Use of Electronic Dental Records in Brazil

This study aims to provide both a quantitative and a qualitative analysis of the usability of the most popular electronic dental records in Brazil regarding its clinical and administrative features. the softwares not only will be evaluated regarding their usage among the Brazilian dental professionals but also regarding their functionalities (present, used and desired) and the difficulties encountered by the dentists during their use.Universidade Federal de São Paulo, Dept Hlth Informat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Hlth Informat, São Paulo, BrazilWeb of Scienc

The effectiveness of Atraumatic Restorative Treatment versus conventional restorative treatment for permanent molars and premolars A critical assessment of existing systematic reviews and report of a new systematic review

Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Available for download at: http://mahara.qmul.ac.uk/view/view.php?id=16447Background: Atraumatic Restorative Treatment (ART) is the removal of caries using hand instruments and restoration of the resulting cavity using an adhesive restorative material. It was designed to restore teeth in communities without access to conventional dental clinics in poorer countries but has come to be used by dentists in the developed world too, as an alternative to conventional restorative treatment. Objectives: 1) to assess the scope and the methodological and reporting quality of existing systematic reviews of the effectiveness of ART compared to conventional restorative treatment; 2) to evaluate the effectiveness of ART compared to conventional treatment in permanent teeth with class I and II cavities. Methods: Searches: 1) for the assessment of existing systematic reviews: Electronic searches were conducted of OVID Medline, OVID Embase, The Cochrane Database of Systematic Reviews (CDSR), the Centre for Reviews and Dissemination (CRD) databases (DARE, NHSEED and HTA), Google Scholar, and the CNKI and CAOD Chinese databases; 2) for the systematic reviews of ART in permanent teeth: the above searches were supplemented by searches of the Cochrane Central Register of Controlled Trials (CENTRAL), LILAC, BBO, IMEAR (WHO Index Medicus for South East Region), WPRIM (WHO Western Pacific Region Index Medicus) and IndMed, Current Controlled Trials, Clinical Trials, OpenSIGLE, IADR conference abstracts and NLM Gateway. Hand searches were conducted of six dental journals known to have reported ART studies. References from retrieved systematic reviews, trials and other related papers were searched for additional reports. Authors were contacted. There were no language restrictions. Selection criteria: 1) for the assessment of existing systematic reviews: systematic reviews that compared ART to conventional treatment for the restoration of dental cavities; 2) for the systematic reviews of ART in permanent teeth: randomised controlled trials that compared ART using any adhesive material to conventional treatment using amalgam or any adhesive material Data collection: 1) for the assessment of existing systematic reviews: Reviews were selected and data was extracted by a single reviewer using a custom made data extraction sheet. Scope was assessed in terms of materials used, teeth and cavity type. Methodological quality was assessed using AMSTAR. Reporting quality was assessed using the PRISMA guidelines; 2) for the systematic reviews of ART in permanent teeth: reports of trials were screened and selected independently by two reviewers and data would have been extracted on a custom made data extraction sheet had there been eligible trials. Results: 1) for the assessment of existing systematic reviews: three systematic reviews were identified. Two of these were restricted to comparing ART with glass-ionomer to conventional treatment with amalgam; two allowed for inclusion of all cavity types in both deciduous and permanent teeth. None was of high methodological quality and reporting quality was good in one of the reviews only; 2) for the systematic reviews of ART in permanent teeth: no eligible trials were identified. Author’s conclusions: 1) existing systematic reviews do not have sufficient scope to allow for the inclusion of potentially eligible trials that would assess ARTs effectiveness and they have been of high to medium risk of bias; 2) it is disappointing that there are no properly conducted randomised controlled trials comparing ART to conventional treatment in class I and II cavities in the permanent dentition

Got Caries? Breast milk and Early Childhood Caries?

Objective: To provide an analysis of the association between the longevity of breastfeeding and development of ECC. Determine the optimal time frame in which mothers should cease breastfeeding to reduce ECC development. Methods: Dr. Brickhouse, PubMed, Google Scholar and other scholarly databases were utilized to find current scientific evidence on the effects of breast milk on ECC. Relevant articles were summarized to write a review of literature. 16 articles published from 2015 to the present date were reviewed and cited. Results: From the studies, there is strong evidence to support breastfeeding beyond 12 months of age increases the prevalence of ECC. Furthermore, increased frequency and duration of breastfeeding leads to higher incidence of ECC. Conclusion: Findings indicate dental health care providers should recommend either ceasing breastfeeding at 12 months of age or provide ECC prevention education to caregivers. Further research is required to minimize data discrepancies between US and international countries.https://scholarscompass.vcu.edu/denh_student/1002/thumbnail.jp

