Abstract The current study aims to assess the effectiveness of e-learning in compliance with the new biosafety recommendations in dentistry in the context of COVID-19 applied to the clinical staff of a dental school in Brazil. A quasi-experimental epidemiological study was carried out by means of a structured, pre-tested online questionnaire, applied before and after an educational intervention, using an e-learning format. After data collection, statistical tests were performed. A total of 549 members of the clinical staff participated in the study in the two collection phases, with a return rate of 26.9%. After the e-learning stage, a reduction was found in the reported use of disposable gloves, protective goggles, and surgical masks. The course had no impact on the staff’s knowledge concerning the proper sequence for donning PPE and showed 100% effectiveness regarding proper PPE doffing sequence. Knowledge about avoiding procedures that generate aerosols in the clinical setting was improved. Despite the low rate of return, it can be concluded that online intervention alone was ineffective in significantly improving learning about the new clinical biosafety guidelines. Therefore, the use of hybrid teaching and repetitive training is highly recommended.

ABSTRACT Objective: To describe dental findings of kidney and liver, pre and post-transplant patients of an oral health care service from a Brazilian Southeast state. Material and Methods: A descriptive cross-sectional study was developed with a sample of patients attending the oral health care program for transplantation of Universidade Federal de Minas Gerais. Participants were divided into two groups according to the kind of transplantation-kidney or liver. Characteristics of the sample, sex (male/female), age (18-44; 45-54; 55-80), living region (Belo Horizonte, or outside), phase of transplantation (pre-Tx or post-Tx), and self-report of diabetes mellitus and hypertension were presented by frequencies. Dental caries experienced was measured by Decayed, Missing and Filled-Teeth (DMF-T) index. Results: 185 patients, kidney (46; 24.9%), and liver (139; 75.1%) were included. Mean DMFT was 18.3 (20.0). DMFT scores of males (18.7; 20.0), females (17.2; 18.0), pre-transplanted (18.3; 20.0), and post-transplanted (18.1; 20.0) were similar. The liver transplantation group (19.3; 20.0) showed higher caries experience comparing to kidney´s (15.2; 17.0). Conclusion: Dental caries experience was high in kidney and liver patients under transplantation therapy. This highlights the demand for treatment need in this population.

Abstract The aim of this study was to assess the frequency of opioid analgesics prescribed by Brazilian dentists, potential regional differences and their association with socioeconomic and health-related factors. Data for all opioid prescriptions by dentists was obtained from the 2012 database of the National Controlled Substances Management System, regulated by the Brazilian Health Surveillance Agency. The number of defined daily doses (DDD) and DDDs per 1,000 inhabitants per day for each Brazilian state were calculated as the primary outcomes. DDDs were compared by regions and Brazilian states. Spearman’s rho correlation coefficient was used to determine the influence of the states’ characteristics, such as the Human Development Index; poverty; education; number of dentists per 100,000 inhabitants; visit to the dentist; dental care plan; good or very good oral health; number of pharmaceutical establishments per 100,000/inhabitants; and ability to get all prescribed medications. Data analysis was performed using IBM SPSS Statistics 25.0. A total of 141,161 prescriptions for opioids analgesics by 36,929 dentists were recorded, corresponding to 658,855 doses of opioids dispensed in 2012. The most commonly dispensed opioids were codeine associated with paracetamol (83.2%; n = 117,493). The national DDDs per 1,000 inhabitants per day was 0.0093 (range: 0.0002-0.0216). DDD per 1,000 inhabitants per day was positively associated to visits to dentists (rs = 0.630; P < 0.001) and inversely associated to poverty (rs = -0.624; p = 0.001). There are significant differences in opioid prescriptions in dentistry among the Brazilian states. These differences may be associated with non-clinical factors.

RESUMO O transplante de fígado é o tratamento de escolha para o estágio final da doença hepática e oferece a possibilidade ao paciente de retorno a uma vida ativa e longa. Uma avaliação dentária antes do transplante é recomendada como pre-requisito para a eliminação de infecções orais, as quais podem piorar o quadro do paciente. Este relato de caso se refere a uma fratura radicular de dente anterior em um paciente em tratamento odontológico prévio ao transplante de fígado. No exame clínico, o incisivo central superior direito (11) apresentava-se sem alteração na coloração mas com mobilidade no sentido vestíbulo-lingual, ligeira vestibularização e extrusão, e fístula na gengiva inserida na distal do 11. O paciente relatou ter sofrido traumatismo na região há mais de 30 anos. Ao exame radiográfico, foi identificada uma linha de fratura radicular horizontal no terço médio, associada à lesão óssea indicada por uma área radiolúcida na superfície distal do 11. O tratamento proposto para o caso envolveu procedimentos de raspagem e alisamento subgengival da superfície distal, o tratamento endodôntico radical da porção coronária radicular com posterior obturação com Agregado Trióxido Mineral e imobilização dental. O acompanhamento clínico e radiográfico, em intervalos de três meses, permitiu observar a regressão gradual da lesão, com formação de osso no local, contribuindo para manutenção do quadro de saúde geral e emocional do paciente, preservando seu sorriso e sua qualidade de vida.

