeons-dentists acceptability in the field of public health in the city of Natal, State of Rio Grande do Norte, about the possibility of medicinal plants insertion in basic attencion of health. Moreover, it searchs to know if during their professinal formation it had some theoretician-pratical basement on this subject, as well as investigating their confidence on the medicinal plants. The basic motivation for developing this study is the possibility of contributing to the insertion of a tradicional health pratical at public assistance scope, endorsed by popular use, but now scientifically proven. For in a such way, the medicinal plants use is emphasized as a way to be followed to increase basic pharmaceutical assistance, improving the acess to the medicine and diminish expenses. Following this logic, family health program constitutes the way through which this pratical will be available to the users of health services. The research was done over thirty surgeonsdentists, all ofthem pertaining to public service ofNatal, state ofRio Grande do Norte. It was used, as research instrument, semi-estructured interview associated with methodological analysis user s speeches. On this form, this work is inserted in a trend observed nowadays not only in Brazil, where the use of the medicinal plants has been stimulated and defended to be inserted at programs ofprimary attenction of health

Hipossalivação e seus fatores de risco em idosos funcionalmente independentes e não institucionalizados

The aim of this study was to investigate the risk factors related to hyposalivation among non-institutionalized independently living elderly people, living in Natal-RN, Brazil. The study was a control-case type and the data collection was accomplished by carrying a questionnaire, oral examination and a non-stimulated and stimulated sialometry. The cases were identified by values of salivary flow rate <0,1mL/min and stimulated ≤ 0,5 mL/min, and the controls were by observing the values of sialometry that were bigger than the previously defined parameters. Age and gender were used as pairing variables. The data were analyzed using X2 (α = 0,05) and odds ratio. The sample was composed of 98,1% female and 1,9% male, with mean age 68. There was not association between hyposalivation and the following studied variables: income, schooling, profession, dwelling conditions, domiciliary density, illness, number of teeth and use of prothesis. However, a link was found between hyposalivation and smoking frequency in the passet (OR=5,14), indicating that, referring to elderly people, the tabagism frequency habit was a risk factor to the studied condition. Therefore, refering to non-institutionalized independently elderly people, economic-social-demographic conditions, general and bucal health, diet and habits such as alcoholism have been not risk factors to hyposalivation. However, people that have been smoking have more risk to have the studied conditions

Atividades educativas na rede pública de ensino: efeitos sobre a higiene oral e o nível de informação em Saúde Bucal

The contents introduction concerning the individual health cares reveals important since the school education. In this direction, the present study objectified to know an effect of Oral Health education intervention in the oral hygiene and in the schools children information level, of 4º e 5º basic education years. The study was composed by two groups, chosen of random form: control group (n = 115) and experimental group (n = 132), with 247 public net school children in total sample. The experimental group participated of some educative activities in Oral Health, with biweekly frequency, during the 4 months period, given for a surgeon-dentistry. Both the groups were submitted to a clinical examination for a previous verification of the Plaque Index (PI) and of Loe Silness Gingival Index (GI). A questionnaire with closed questions on Oral Health was applied before and after to verify the school children rightness index. After the intervention, the final data, represented for the PI, GI and Rightness Index verification, has been collected for statistical analyses through the chi-square test to a 95 % of reliable level, using the SPSS 10,0 software. The PI and GI were categorized in high and low on the initials index basis medium; already the Rightness Index was categorized in inadequate (< 50%) and adequate (≥ 50%). It was verified that the PI (p = 0,014; IC 0.24-0.86) and the GI (p = 0,013; IC 0,28-0,84) presented differences statistically significant, after the education activities, when compared to with the control, favoring the experimental group. It was verified too the experimental group got greater rightness index, presenting difference highly significant (p<0,0001; IC 3,73-26,81). It was still observed that there was no association between the oral hygiene indicators and the school children information level. Ahead the results, it can been concluded that education activities related in the school routine were capable to give positives effects in the oral hygiene control and in the information level about Oral Health, however, not necessarily, the individual with bigger information is that one who has practiced an oral hygiene more adjusted. One become necessary, however, that the education in Oral Health occurs of permanent and integrated form with others school actors, for the positive effect does not lose the student s life longterm