Análisis de expedientes dentales endodónticos de pacientes tratados en una universidad pública del sur de Brasil

Dental record has a fundamental role in dentist performance. This study evaluated the standard registration of dental records of patients submitted to endodontic treatment for undergraduate students (CG) and specialists endodontics students (CE) in a public university in the south of Brazil. The sample was obtained by convenience, consecutively and included dental records patients of a public university in the south of Brazil who were treated at CE and clinical records of patients who were treated at CG, during on the year 2014. Was analyzed the description of endodontic treatment, data retrieved was scored and rated using a modification of the scoring system proposed by Streiner & Norman (1996) and quality of radiographs was performed according to the guidelines of “National Radiological Protection Board”. At dental records were analyzed, 223 belong to CG and 219 belong CE. The records from CE and CG had similar information on the evaluated parameters, except for “presence of rubber dam” and “presence of abbreviature in the description” (Mann-Whitney Test, P = 0.386). The absence of periapical radiographs was higher in CE than CG records (CE = 36.77%; CG = 0.46%). (Mann-Whitney test, P<0.0001). There was a predominance of periapical radiographs with the grades “excellent” and “diagnostically acceptable” in both groups.The quality of records generally obtained good results. The incorporation of new science into the educational program like electronic records and digital imaging techniques, facilitating the constant updating of data related to health and treatment of patients improving the record of the evolution of procedures.O prontuário odontológico tem papel fundamental na atuação do cirurgião-dentista. Este estudo avaliou o padrão de registro de prontuários odontológicos de pacientes submetidos ao tratamento endodôntico por alunos de graduação (GC) e alunos especialistas em endodontia (CE) em uma universidade pública do sul do Brasil. Amostra foi obtida por conveniência, de forma consecutiva e incluiu prontuários odontológicos de pacientes atendidos por CE e prontuários de pacientes atendidos por GC, durante o ano de 2014. Foi analisada a descrição do tratamento endodôntico, os dados recuperados foram pontuados e avaliados usando uma modificação do sistema de pontuação proposto por Streiner & Norman (1996) e a qualidade das radiografias foi analisada de acordo com as diretrizes do “National Radiological Protection Board”. Nos prontuários odontológicos foram analisados, 223 pertencentes ao GC e 219 pertencentes ao CE. Os prontuários do CE e do CG apresentaram informações semelhantes sobre os parâmetros avaliados, exceto para “presença de isolamento absoluto” e “presença de abreviaturas na descrição” (Teste de Mann-Whitney, P = 0,386). A ausência de radiografias periapicais foi maior em CE do que os registros do CG (CE = 36,77%; CG = 0,46%) (Teste de Mann-Whitney, P <0,0001). Houve predomínio de radiografias periapicais com notas “excelente” e “diagnóstico aceitável” em ambos os grupos. A qualidade dos registros obteve bons resultados. Conclui-se que a incorporação de novas ciências ao programa educacional como prontuários eletrônicos e técnicas de imagem digital, facilita a atualização constante dos dados relacionados à saúde e tratamento dos pacientes, melhorando o registro da evolução dos procedimentos.El registro dental juega un papel fundamental en el desempeño del odontólogo. Este estudio evaluó el patrón de registro de registros dentales de pacientes sometidos a tratamiento de endodoncia por estudiantes de pregrado (GC) y estudiantes especialistas en endodoncia (EC) en una universidad pública en el sur de Brasil. La muestra se obtuvo por conveniencia, de forma consecutiva, e incluyó registros dentales de pacientes tratados por CE y registros médicos de pacientes tratados por GC durante 2014. La descripción del tratamiento endodóntico, los datos recuperados fueron puntuados y evaluados utilizando una modificación del sistema de puntuación propuesto por Streiner & Norman (1996) y se analizó la calidad de las radiografías de acuerdo con las directrices de la National Radiological Protection Board. En los registros dentales se analizaron 223 pertenecientes al GC y 219 pertenecientes a la CE. Las historias clínicas de la CE y CG presentaron información similar sobre los parámetros evaluados, excepto por “presencia de aislamiento absoluto” y “presencia de abreviaturas en la descripción” (prueba de Mann-Whitney, p = 0,386). La ausencia de radiografías periapicales fue mayor en los registros de EC que en los de GC (EC = 36,77%; GC = 0,46%) (prueba de Mann-Whitney, P <0,0001). Hubo un predominio de radiografías periapicales con puntajes de “excelente” y “diagnóstico aceptable” en ambos grupos. La calidad de los registros en general tuvo buenos resultados. Se concluye que la incorporación de nuevas ciencias al programa educativo, como la historia clínica electrónica y las técnicas de imagen digital, facilita la actualización constante de los datos relacionados con la salud y el tratamiento de los pacientes, mejorando el registro de la evolución de los procedimientos

