Abstract In dentistry, most equipment is designed for right-handed (RH) individuals. Thus, left-handed (LH) individuals are often forced to adapt to demanding RH working conditions, and therefore, experience difficulties in their practice. The objective of this study was to determine the prevalence of left handedness among dental students at the Dental Clinic of Monastir, Tunisia, and to investigate the difficulties for LH individuals during clinical practice. A cross-sectional study was conducted among dental students during the academic year from September 2019 to March 2020. An adaptation of the Grad-Corllet Diagram and a specific questionnaire on clinical practices were administered to 221 participants. Data were analyzed using SPSS 24.0 statistical software for descriptive statistics and the chi-square test was performed (with a 5% significance level). The study revealed that 18.1% of dental students were LH. Among which, 82.5% of LH students had difficulties using instruments designed for RH dentists, 47.5% of LH students preferred the 3 o’clock working position, and 77.5% of LH students preferred to work in a sitting position. Most LH students (70%) reported that endodontic treatment was the most difficult procedure to perform. All students, whether RH or LH, presented a higher percentage of pain in the lumbar and neck/cervical regions; however, LH students presented higher values (77.5%) with statistically significant differences being reported for lower back pain (p = 0.026) and neck pain (p = 0.012). This study highlights the difficulties that LH dental students face in performing dental work. Dental Schools should provide LH students with appropriate equipment and a proper learning environment.

Abstract Objective: To present the profile of hospitalizations due to transport accidents in individuals aged 0-19 years in a reference hospital for urgent and emergency traumatology care. Material and Methods: This retrospective study is grounded on analyzing medical records of children and adolescents hospitalized due to transport accidents in 2016 and 2017. The bivariate analyses included Chi-square and Fischer’s exact tests and binary logistic regression, with a 5% significance level. Results: Four hundred and seventy-five (43.7%) of the 1,088 medical records investigated corresponded to transport accidents, and accidents involving motorcycles were the most frequent (68.3%), affecting adolescents (81.3%), while children were more involved in accidents as pedestrians (57.1%). Advancing age increases the likelihood of the outcome, with a significant association in the multivariate analysis (p<0.001). The mandible was most frequently affected in maxillofacial fractures. Conclusion: Transport accidents predominantly affect male adolescents, involving motorcycles, and the lower limbs are the most affected. The mandible was the most affected bone in maxillofacial fractures.

ABSTRACT Objective: To estimate the prevalence of dental fear and evaluate its association with dental caries and with Molar Incisor Hypomineralization (MIH) in schoolchildren aged 11-14 years. Material and Methods: A cross-sectional study was conducted with 375 adolescents in Campina Grande, Brazil. Socioeconomic and oral health information was collected, while dental fear was measured using the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS). The diagnosis of dental caries and MIH was performed by three trained examiners (κ ≥ 0.61) using the International Caries Detection & Assessment System – ICDAS II and a previously validated index, respectively. Data were descriptively analyzed using the Chi-Square, Fisher's Exact, and Poisson regression tests with robust variance (p<0.05). Results: The prevalence of dental fear was 18.4%, and the mean CFSS-DS total score was 28.96 ± 8.92. After adjusting for covariates family structure, schooling of parents/guardians, type of dental health service and dental pain in the last six months, the prevalence of dental fear was associated with dental pain in the last six months (PR=2.03; 95%CI=1.31-3.16; p=0.002). Conclusion: Although no association was found between dental fear, dental caries and MIH in adolescents, those who experienced dental pain in the last six months had a higher prevalence of dental fear.

