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- Determinants of gingival recessions in Portuguese adultsPublication . Lapa, João; Veiga, Nélio J.; Ribeiro, Cláudia; Marques, Tiago; Santos, Nuno Malta; Sousa, Manuel deObjectives: The objective of this study consisted in determining the prevalence of gingival recession and potential risk factors associated in a sample of patients that had a dental appointment in the University Clinic of the Portuguese Catholic University in Viseu, Portugal. Methods: We conducted an epidemiological observational cross-sectional study where a sample of 101 patients was assessed. The participants were subjected to a questionnaire and an intra-oral clinical examination was made in order to assess gingival recessions. Results: The prevalence of recession was 85.1%. The presence of habits and a high plaque index are associated with the onset of recessions and its severity. The aesthetic condition was influenced only in 14.0% of the cases and just 17.4% of the patients with gingival recession had tooth hipersensibility. There is a stronger association between the development of recessions and using a brushing technique based mostly on horizontal movements and brushes with harder bristles. Conclusion: Although further studies need to be applied in a more representative sample, we conclude that the majority of the analyzed sample has already suitable oral health behaviors, however, some need to be modified as the understanding of the need to change certain habits to prevent development of recessions.
- #099. A prescrição terapêutica em alunos de medicina dentária: um estudo comparativoPublication . Lopes, Melanie; Veiga, NélioObjetivos: O objetivo deste estudo consiste na caracterização do nível de preparação para a prescrição terapêutica dos alunos do 5.° ano das faculdades de medicina dentária portuguesas e da Faculdade de Medicina Dentária de Nancy (França). Materiais e métodos: Realizou‐se um estudo observacional transversal com uma amostra de estudantes que frequentam o curso de Medicina Dentária nas várias faculdades de Portugal e outra amostra de estudantes que frequentam a Faculdade de Medicina Dentária de Nancy, em França. A amostra final do estudo foi constituída por 135 estudantes, dos quais 77,0% (n = 104) de alunos a frequentarem o curso de Medicina Dentária em Portugal e 23,0% (n = 31) de alunos da Faculdade de Medicina Dentária de Nancy, França. A recolha de dados realizou‐se através da distribuição de um questionário autoaplicado aos estudantes, com questões referentes aos conhecimentos sobre prescrição terapêutica em casos clínicos específicos que podem encontrar durante a sua prática clínica. Resultados: A razão mais frequente para a prescrição terapêutica foi a «dor» (71,1%), seguida da «infeção» (20,0%) e «inflamação» (8,1%). Não saber os nomes comerciais e não ter a certeza do fármaco adequado para prescrever (53,5%), indicar a posologia errada (48,1%) e não conhecer as reações adversas (40,7%) são os erros mais comuns que os alunos referem ter no momento da prescrição. Uma maior percentagem de alunos portugueses refere um nível de conhecimento «muito baixo» e «baixo», comparativamente aos alunos franceses. Relativamente à pergunta: «Que importância dá à farmacologia para o seu futuro exercício prático em medicina dentária?», 85,2% da amostra assinala como «muito importante». Existem diferenças estatisticamente significativas entre a prescrição feita pelos diferentes alunos das faculdades portuguesas entre si e entre a Faculdade de Nancy (p = 0,001), com estes últimos a referirem que estão mais bem preparados para a realização da prescrição terapêutica. Conclusões: A maioria dos alunos considera importante esta temática, sendo este estudo importante para demonstrar a necessidade de enfatizar o ensino e fomentar as boas práticas clínicas e terapêuticas para um bom exercício clínico. A prescrição medicamentosa é fundamental na área da medicina dentária, devendo haver a clara noção de um conjunto de cuidados a ter em conta na hora de medicar o paciente.
- Review on polypharmacy and oral health among the elderlyPublication . Veiga, Nelio Jorge; Garcia, Marta; Pestana, Valéria; Rey-Joly , Carlota; Rodrigues, Cátia; Coelho, CarinaThe increase in the elderly population is a factor that occurs worldwide. This fact can be explained by the improvement of living conditions of the populations, advances in medicine, improved sanitation and increase in the community and individual health care. The use of several drugs, self-medication, drug side effects, several drug interactions and decreased quality of life of the population has become an important public health issue. The gradual aging of the population and the increasing prevalence of chronic diseases has led to polypharmacy and the use of drugs that potentially are considered inappropriate for using among the elderly population. Oral diseases, such as periodontal disease, dental caries, lesions in the oral mucosa and xerostomia could be complications associated with polypharmacy among the elderly. It is crucial that the health professional, using his contemporary knowledge, is able to protect the elderly population from complications caused by polypharmacy. The purpose of this article was to highlight the importance of knowledge and recognition of the risks that polypharmacy may represent during dental treatment based on the international scientific literature.