Integrality, absenteeism and resolubility of specialized care for pediatric patients : a cross-sectional study

Dental Specialties Centers (CEOs) are clinics representing part of the secondary oral health care system of the Brazilian Unified Health System (SUS). Pediatric dentistry is not a requirement for service accreditation. However, the CEO of the Federal University of Rio Grande do Sul (CEO-UFRGS) has provided dental care for children aged 3–11 years since 2017. The utilization rates of health services are influenced by absenteeism. Therefore, evaluation of absences for dental appointments is of primary importance. This study aimed to evaluate referral characteristics, absenteeism, and resolubility of pediatric dentistry appointments at the CEO-UFRGS. This retrospective cross-sectional study was conducted at the Dental Teaching Hospital of the university and analyzed secondary data from referrals and medical records. From August 2017 to December 2019, 167 referrals and 96 medical records were reviewed, from which data of individual variables related to the referral process and treatment were collected. Data were collected by a single trained examiner and analyzed using SPSS software. The main reasons for referral to secondary care were dental caries and pulpal or periapical diseases associated with difficult-to-manage behavior. An absenteeism rate of 28.1% at the first pediatric dental visit and a resolution rate of 65.6% were found. Binary logistic regression analysis indicated that each day of waiting for specialized care resulted in a 0.3% of higher chance of absence for appointment. This also increased the chance by 0.7% in child who attended the first visit to complete treatment, suggesting that the waiting time for attendance was associated with absenteeism and resolubility. Public policies that expand providing child dental care in secondary care are recommended to improve access to and resolubility of services

Evaluación de seis años de interconsultas odontológicas provenientes del área de internación pediátrica del Hospital Criança Conceição de Porto Alegre, Brasil

Introduction: this study aimed to describe the profile of the referrals sent to the hospital dentistry team from patients in Hospital Criança Conceição in Porto Alegre, Rio Grande do Sul, Brazil, from January 2012 to July 2018. Methods: a descriptive, retrospective study was conducted, evaluating 193 electronic dental records to extract the following data: patient’s sex and age, description of the referral made by other health professionals and the dentist’s behavior in solving the presented problem. Results: 61.6% of patients were male and the mean age of all patients was 10.5 years. Most dental referrals came from the oncohematology area (75.12%) and the predominant reason was pre- and post-chemotherapy patients’ dental care (40.4%). The diagnosis most commonly found by dentists was mucositis (17.6%) and caries (16%). There was absence of oral diseases in 23.8% of cases. The interventions most commonly performed by the hospital dentistry team were laser therapy (57.5%) and oral hygiene instructions (49.1%) in the hospital setting, while procedures in dental offices and surgical rooms included exodontias (27.7%) and restorations (11.7%). Conclusions: the profile of referrals sent to the hospital dentistry team from patients hospitalized in the Hospital Criança Conceição in Porto Alegre, Rio Grande do Sul, Brazil, is inadequate, since there was a lack of transdisciplinary management including dental care, in addition to poor use of information technology resources and lack of more objective medical records for easy retrieval of patient health information.Introducción: este estudio pretende describir el perfil de las interconsultas enviadas al equipo de odontología hospitalaria provenientes de pacientes internados en el Hospital Criança Conceição de Porto Alegre, Rio Grande do Sul, Brasil, en el período de enero de 2012 a julio de 2018. Métodos: estudio descriptivo retrospectivo en el que se evaluaron 193 historias clínicas odontológicas electrónicas para extraer los siguientes datos: sexo y edad del paciente, descripción de la interconsulta realizada por otros profesionales de salud y conducta del cirujano dentista frente al problema presentado. Resultados: el 61,6% de los pacientes fue de sexo masculino y la edad promedio general fue 10,5 años. Las interconsultas más solicitadas para los cirujanos dentistas fueron provenientes del área de oncohematología (75,12%) y el motivo predominante fue sobre el cuidado bucal a pacientes pre y posquimioterapia (40,4%). El diagnóstico que más encontraron los dentistas fue mucositis (17,6%) y lesiones de caries (16%). Hubo ausencia de enfermedades bucales en 23,8% de los casos. Las intervenciones más realizadas por el equipo de odontología fueron aplicaciones de laserterapia (57,5%) y orientaciones de higiene bucal (49,1%) en ámbito hospitalario; en sillón dental y sala quirúrgica, fueron exodoncias (27,7%) y restauraciones (11,7%). Conclusiones: el perfil de las interconsultas enviadas al equipo de odontología hospitalaria provenientes de pacientes internados en el Hospital Criança Conceição de Porto Alegre, Rio Grande do Sul, Brasil, es inadecuado, pues se demostró falta de manejo transdisciplinar que incluya odontología, además de la necesidad de un mejor aprovechamiento de los recursos de tecnología de información e historias clínicas más objetivas y que permitan obtener más fácilmente la información de salud de los pacientes