Abstract Limited research attention has been paid to Turkish dentists’ perceptions of child abuse and neglect (CA/N). This study aimed to examine Turkish dentists’ knowledge about, attitudes toward, and perceptions of CA/N. A total of 229 Turkish dentists responded to the self-administered, valid and reliable questionnaire. It consisted of 34 questions that could be classified into the following conceptual categories: a) sociodemographic data, b) knowledge about legal procedures and the orofacial characteristics and findings that are indicative of CA/N, and c) self-efficacy and attitudes toward CA/N. Multivariate analysis of variance was conducted and partial eta squared coefficients were used statistically. Knowledge about legal obligations was associated with occupational experience, highest CA/N education, frequency of child dental treatment. Prior experience with case of suspected CA/N demonstrated the greatest effects. Knowledge about the orofacial characteristics and findings that are indicative of CA/N was associated with prior experience with at least one case of suspected CA/N. The most frequently provided reasons for failure to report cases of suspected CA/N were fear that the child would be harmed. Turkish dentists demonstrated moderate levels of knowledge about their legal obligations and the orofacial characteristics and findings that are indicative of CA/N. Dentists should receive detailed education on CA/N in their undergraduate and postgraduate education. In addition, it is necessary to increase awareness and knowledge about CA/N by providing in-service trainings at the institutions where they work.

Abstract Objective: To describe systemic manifestations, the characteristics related to tooth eruption, and the occurrence of enamel defects in children with Congenital Zika Virus Syndrome (CZS). Material and Methods: Prospective case series based on nine children with confirmed CZS diagnosis assisted at a reference center in a municipality in the Northeast Region of Brazil. Through a structured interview directed to mothers, information related to prenatal, delivery, and postpartum periods was collected. Tooth eruption was monitored through clinical examinations for 36 months. The modified developmental defect of enamel index (DDE) was used to identify opacities and hypoplasia. Data were presented using descriptive statistics. Results: A high proportion (77.8%) had microcephaly, and 55.5% had low birth weight. Musculoskeletal disorders, swallowing difficulty, and self-injury practices were present in all children. Among the systemic findings, visual impairment (77.8%) and seizures (77.8%) were widely reported. Concerning disorders related to the stomatognathic system, bruxism (66.7%) and difficulty in sucking (33.3%) were present. For most children (77.8%), the deciduous right lower central incisor was the first tooth to erupt (minimum 8 months and maximum 17 months). Enamel defects were diagnosed in only two children (22.2%). Conclusion: A wide range of systemic manifestations was observed in children with CZS, including visual impairment and musculoskeletal disorders. Delayed eruption of the first deciduous tooth was also observed. Enamel defects were present in a small proportion of children.

Resumo Objetivo: Avaliar a relação entre os itens do questionário Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) e o sexo e a idade de crianças com níveis de medo odontológico moderado e elevado. Métodos: Estudo transversal, realizado em um município da região Nordeste do Brasil, com 185 crianças entre 8 e 10 anos, de ambos os sexos, que tiveram escore mínimo de 32 no questionário CFSS-DS, pontuação que configurava como com medo odontológico. Foi realizada a análise estatística descritiva, testes de Kolmogorov-Smirnov, U de Mann-Whitney e de Kruskal-Wallis. O nível de significância adotado foi de 5%. Resultados: A maioria das crianças era do sexo feminino (59,5%) e tinha 9 anos (37,3%). A média do escore total do CFSS-DS foi de 40,44 ± 6,81 (com mínimo de 32 e máximo de 75). De acordo com o CFSS-DS, 53,5% das crianças apresentaram elevado medo odontológico. Os itens: “Anestesia”, “Uma pessoa que você não conhece encostar em você”, “Motorzinho do dentista”, “Alguém colocar instrumentos na sua boca”, “Engasgar” e “Ter que ir para o hospital” apresentaram os maiores valores de mediana. Houve diferença significativa entre as crianças para o item “Uma pessoa que você não conhece encostar em você” (p=0,001). Conclusão: O item “Uma pessoa que você não conhece encostar em você” do questionário CFSS-DS apresentou diferença estatisticamente significante com a idade, não existindo diferenças nos demais itens em relação ao sexo.