- Helicobacter pylori infection and functional dyspepsia in adolescencePublication . Pereira, Carlos; Veiga, Nélio; Amaral, Odete; Pereira, Joana; Bastos, IldaIntroduction: Studies confirm that Helicobacter pylori (H. pylori) infection may be a predisposing factor for gastric pathology later in life. This study consisted in determining the prevalence of H. pylori present in the stomach and functional dyspepsia in sample of Portuguese adolescents. Participants and methods: A sample of 437 adolescents aged 12 to 19 years old, attending a public school in Sátão, Portugal, was enrolled in this cross sectional study. A self-administered questionnaire focusing socio-demographic variables, social and daily habits and gastric-related pathologies was filled out by all participants in this study. The self-reported form for children and adolescents of the Rome III Diagnostic Questionnaire was also applied in order to assess functional dyspepsia. The adolescents were screened for H. pylori infection using the Urease Breath Test (UBT) that consists in the exhalation of carbon dioxide in samples before and after swallowing urea labeled with non radioactive carbon-13. Prevalence was expressed in proportions and compared by the chi-square test. Crude odds ratio (OR) with 95% confidence intervals (CI) were used. Results: The prevalence of gastric H. pylori was 35.9%. Functional dyspepsia was present in 22.4% of the sample and was associated with age (≤ 15years OR=2.25, 95%CI=1.17-4.33), residential area (rural OR=1.98, 95%CI=1.05-4.35) and family history of gastric disease (OR=3.39, 95%CI=1.17-9.87). After adjustment by multivariate logistic regression for socio-demographic variables and family history of gastric disease, the results demonstrate no association between H. pylori infection and functional dyspepsia (OR=1.08 95%CI=0.8-1.3). Conclusions: We found a high prevalence of H. pylori infection and functional dyspepsia among adolescents, suggesting that gastric pathology continues to be an important public health issue. This study provides important baseline measurements for future preventive measures
- Consumo de bebidas alcoólicas durante a gravidezPublication . Coutinho, Emília; Pereira, Carlos; Amaral, Odete; Nelas, Paula; Chaves, Cláudia; Veiga, Nélio; Cruz, CarlaIntrodução: O consumo de bebidas alcoólicas durante a gravidez é altamente prejudicial à saúde da mãe bem como à saúde do feto. O consumo de álcool durante a gravidez leva-nos a questionar a qualidade dos cuidados de saúde. Os objetivos deste estudo foram quantificar a prevalência do consumo de bebidas alcoólicas durante a gravidez por mulheres portuguesas e imigrantes em Portugal e analisar a informação veiculada nas consultas de vigilância de gravidez. Métodos: Estudo transversal, parcialmente analisado como caso controlo, envolveu 753 mães imigrantes com idades entre os 16 e os 45 anos (29,30±5,76) e 1654 portuguesas com idades entre os 15 e os 44 anos (29,99±5,42). Recolha de dados por questionário autopreenchido, em 32 maternidades/ hospitais portugueses, de janeiro de 2010 a dezembro de 2011. Considerou-se consumo de bebidas alcoólicas a ingestão de qualquer quantidade de álcool durante a gravidez. As prevalencias foram expressas em proporções e determinou-se ainda a magnitude de associação entre as variáveis com recurso aos Odds Ratio (OR) e respetivos intervalos de confiança a 95%. Resultados: Cerca de 9 em cada 10 das grávidas não ingeriu bebidas alcoólicas, mas entre as que ingeriram, a maior percentagem ocorreu entre as imigrantes (12,0% vs 6,6%) com significância estatística (OR 0,52; IC95% 0,37-0,7; x2=19,617; p menor que 0,001). Quanto à frequência do consumo, consumiram algumas vezes 57,8% das portuguesas e 71,1% das imigrantes (OR 0,37; IC95% 0,26-0,52). Quanto à qualidade de informação sobre o consumo de álcool 39,2% das portuguesas considerou- a boa e 34,9% das imigrantes, razoável. Conclusão: As imigrantes consomem mais bebidas alcoólicas durante a gravidez que as portuguesas. A prevalência de qualquer consumo de álcool durante a gravidez por imigrantes e portuguesas sugere cuidados pré-natais inadequados.