Specialized Dental Care in the Brazilian Unified National Health System (SUS)

Objective: To analyze specialized dental care through access, demand and the work processes provided by the CEO\u27s, using secondary data from the cycles of the PMAQ-CEO. Material and Methods: Cross-sectional study using public domain data. Variables of interest were selected from the external evaluation instrument data matrices and were grouped in categories. The categories were geographic distribution, structural, human resources, work processes and access and coordination. Results: The total of 932 CEO’s were evaluated in 2014 and 1,042 in 2016, most of them type II, present in the Northeast region. In both cycles, the highest average of dentists worked in the endodontic specialty (2.4 professionals per CEO) and the lowest in oral medicine (0.8 professionals per CEO). Of the two cycles, 91.5% of the CEO’s had a manager, 79.5% performed action planning activities and 74.5% realized internal self-assessment processes. There was an increase in the mean number of days to be seen at the CEO in all analyzed specialties (p&lt;0.001) and 85.2% of the CEO\u27s managers reported that there is a reference for oral cancer confirmed cases. Conclusion: Between the PMAQ-CEO cycles the number of CEO has increased, but there are still a big pent-up demand and the presence of care gaps. However, an expansion and improvement of the CEO’s actions was evidenced, mainly related to the work processes

A systematic literature review of cloud computing in eHealth

Cloud computing in eHealth is an emerging area for only few years. There needs to identify the state of the art and pinpoint challenges and possible directions for researchers and applications developers. Based on this need, we have conducted a systematic review of cloud computing in eHealth. We searched ACM Digital Library, IEEE Xplore, Inspec, ISI Web of Science and Springer as well as relevant open-access journals for relevant articles. A total of 237 studies were first searched, of which 44 papers met the Include Criteria. The studies identified three types of studied areas about cloud computing in eHealth, namely (1) cloud-based eHealth framework design (n=13); (2) applications of cloud computing (n=17); and (3) security or privacy control mechanisms of healthcare data in the cloud (n=14). Most of the studies in the review were about designs and concept-proof. Only very few studies have evaluated their research in the real world, which may indicate that the application of cloud computing in eHealth is still very immature. However, our presented review could pinpoint that a hybrid cloud platform with mixed access control and security protection mechanisms will be a main research area for developing citizen centred home-based healthcare applications

A snapshot of compliance with the sepsis six care bundle in two acute hospitals in the West Midlands, UK

The sepsis six care bundle has been adopted by hospitals in England and Wales for the management of patients with sepsis, with the aim of increasing survival when all elements of the bundle are achieved. To assess compliance with the Sepsis Six Care Bundle in two acute NHS hospitals in the West Midlands. Adults admitted to hospital over a 24-hour period were screened for sepsis. Sepsis was identified using the Systemic Inflammatory Response (SIRS) criteria and the quick sequential organ failure assessment (qSOFA) score. Adherence to the Sepsis Six Care Bundle was assessed. 249 patients were screened and 24 patients were identified as having sepsis (9.6%). One patient received all six elements of the bundle. Compliance was highest for giving intravenous fluids (58.3%) and antibiotics (58.3%), and lowest for measuring urine output (16.7%). Further research is needed to establish the reasons for low compliance. Frankling C, Patel J, Sharif B, Melody T, Yeung J, Gao F, et al. A Snapshot of Compliance with the Sepsis Six Care Bundle in Two Acute Hospitals in the West Midlands, UK. Indian J Crit Care Med 2019;23(7):310-315