Abstract Objective: To assess the relationship between the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) questionnaire’s items and sex and age in children with moderate and high dental fear levels. Methods: Cross-sectional study carried out in a municipality in the Northeastern region of Brazil with 185 children aged 8-10 years of both sexes, who had a minimum score of 32 on the CFSS-DS questionnaire, corresponding to dental fear. Descriptive statistical analysis and the Kolmogorov-Smirnov, Mann-Whitney U, and Kruskal-Wallis tests were performed. The significance level adopted was 5%. Results: Most children were female (59.5%) and 9 years old (37.3%). The average of the total CFSS-DS score was 40.44 ± 6.81 (with a minimum of 32 and a maximum of 75). According to the CFSS-DS, 53.5% of children had high dental fear. Items “Injections,” “Having a stranger touch you,” “The dentist drilling,” “Having somebody put instruments in your mouth,” “Choking,” and “Having to go to the hospital” had the highest median values. A significant difference was observed between ages for the item “Having a stranger touch you” (p=0.001). Conclusion: The item “Having a stranger touch you” in the CFSS-DS questionnaire showed a statistically significant difference with age, while no differences were found regarding sex.

Introduction: The COVID-19 pandemic brought changes in all segments of society, including with impact on dental education. Objective: To evaluate the fear of COVID-19 in dental students. Methodology: Cross-sectional study composed of 40 dental students from a private university. Data were collected regarding sociodemographic issues and the Fear of COVID-19 Scale (FCV-19S) was applied. The data were tabulated using the IBM SPSS software and analyzed descriptively (absolute and percentage frequencies, measures of central tendency and variability). Results: Most students were female (60.0%), between 16 and 20 years old (50.0%) and 45.0% had a monthly family income of more than one and less than three minimum wages. The average of the total score on the FCV-19S was 18.45 (SD = 6.08), with a minimum score of 7 and a maximum of 30. Most students showed “little fear” of COVID-19 (55.0 %). The items “I am very afraid of COVID-19”, “I am afraid of dying because of COVID-19”, and “I get nervous or anxious when I see news in the newspapers and on social media about COVID-19” obtained the highest average values. Conclusion: Most students showed little fear of COVID-19, despite the items “I am very afraid of COVID-19”, “I am afraid of dying because of COVID-19” and “I get nervous or anxious when I see news in newspapers and social media about COVID-19” having obtained the highest average values.

Introdução: A pandemia da COVID-19 acarretou mudanças em todos os segmentos da sociedade, inclusive com impacto na educação odontológica. Objetivo: Avaliar o medo frente à COVID-19 em estudantes de Odontologia. Metodologia: Estudo transversal composto por 40 estudantes de Odontologia de uma universidade privada. Foram coletados dados referentes a questões sociodemográficas e aplicada a Escala de Medo da COVID-19 (EMC-19). Os dados foram tabulados utilizando-se o software IBM SPSS e analisados descritivamente (frequências absoluta e percentual, medidas de tendência central e de variabilidade). Resultados: A maioria dos estudantes era do sexo feminino (60,0%), tinha entre 16 e 20 anos (50,0%) e 45,0% possuía renda familiar mensal de mais de um e menos de três salários mínimos. A média do escore total na EMC-19 foi de 18,45 (DP = 6,08), com escore mínimo de 7 e máximo de 30. A maior parte dos estudantes apresentou “pouco medo” da COVID-19 (55,0%). Os itens “Eu tenho muito medo da COVID-19”, “Eu tenho medo de morrer por causa da COVID-19”, e “Eu fico nervoso ou ansioso quando vejo notícias nos jornais e nas redes sociais sobre a COVID-19” obtiveram os maiores valores médios. Conclusão: A maioria dos estudantes apresentou pouco medo da COVID-19, apesar dos itens “Eu tenho muito medo da COVID-19”, “Eu tenho medo de morrer por causa da COVID-19” e “Eu fico nervoso ou ansioso quando vejo notícias nos jornais e nas redes sociais sobre a COVID-19” terem obtido os maiores valores médios.