- Oral health behaviors and dental caries in a sample of Portuguese militariesPublication . Azevedo, Luís; Martins, David; Fialho, Joana; Veiga, Nélio; Correia, AndréObjectives: To determine the prevalence of dental caries and oral health behaviors in a sample of the Portuguese army. Methods: An observational cross-sectional study was conducted in a sample of army soldiers of the Infantry Regiment no. 14 of Viseu, Portugal, using a questionnaire. The study involved 122 members of the armed forces, who were asked to complete a questionnaire autonomously. The questionnaire enquired about general oral-health behaviors but focused mainly on: i) frequency of toothbrushing, ii) use of dental floss and iii) frequency of dental appointments. It also asked about sociodemographic information, like age and gender. An intra-oral observation was also conducted to determine the DMFT index and to record dental plaque based on the Silness and Löe plaque index (1964). Results: The prevalence of dental caries was high (51.6%±7.4%; DMFT of 4.6±3.5). The most prevalent score of the Silness and Löe plaque index was score 2 - visible plaque (58.2%). Regarding oral hygiene habits, most of the sample reported brushing their teeth at least twice a day (65.6%) and using fluoride toothpaste (64.8%). However, very few participants (18%) used dental floss. More than 30% of the participants had not visited a dentist within the previous year. Furthermore, 45.9% were current smokers. Conclusion: Prevention programs and promoting actions for oral health with these specific groups are important and should be adopted to reduce the prevalence of dental caries and to increases the knowledge about oral-health behaviors.
- Oral health attitudes and behaviours among Portuguese dental studentsPublication . Dias, António; Dias, Ana Rita; Veiga, Nelio Jorge; Saraiva, Regina Célia; Dias, Inês MargaridaIntroduction: Today’s dental students are going to be the future dentists responsible for oral health education and promotion. Oral health professionals’ attitudes and behaviours towards their own health relect their understanding about the importance of oral problems prevention and may contribute to the improvement of their patients’ oral health. Objectives: Evaluate oral health attitudes and behaviours (OHAB) among Portuguese students. Materials and methods: We conducted a cross sectional study in a sample constituted by 203 students of Portuguese Catholic University, Viseu. Data collection was performed through a self-administered questionnaire about OHAB, which included the Hiroshima University Dental Behavioural Inventory. Results: We found that 69.5% of the students adopted less adequate OHAB. Only the year of the course inluenced OHAB. Therefore, the higher the year, the better were OHAB. By calculating the variability, we found that the year was responsible for 8.87% of the variation in OHAB and the statistical differences were between the students of 1st and 4th year and 1st and 5th year. Conclusion: These results are consistent with some studies that point to the likely inluence of the exposure and acquisition of knowledge about OHAB transmitted along the academic education and clinical experience. As students progress through the course, they are more aware and more attentive to their oral health. Consequently, they adopt better attitudes and preventive behaviours. It is very important to change the way we do oral health education. The planning of teaching strategies for oral health behavioural changes should give importance to teaching selfcare techniques, towards to alert to the perception of risk factors what are in the origin of oral diseases.