ABSTRACT Liver transplantation is the treatment of choice for end-stage liver disease patients, and offers them the possibility of returning to active and longer life. A dental evaluation before transplantation is a recommended prerequisite to avoid oral infections, which can worsen the patient’s overall situation. This case report refers to the root fracture of an anterior tooth in a patient who was undergoing dental treatment prior to liver transplantation. On clinical examination, the maxillary right central incisor (11) presented without color change, but with mobility in the buccolingual direction, slight flaring and extrusion, and fistula in the attached gingiva on the distal side of tooth 11. The patient reported that he had suffered a trauma in that region 30 years before. The radiographic examination showed a horizontal fracture of the middle third of the root, associated with bone damage, indicated by a radiolucent area at the distal surface of 11. The proposed treatment consisted of: scraping procedure and straightening of the distal surface, radical endodontic treatment of the coronal portion of the root, subsequent filling with Mineral Trioxide Aggregate and dental immobilization. The clinical and radiographic follow-up at three-monthly intervals allowed us to observe gradual regression of the lesion with bone formation, contributing to maintenance of the patient’s general and emotional health, preserving his smile and quality of life.

Esse estudo qualitativo analisou as repercussões da perda dentária total de usuários do serviço público. Aplicou-se o Oral Health Impact Profile simplificado(OHIP14) a cinquenta voluntários e, após a apuração dos resultados, foram selecionados treze pacientes para entrevistas individuais baseadas em um roteiro com questões abertas. A seleção das pessoas foi de acordo com o grau de percepção do impacto da condição bucal na qualidade de vida, medida pela pontuação OHIP, de forma a incluir a maior variedade de perfis da amostra inicial. Da análise do conteúdo dos depoimentos, verificou-se que a perda dentária total tem forte impacto na vida das pessoas e implica consequências negativas como vergonha, dificuldade em se alimentar, prejuízo ao relacionamento social e sentimento de incompletude. A possibilidade de reposição protética dos dentes gera ansiedade nas pessoas e, embora elas saibam que a utilização das próteses possa representar sacrifícios, a expectativa de retorno ao padrão social geralmente aceito e de recuperação de sua própria imagem rejuvenescida faz valer a pena quaisquer sacrifícios.

This qualitative research analyses the repercussions of total dental loss on people's quality of life. The Oral Health Impact Profile short-form (OHIP14) was applied to 50 volunteers, and after analyzing the results, 13 out of those 50, were selected to be individually interviewed in an opened questions script. The criteria to select these 13 people were: perception of the impact of mouth condition on quality of life measured by the score reached on OHIP. We tried to comprise the sample with a good variety, according to the profile of the initial sample. After analyzing people's statements, it was possible to verify that dental loss had strong negative consequences on people's life, like shame, difficulty to eat, impact on social relationship and feeling of not being complete. The possibility of having their teeth replaced generates some anxiety. Although being aware that wearing total prosthesis represents some sacrifices, people considered it worthwhile because the possibility of regaining the social pattern and the self-image is renewed.

Para avaliar o impacto da perda dentária na qualidade de vida, foram selecionados cinquenta pacientes, usuários do Serviço Público de Saúde, em tratamento para inserção ou substituição do par de dentaduras. Antes do tratamento, aplicou-se o Oral Health Impact Profile (OHIP-14) e a coleta de dados sociodemográficos. Os escores do OHIP-14 foram obtidos por meio do peso de cada pergunta associado à escala de Likert. Maior a pontuação alcançada, maior o impacto negativo da dimensão na qualidade de vida. Na amostra, 82% eram do gênero feminino, 52% tinham 41 a 60 anos (média de 59,1 anos), e 34% eram casados. Para cada dimensão, os valores máximos OHIP-14 foram: desconforto psicológico (122); dor (121); inabilidade psicológica (113); inabilidade física (109); limitação funcional (93); incapacidade (82) e inabilidade social (76). A perda dentária ou o uso de próteses inadequadas implicam impactos negativos na qualidade de vida, especialmente no que se refere à preocupação, estresse decorrente de problemas na boca e à vergonha. Foi percebido menor impacto no que se refere às relações interpessoais e ao desenvolvimento das atividades rotineiras - dimensão inabilidade social. Estas informações são relevantes para os profissionais, pois ampliam seu conhecimento sobre pessoas desdentadas e melhoram sua capacidade de lidar com elas.

