Relato de dor e desconforto de origem dentária em pré-escolares e principais fatores associados

Orientador: Prof. Dr. José Vitor Nogara Borges de MenezesCoorientadora: Profª. Drª. Juliana Feltrin de SouzaDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Odontologia. Defesa: Curitiba, 23/06/2017Inclui referências : f. 51-54Resumo: A falha em identificar dor ou desconforto de origem dentária em crianças pré-escolares pode afetar aspectos importantes do desenvolvimento infantil e as atividades diárias do responsável pela criança. Os objetivos deste estudo transversal foram analisar o relato dos pais sobre presença de dor ou desconforto de origem dentária em pré-escolares, identificar fatores clínicos e sociodemográficos associados, bem como a interferência da dor ou do desconforto dentários sobre as atividades diárias do responsável e, ainda, a associação entre o relato parental de dor da criança com o autorrelato da criança. Este estudo censitário envolveu pré-escolares de 4 e 5 anos de idade matriculados na rede municipal de ensino de Campo Magro - PR e seus responsáveis. Para análise do relato de dor, os responsáveis responderam à versão brasileira do Dental Discomfort Questionnaire (DDQ-B). Um questionário sociodemográfico testado previamente em um projeto piloto também foi aplicado. As crianças foram examinadas utilizando o índice de dentes cariados, perdidos, extraídos ou com extração indicada ou obturados para dentição decídua (ceo-d), seguindo os critérios da Organização Mundial da Saúde, e o índice que mede as consequências clínicas de lesões de cárie não tratadas para dentes decíduos (pufa), por duas examinadoras calibradas para ambos os índices (kappa interexaminador > 0,763 e intraexaminador > 0,792). Também foram avaliados a presença de mobilidade fisiológica em dentes decíduos anteriores e processo de erupção dos primeiros molares permanentes. O autorrelato de dor foi avaliado por meio da Faces Pain Scale (FPS-R) aplicada às crianças. Um total de 376 crianças participaram da pesquisa. A prevalência de dor ou desconforto de origem dentária foi de 70,3%. Para análise dos dados, realizou-se regressão univariada e multivariada de Poisson. A prevalência do relato de dor ou desconforto de origem dentária apresentou-se significantemente maior em famílias com estrutura não nuclear (RR=1,31; IC95% 1,04-1,66), menor nível de escolaridade do responsável (RR=1,89; IC95% 1,34-2,60), crianças cuja última consulta odontológica foi por motivo de dor (RR=2,06; IC95% 1,56-2,72), pais com pior percepção sobre a saúde bucal da criança (RR=1,83; IC95% 1,45-2,30), crianças com menor frequência de escovação dentária diária (RR=1,68; IC95% 1,30-2,18), crianças com experiência de cárie (ceo-d) (RR=1,49; IC95% 1,17-1,88), e com componente cariado do ceo-d (RR=1,51; IC95% 1,20-1,91), bem como em crianças com dentes apresentando consequências clínicas das lesões de cárie não tratadas (pufa) (RR=1,72; IC95% 1,33-2,23) e faltas escolares das crianças (RR=1,51; IC95% 1,08-2,11). A prevalência do relato de dor ou desconforto de origem dentária apresentou-se significantemente maior em famílias com interrupção de tarefas domésticas (RR=1,49; IC95% 1,01-2,19) e autorrelato de dor dos pré-escolares (RR=1,35; IC95% 1,08-1,70). Na regressão multivariada, crianças com dentes que apresentavam consequências clínicas das lesões de cárie não tratadas apresentaram maior prevalência de relato de dor, independentemente das demais variáveis. Concluiu-se que o relato de dor ou desconforto de origem dentária foi alto e está associado com características sociodemográficas e consequências clínicas das lesões cariosas não tratadas. O relato dos pais sobre dor ou desconforto dentários da criança está associado com o autorrelato de dor dos pré-escolares. Ainda, a presença de dor dentária na criança impacta na rotina escolar e nas atividades diárias do responsável. Palavras-chave: Odontalgia. Percepção da dor. Cárie dentária. Núcleo familiar.Abstract: Failure to identify dental pain or discomfort in preschool children can affect important aspects of the children's development and their caregiver's daily activities. The aims of this cross-sectional study was to analyze the parents' report of the presence of dental pain or discomfort in preschool children, to identify associated clinical and sociodemographic factors, as well as the interference of dental pain or discomfort on the daily activities of the caregiver and the association with the children's self-report of pain. This census study involved preschoolers of 4 and 5 years old enrolled in the Campo Magro - PR municipal school system and their caregivers. The caregivers answered the Brazilian version of the Dental Discomfort Questionnaire (DDQ-B) and a sociodemographic questionnaire previously tested in a pilot project. The children were examined using the index of decayed, missing or filled deciduous teeth (ceo-d), following the World Health Organization (WHO) criteria, and the pufa index (pulp involvement, ulceration due to trauma, fistula and abcess for deciduous teeth), by two examiners calibrated for both indexes (interexaminer kappa > 0.763 and intraexaminer > 0.792). The presence of physiological mobility in anterior primary teeth and the eruption process of the first permanent molars were also evaluated. Self-report of pain was assessed using the Faces Pain Scale (FPS-R) applied to children. A total of 376 children participated in the survey. The prevalence of dental pain or discomfort was 70.3%. Statistical analysis involved univariate and multivariate Poisson regression. The prevalence of dental pain or discomfort was significantly higher in non-nuclear family structure (RR = 1.31, 95% CI 1.04-1.66), lower level of education of the caregiver (RR = 1 , 89, 95% CI 1.34-2.60), the last dental visit of the child due to pain (RR = 2.06, 95% CI 1.56-2.72), worse caregiver's perception of the child's oral health (RR = 1.83, 95% CI 1.45-2.30), lower frequency of daily dental brushing (RR = 1.68, 95% CI 1.30-2.18), caries experience (dmft) (RR = 1.49, CI 95% CI 1.17-1.88), caries component of dmft (RR = 1.51, CI 95% 1.20-1.91), clinical consequences of non-carious lesions (RR = 1.72, IC95% 1.33-2.23) and children's school absences (RR = 1.51, 95% CI 1.08-2.11). The prevalence of reported dental pain or discomfort was significantly higher in families with interruption of domestic tasks (RR = 1.49, 95% CI 1.01-2.19) and self-reported pain of the preschool children (RR = 1.35, 95% CI 1.08-1.70). In the multivariate regression, children with teeth that had clinical consequences of untreated caries lesions presented a higher prevalence of pain, independently of the other variables. It can be concluded that the report of dental pain or discomfort was high and it is related to sociodemographic characteristics and clinical consequences of untreated caries lesions. Caregiver's reports of dental pain or discomfort in the child are associated with the self-reported pain of preschoolers. Still, the presence of dental pain in the child impacts on the school routine and daily activities of the caregiver. Keywords: Toothache. Pain Perception. Dental Caries. Nuclear Family