Abstract This study aimed to identify the prevalence of molar-incisor hypomineralization (MIH) in schoolchildren and its association with dental caries experience. This was a cross-sectional study with a sample of 471 children aged 8 to 10 years. Data were collected via a sociodemographic questionnaire. Intra-oral clinical examination was done to identify and diagnose MIH (EAPD Criteria) as well as dental caries (ICDAS Index). Statistical analyses were performed with Person’s Chi-square, Fisher’s exact, and Mann-Whitney tests, and Poisson regression models were built. Statistical significance was set at an alpha-level of 0.05. The prevalence of MIH in our participants was 9.8%, with lesions being mostly of the mild form (65.2%) and affecting the first permanent molars but not the incisors in 54.2% of the children. Dental caries was observed in 88.1% of subjects. We observed a significant association between dental caries and the following variables: presence of MIH (p < 0.01; PR = 1.13), dental visit (p < 0.02; PR=0.92), and parents or legal guardians’ education level (p < 0.05; PR = 1.07). A MIH diagnosis was also significantly associated with family income (p < 0.05; PR = 4.09). Children with MIH had more caries lesions on molar surfaces (p < 0.01; PR = 4.05). The prevalence of MIH was found to be moderate, based on previous studies, and the presence of enamel defect was associated with dental caries. The teeth most affected by MIH lesions were the first permanent molars.

ABSTRACT Objective: To evaluate the quality of life of mothers of Brazilian children with congenital Zika virus syndrome (CZS) and associated factors. Material and Methods: This cross-sectional study assessed the quality of life (QoL) of 65 mothers of children diagnosed with CZS using the WHOQOL-bref questionnaire. Information related to mothers and children's characteristics and aspects of QoL (physical, psychological, social and environment domains) was collected. Data were presented using descriptive and inferential statistics. Associations between independent variables and quality of life outcome were carried out through bivariate analyses, adopting a 5% significance level. Results: The “physical” domain showed the highest score (65.98 ± 17.62), while the “environment” domain showed the lowest score (48.55 ± 14.75). The quality of life for the physical domain was associated with maternal schooling and child's sex, while the psychological domain was associated with family income and child's sucking difficulty. Conclusion: Socioeconomic characteristics and comorbidities were associated with mothers' QoL. Knowledge of QoL determinants and their impact on different dimensions of life can serve as a guide for interventions aimed at improving the QoL of this population.

RESUMO A síndrome respiratória aguda grave do novo coronavírus, SARS CoV-2, que se tornou uma pandemia, foi relatada pela primeira vez em Wuhan, Hubei, China em dezembro 2019. Pode acarretar sintomas leves, porém em alguns casos pode provocar graves complicações levando o indivíduo ao óbito. A doença se espalha através de gotículas de aerossol e tem um período de incubação do coronavírus estimado entre 2 e 14 dias (período este no qual o paciente tem alto potencial de infectar outras pessoas). Os endodontistas apresentam alto risco de exposição ao COVID-19 quando comparado a outros profissionais de saúde, pois a maior parte do trabalho envolve a geração de aerossóis e os atendimentos a pacientes em situações emergentes, como pulpite irreversível sintomática, periodontite apical sintomática, abscesso apical agudo e lesões dentárias traumáticas são imperativos. Dessa forma, essa revisão crítica aborda considerações sobre o atendimento endodôntico, nesta época de pandemia, cujas emergências imprimem necessidade real de tratamento, bem como os cuidados que devem ser adotados visando minimizar riscos tanto para o profissional quanto para os pacientes que buscam a resolução dos seus quadros clínicos de dor.

ABSTRACT The severe acute respiratory syndrome of the new coronavirus, SARS CoV-2, which became a pandemic, was first reported in Wuhan, Hubei, China, in December 2019. It can cause mild symptoms, but in some cases, it can cause serious complications, leading to death. The disease spreads through aerosol droplets and has an estimated incubation period between 2 and 14 days (a period in which the patient has high potential to infect other people). Endodontists have a high risk of exposure to COVID-19 when compared to other health professionals, since most of the work involves the generation of aerosols and care for patients in emergency situations, such as symptomatic irreversible pulpitis, symptomatic apical periodontitis, acute apical abscess and traumatic dental injuries, is imperative. Thus, this critical review addresses considerations about endodontic care in times of pandemic, whose emergencies imply a real need for treatment, as well as the care that must be adopted to minimize risks for both professionals and patients who seek the resolution of their clinical pain conditions.