In order to evaluate the impact of tooth loss in patient's quality of life, 50 volunteers were selected among patients who use the Public Health Services in treatment for their complete denture's placement or replacement. The Oral Health Impact Profile (OHIP-14) and a socio-demographic data collection were applied before treatment. The values were founded through the weight of each question in association with Likert's Scale. As higher was the score, higher was the impact in the quality of life. In this survey 82% were female, 52% of patients between 41 and 60 years old (average: 59.1), and 34% married. The higher values of OHIP-14 dimensions in patient's quality of life were: Psychological Discomfort (122), Physical Pain (121), Psychological Disability (113), Physical Disability (109), Functional Limitation (93), Handicap (82) and Social Disability (76). As it could be observed, the lost of teeth or the use of inadequate prosthesis could bring negative impacts in life's quality, especially regarding preoccupation, stress with mouth problems and shame, although people perceive minor impacts in social relationships and development of their daily activities. This information can be relevant to prepare dentists to raise their knowledge about edentulous people and how to work with them.

Para avaliar o impacto da perda dentária na qualidade de vida, foram selecionados cinquenta pacientes, usuários do Serviço Público de Saúde, em tratamento para inserção ou substituição do par de dentaduras. Antes do tratamento, aplicou-se o Oral Health Impact Profile (OHIP-14) e a coleta de dados sociodemográficos. Os escores do OHIP-14 foram obtidos por meio do peso de cada pergunta associado à escala de Likert. Maior a pontuação alcançada, maior o impacto negativo da dimensão na qualidade de vida. Na amostra, 82% eram do gênero feminino, 52% tinham 41 a 60 anos (média de 59,1 anos), e 34% eram casados. Para cada dimensão, os valores máximos OHIP-14 foram: desconforto psicológico (122); dor (121); inabilidade psicológica (113); inabilidade física (109); limitação funcional (93); incapacidade (82) e inabilidade social (76). A perda dentária ou o uso de próteses inadequadas implicam impactos negativos na qualidade de vida, especialmente no que se refere à preocupação, estresse decorrente de problemas na boca e à vergonha. Foi percebido menor impacto no que se refere às relações interpessoais e ao desenvolvimento das atividades rotineiras - dimensão inabilidade social. Estas informações são relevantes para os profissionais, pois ampliam seu conhecimento sobre pessoas desdentadas e melhoram sua capacidade de lidar com elas.

In order to evaluate the impact of tooth loss in patient's quality of life, 50 volunteers were selected among patients who use the Public Health Services in treatment for their complete denture's placement or replacement. The Oral Health Impact Profile (OHIP-14) and a socio-demographic data collection were applied before treatment. The values were founded through the weight of each question in association with Likert's Scale. As higher was the score, higher was the impact in the quality of life. In this survey 82% were female, 52% of patients between 41 and 60 years old (average: 59.1), and 34% married. The higher values of OHIP-14 dimensions in patient's quality of life were: Psychological Discomfort (122), Physical Pain (121), Psychological Disability (113), Physical Disability (109), Functional Limitation (93), Handicap (82) and Social Disability (76). As it could be observed, the lost of teeth or the use of inadequate prosthesis could bring negative impacts in life's quality, especially regarding preoccupation, stress with mouth problems and shame, although people perceive minor impacts in social relationships and development of their daily activities. This information can be relevant to prepare dentists to raise their knowledge about edentulous people and how to work with them.

Esse estudo qualitativo analisou as repercussões da perda dentária total de usuários do serviço público. Aplicou-se o Oral Health Impact Profile simplificado(OHIP14) a cinquenta voluntários e, após a apuração dos resultados, foram selecionados treze pacientes para entrevistas individuais baseadas em um roteiro com questões abertas. A seleção das pessoas foi de acordo com o grau de percepção do impacto da condição bucal na qualidade de vida, medida pela pontuação OHIP, de forma a incluir a maior variedade de perfis da amostra inicial. Da análise do conteúdo dos depoimentos, verificou-se que a perda dentária total tem forte impacto na vida das pessoas e implica consequências negativas como vergonha, dificuldade em se alimentar, prejuízo ao relacionamento social e sentimento de incompletude. A possibilidade de reposição protética dos dentes gera ansiedade nas pessoas e, embora elas saibam que a utilização das próteses possa representar sacrifícios, a expectativa de retorno ao padrão social geralmente aceito e de recuperação de sua própria imagem rejuvenescida faz valer a pena quaisquer sacrifícios.

This qualitative research analyses the repercussions of total dental loss on people's quality of life. The Oral Health Impact Profile short-form (OHIP14) was applied to 50 volunteers, and after analyzing the results, 13 out of those 50, were selected to be individually interviewed in an opened questions script. The criteria to select these 13 people were: perception of the impact of mouth condition on quality of life measured by the score reached on OHIP. We tried to comprise the sample with a good variety, according to the profile of the initial sample. After analyzing people's statements, it was possible to verify that dental loss had strong negative consequences on people's life, like shame, difficulty to eat, impact on social relationship and feeling of not being complete. The possibility of having their teeth replaced generates some anxiety. Although being aware that wearing total prosthesis represents some sacrifices, people considered it worthwhile because the possibility of regaining the social pattern and the self-image is renewed.