Daily Toothbrushing Frequency and the Association with Parental Report of Dental Pain and Discomfort in Preschool Children

Objective: To evaluate the impact of daily toothbrushing frequency on parental reports of dental pain and discomfort in preschoolers. Material and Methods: An observational cross-sectional study was conducted involving 376 children between four and five years of age at public preschools in the city of Campo Magro, Brazil. Parents/guardians answered a socioeconomic questionnaire that contained a single question on the child's daily toothbrushing frequency and the Brazilian version of the Dental Discomfort Questionnaire (DDQ-B). Statistical analysis involved bivariate and multivariate Poisson regression analyses (α=0.05). Results: After the adjustments in the multivariate analysis, the prevalence of dental pain and discomfort was lower among children whose last visit to the dentist was for prevention (PR = 4.42; 95% CI: 1.75–11.14; p=0.002) and those with a higher daily toothbrushing frequency (PR = 2.13; 95% CI: 1.12–4.05; p=0.021). Conclusion: A lower toothbrushing frequency is associated with parental reports of dental pain and discomfort in preschoolers. Educational and preventive measures that stimulate an increase in daily toothbrushing frequency can contribute to a better oral health status in preschoolers, consequently, less prevalence of dental pain and discomfort

Exploring the applicability of solar driven photocatalytic processes to control inestation by zebra mussel

Dreissena polymorpha (zebra mussel) is an invasive freshwater bivalve mollusc that causes important technical and environmental problems. Titanium dioxide solar photocatalysis was checked for disinfestation of veligers of zebra mussel. Approximately 70% damaged larvae were observed after 2h of solar irradiation with 0.2 and 0.5g/l of TiO 2. Neutral photo-Fenton could be a promising alternative as ca. 80% damaged larvae were detected in only 3h irradiation in the presence of H 2O 2 (10mg/l). This process was clearly more effective than sunlight irradiation, H 2O 2, or dark Fenton. The performance of the process was slightly improved when a pH value of 5.5 was employed, although further research is needed to explore the compatibility of this medium with irrigation. Finally, the process was scaled up to 4l using a solar photo-reactor; again in this case, 90% of the veligers were damaged after 3h of irradiation. © 2011 Elsevier B.V.We want to acknowledge the financial support of Spanish Ministerio de Medio Ambiente, Medio Rural y Marino (Project 100/RN08/03.4) and Confederacion Hidrografica del Ebro for providing water samples infested with zebra mussel.Bernabeu García, A.; Vicente Candela, R.; Peribañez Lopez, MA.; Arques Sanz, A.; Amat Payá, AM. (2011). Exploring the applicability of solar driven photocatalytic processes to control inestation by zebra mussel. Chemical Engineering Journal. 171(2):490-494. https://doi.org/10.1016/j.cej.2011.04.009S490494171