Resumo O objetivo deste estudo foi investigar a prevalência de medo odontológico e avaliar sua associação com a cárie dentária e a Hipomineralização molar-incisivo (HMI), em escolares de 8 a 10 anos, em um município da região Nordeste do Brasil. Foram coletados dados de 466 estudantes matriculados em escolas públicas urbanas, em um estudo transversal. Os pais/responsáveis responderam a um questionário abordando características sociodemográficas, o medo odontológico foi mensurado por meio do Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS), e os exames clínicos foram realizados por três examinadores calibrados para o diagnóstico de cárie dentária, utilizando o índice International Caries Detection & Assessment System (ICDAS II) e, por um índice previamente validado, para HMI. Foi realizada a análise descritiva dos dados e as associações entre medo odontológico, cárie dentária e HMI foram avaliadas pela regressão robusta de Poisson para amostras complexas (p<0,05). A prevalência de medo odontológico foi de 21,6%, e o escore médio total do CFSS-DS foi de 29,97 (IC 95%=29,05-30,89). No modelo multivariado ajustado, a prevalência de medo odontológico esteve associada à renda familiar (RP=1,78; IC 95%=1,02-3,08; p= 0,041). A renda familiar mensal foi associada ao medo odontológico em crianças, enquanto a cárie dentária e a HMI não foram associadas ao medo odontológico.

Abstract The aim of this study was to investigate the prevalence of dental fear and to evaluate its association with dental caries and molar incisor hypomineralization (MIH) in schoolchildren aged 8-10 years from a municipality in Northeastern Brazil. Data from 466 students enrolled in urban public schools in a cross-sectional study were collected. Parents/guardians answered a questionnaire addressing sociodemographic characteristics, dental fear was measured by means of the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and clinical examinations were performed by three calibrated examiners for diagnosis of dental caries, using the International Caries Detection & Assessment System - ICDAS II and a previously validated index for MIH. Descriptive data analysis was performed, and associations between dental fear, dental caries and MIH were analyzed using robust Poisson regression for complex samples (p<0,05). The prevalence of dental fear was 21.6%, and the mean total CFSS-DS score was 29.97 (CI 95%=29.05-30.89). In the multivariate adjusted model, the prevalence of dental fear was associated to family income (PR=1.78; CI 95%=1.02-3.08; p= 0.041). Monthly family income was associated with dental fear in children, whereas dental caries and MIH were not associated with dental fear.

The effects of the Coronavirus Disease 2019 (COVID-19) pandemic on the mental health of healthcare professionals has become a concern, particularly among those who are in close contact with infected patients, including dentists. The aim of this critical literature review was to analyze the possible implications of the COVID-19 pandemic on the mental health of dentists. This bibliographic search was carried out in the PubMed, Web of Science and Scopus databases, using the following search keywords “Psychiatry OR anxiety OR fear OR depression OR psychological distress OR mental health” AND “COVID-19 OR SARS-CoV-2” AND “Dentists OR dental practice. Original research publications that included data on the mental health status of dentists during the COVID-19 pandemic were included. Data were tabulated in Microsoft Excel 2016 for Windows and descriptively presented. Eleven publications were eligible for this review. All studies had cross-sectional design. Most of them used questionnaires created by study researchers (81.8%) and were carried out in Italy (45.5%). The number of participants ranged from 14 to 1,500. Effects on the mental health of dentists during the COVID-19 pandemic were observed, regarding fear of contamination, anxiety, concerns, stress, depression, job insecurity, subjective overload, perceived risk and feelings and emotions. It was concluded that the COVID-19 pandemic had negative impact on the mental health of dentists, with high prevalence of fear, anxiety and concern, among other psychological symptoms.

The severe acute respiratory syndrome of the new coronavirus, SARS CoV-2, which became a pandemic, was first reported in Wuhan, Hubei, China in December 2019. It can cause mild symptoms, but in some cases it can cause serious complications, leading to death. The disease spreads through aerosol droplets and has estimated incubation period between 2 and 14 days (a period in which the patient has high potential to infect other people). Endodontists have high risk of exposure to COVID-19 when compared to other health professionals, since most of the work involves the generation of aerosols and care for patients in emergency situations, such as symptomatic irreversible pulpitis, symptomatic apical periodontitis, acute apical abscess and traumatic dental injuries, is imperative. Thus, this critical review addresses considerations about endodontic care in times of pandemic, whose emergencies imply real need for treatment, as well as the care that must be adopted in order to minimize risks for both professionals and patients who seek the resolution of their clinical pain conditions.