- Embedding environmental sustainability within the modern dental curriculum – exploring current practice and developing a shared understandingPublication . Duane, Brett; Dixon, Jonathan; Ambibola, Giwa; Aldana, Clara; Couglan, James; Henao, Daniel; Timus, Daniela; Veiga, Nélio; Martin, Nicolas; Darragh, Jáuregui‐Hogan; Ramasubbu, Darshini; Perez, Francesc; Schwendicke, Falk; Correia, Maria; Quinteros, Maria; Harten, Maria van; Paganelli, Corrado; Vos, Peter; Lopez, Rosa Moreno; Field, JamesIntroduction: Evidence concerning the interactions between human health and planetary health has grown extensively in recent years. In turn, the perceived importance of environmental sustainability within higher education is growing at a rapid rate. This paper provides a summary of key elements as they apply to dentistry, and provides an introduction to the reader of an early consensus of how sustainability could be included as part of the dental curriculum. Methods: The consensus opinion within this paper largely centres around discussion at the ADEE sustainability workshop at the annual conference in Berlin (August 2019). In order to help inform discussions at the workshop, a brief scoping questionnaire was circulated to potential participants regarding their understanding and current teaching practices in sustainability. An infographic was designed to help delegates remember the important elements of sustainable dentistry. Delegates discussed the concept of sustainability alongside the infographic, and how they could link these with the Graduating European Dentist (GED) curriculum. Results: The discussions within the workshop largely centred around 4 main themes: Disease prevention and health promotion, Patient education and empowerment, Lean service delivery and Preferential use of strategies with lower environmental impact. Discussion: It is apparent that there is a widespread need for teaching materials relating to environmental sustainability; this includes specific learning outcomes relating to the 4 educational domains of the Graduating European Dentist curriculum, and methods for teaching and assessing these outcomes. Conclusion: This paper reports consensus on the first phase of a pan‐European working group on Sustainability in dental education.
- Fissure sealants: a review of their importance in preventive dentistryPublication . Veiga, Nélio J.; Ferreira, Paula C.; Correia, Ilídio J.; Pereira, Carlos M.Background: For the prevention of dental caries, fissure sealants application is recommended if pits and fissures are very deep and narrow, creating a physical barrier for the plaque's accumulation, in these specific anatomical areas of the tooth. Aim: This review article about fissure sealant aims to address the main properties, indications, advantages and limitations of fissure sealants that are used in order to acquire a higher level of knowledge about what is known today about this biomaterial and how and when it should be applied by clinicians. Review Results: Studies have shown that fissure sealants applied both in clinics and in schools, are highly effective in preventing dental caries, reducing caries in pits and fissures up to 60% for 2 to 5 years after its implementation. The application of fissure sealants has specific indications, such as: newly erupted teeth, with deep fissures and clinically free of dental caries; patients who present physical and mental disabilities; adult patients that are under medical treatment that involves a significant decrease of the salivary flow. Several studies analyzed do not clarify which type of fissure sealant, if a resin-based or glass ionomeric fissure sealant, has higher retention rate and effectiveness. Conclusion: The application of sealants is a recommended procedure to prevent or control dental caries. However, the relative effectiveness of different types of sealants has yet to be established. Clinical Significance: Fissure sealants are recommended to be applied soon after tooth eruption, mainly at the level of the first permanent molars. However, health professionals should always take into account that fissure sealants, currently used, have limitations such as microleakage. Regular reassessment, in order to avoid the development of dental caries, on teeth with partial or total loss of fissure sealants is recommended.
- Educação para a saúde baseada em evidênciasPublication . Pereira, Carlos; Veiga, NélioEste artigo descreve a forma como o conceito “evidência” evoluiu na área da saúde e os princípios e metodologias adotados na sua exploração, especialmente na educação para a saúde. Foi efetuada uma pesquisa nas bases de dados Pubmed/Medline para identificar publicações originais, editoriais e artigos de revisão sobre a temática em estudo, com recurso às seguintes palavras-chave, “health education”, “evidence based medicine”, “evidence based public health”, “health promotion”, “evidence based health promotion”. A utilização do termo “evidência” tornou-se corrente no âmbito do debate em saúde pública e na avaliação das práticas clínicas, em particular na área da prevenção e promoção da saúde. A medicina baseada na evidência consiste numa abordagem que visa integrar o conhecimento clínico individual com a melhor evidência disponível resultante de uma investigação sistemática. A abordagem baseada na evidência alargou-se, gradualmente, a outras esferas, desde a saúde pública, às intervenções comunitárias, passando pela educação para a saúde. Assim, surgiram novos conceitos como a saúde pública ou promoção da saúde baseada na evidência. No entanto, novos desafios se colocam quando se pretende explorar o efeito de intervenções nas comunidades, envolvendo novas abordagens na exploração da melhor evidência disponível. O debate sobre a promoção e educação para saúde baseada na evidência tem-se centrado em duas questões essenciais: qual o tipo de evidência que deve ser explorada de forma a estabelecer a sua efetividade e quais as metodologias mais adequadas na exploração dessas evidências.