Resumo Introdução O homicídio, para além de um problema de saúde pública, é também revelador de um complexo contexto de desigualdade social, que impera nas capitais e grandes cidades do Brasil. Objetivo Analisar o contexto socioespacial de vítimas de homicídio doloso em uma capital do nordeste brasileiro. Método Estudo ecológico, de base documental, com abordagem quantitativa, realizado em João Pessoa, no estado da Paraíba, no Brasil, em 2015. Consideraram-se 369 vítimas de homicídio doloso. Os dados foram analisados à luz da estatística descritiva e da geografia espacial. Resultados As vítimas de homicídio doloso eram predominantemente homens, adultos jovens, não brancos, solteiros e com menos de sete anos de estudo. Ademais, verificou-se sobreposição, em grande medida, das áreas em que residiam aqueles indivíduos com as áreas de piores condições socioeconômicas. Conclusão O homicídio repercute substancialmente no quadro epidemiológico, porquanto, para além de sua característica letal, as questões que o circunscrevem, em que figura, de forma importante, são questões sociais complexas, amplas e de difícil modificação no curto prazo.

Abstract Background The homicide, besides being a public health problem, also reveals a complex context of social inequality that prevails in capitals and larges cities of Brazil. Objective The objective of this study was to analyze the socio-spatial context of intentional homicide victims in a capital of Brazilian Northeast. Method An ecological and documentary based study with a quantitative approach was carried out in João Pessoa, state of Paraíba, Brazil, in 2015, which considered 369 victims of homicide. Data analysis was carried out in light of descriptive statistics and spatial analysis. Results Victims of malice murder were predominantly male, young adults, non-white, singles, and less than seven years of studies. In addition, there was overlap, to a large extent of the areas where the victims of malice murder resided, with the map of the areas with the worst socioeconomic conditions. Conclusion Homicide has a substantial repercussion on the epidemiological context, in addition to its lethal characteristic. The issues surrounding them, in which important complex social issues appear, are broad and difficult to change in the short term.

Resumo Este estudo investigou a utilização dos serviços de saúde segundo determinantes sociais, comportamentos em saúde e qualidade de vida entre diabéticos. A amostra foi composta por 416 diabéticos cadastrados na Estratégia Saúde da Família de um município do Nordeste do Brasil. A análise dos dados incluiu estatísticas descritivas, bivariadas e multivariada por meio da modelagem de Árvore de Decisão usando o algoritmo Chi-squared Automatic Interaction Detector (CHAID). Evidenciou-se expressiva utilização dos serviços públicos de saúde (80,7%). A utilização do serviço público de saúde com regularidade envolveu indivíduos com escolaridade baixa ou média (p < 0,001), empregados ou aposentados e/ou pensionistas (p = 0,019), com alto impacto do diabetes na qualidade de vida (p = 0,032), e que realizavam a quantidade recomendada de exames de glicemia em jejum ao ano (p < 0,001). A utilização dos serviços de saúde pôde ser explicada por diferenças relacionadas aos determinantes sociais, aos comportamentos em saúde e ao impacto do diabetes na qualidade de vida dos usuários.

Abstract The aim of this study was to investigate the use of health services according to social determinants, health behaviors and quality of life among diabetics (n = 416) attended by the Family Health Strategy in a northeastern city in Brazil. Data analysis included descriptive, bivariate and multivariate statistics. Decision Tree modeling was applied using the Chi-squared Automatic Interaction Detector (CHAID) algorithm. Results showed that public health services were used by 80.7% of the sample. The regular use of public health services involved individuals with low or medium schooling (p < 0.001), employed or retired and/or pensioners (p = 0.019), with a high impact of diabetes on quality of life (p = 0.032), and who performed the number of fasting blood glucose tests per year recommended by the Ministry of Health (p < 0.001). The use of health services could be explained by differences related to social determinants, health behaviors and the impact of diabetes on quality of life.