Solar photo-Fenton at mild conditions to treat a mixture of six emerging pollutants

The applicability of photo-Fenton to degrade a mixture of emerging pollutants (EPs) namely amoxycillin, acetaminophen, acetemiprid, caffeine, clofibric acid and carbamazepine has been studied at different scenarios. At high concentrations, acidic photo-Fenton was able to achieve a fast removal of the EPs. Although, complete mineralization was not reached, the toxicity of the solution was decreased according to the respiration of activated sludge and luminescence of Vibrio fischeri assays, although according to this last assay a transitory enhancement of the toxicity was found, attributable to the formation of toxic byproducts such as phenols, chlorophenols and chlorinated pyrydines. Experiments carried out with 5 mg/l of each EP showed that at neutral media the process was two orders of magnitude less efficient than at acidic pH, although it was still able to remove the EPs. The aqueous matrix has a remarkable effect on the process as the presence of humic acids increased the reaction rate and inorganic salts played an inhibitory role. Finally, experiments performed with 10 lg/l of each EP showed that under those experimental conditions nearly complete removal of the EPs was reached with neutral photo-Fenton after 120 min of irradiation; in this case, humic substances played a disfavorable role.We want to thank the financial support of Spanish Ministerio de Ciencia e Innovacion (CTQ 2009-13459-0O5-03) and (CTQ 2009-3459-C05-01).Bernabeu García, A.; Palacios Guillem, S.; Vicente Candela, R.; Vercher Pérez, RF.; Malato Rodríguez, S.; Arques Sanz, A.; Amat Payá, AM. (2012). Solar photo-Fenton at mild conditions to treat a mixture of six emerging pollutants. Chemical Engineering Journal. 198:65-72. https://doi.org/10.1016/j.cej.2012.05.056S657219

Influence of radiation and TiO2 concentration on the hydroxyl radicals generation in a photocatalytic LED reactor. Application to dodecylbenzenesulfonate degradation

One of the main issues associated to the development of photocatalysis is the lack of adequate indexes that allow the comparison of the results obtained in different experimental setup designs. The hydroxyl radicals (o OH) generation rate is a key factor to determine the overall oxidation rate. In this work, using a Light Emitting Diodes (LEDs) reactor aimed to maximize light ef?ciency and minimize energy consumption, the o OH generated have been determined as a function of the radiation and catalyst concentration following an indirect method based on the reaction between o OH and dimethyl sulfoxide (DMSO) to produce formaldehyde. Finally, the methodology has been applied to analyze the degradation kinetics of the anionic surfactant dodecylbenzenesulfonate (DBS), frequently used in shampoo formulations and detergents for washing machines. We propose a method based on the indirect determination of o OH radicals generation rate that allows the assessment and comparison of the kinetics of photocatalytic oxidation of pollutants.Financial support from the Spanish Ministry of Economy and Competitiveness and from FEDER funds (projects CTM2012-33917 and CTQ2012-31639) are gratefully acknowledged

Application of soluble bio-organic substances (SBO) as photocatalysts for wastewater treatment: Sensitizing effect and photo-Fenton-like process

Soluble bio-organic substances (SBO) isolated from urban biorefuses have been investigated in photocatalytic processes for wastewater treatment using a cationic dye, namely crystal violet (CV) as target compound. The SBO have been found to enhance the photobleaching of CV solutions with an optimal SBO concentration of ca. 20 mg L-1. Mechanistic investigation based on chemical probes and changes in the absorption spectrum of CV in the presence of SBO seems to indicate that a complex formed between sensitizer and substrate plays a major role in the process. SBO have also been tested for the implementation of photo-Fenton processes at circumneutral media: the observed pseudo first order rate constants for CV decoloration was higher for UV/SBO/Fe(II)/H2O2 (5.5 x 10(-3) min(-1)) than for UV/Fe(II)/H2O2 (1.5 x 10(-3) min(-1)). A modified mechanism, in which HO center dot are less relevant that at the acidic medium, is in agreement with results of experiments carried out with chemical probes. (C) 2012 Elsevier B.V. All rights reserved.Gomis Vicens, J.; Vercher Pérez, RF.; Amat Payá, AM.; Martire, DO.; Gonzalez, MC.; Prevot, AB.; Montoneri, E.... (2013). Application of soluble bio-organic substances (SBO) as photocatalysts for wastewater treatment: Sensitizing effect and photo-Fenton-like process. Catalysis Today. 209:176-180. doi:10.1016/j.cattod.2012.08.036S17618020

Changes in global groundwater organic carbon driven by climate change and urbanization

YesClimate change and urbanization can increase pressures on groundwater resources, but little is known about how groundwater quality will change. Here, we rely on a global synthesis (n = 9,404) to reveal the drivers of dissolved organic carbon (DOC), which is an important component of water chemistry and substrate for microorganisms which control many biogeochemical reactions. Groundwater ions, local climate and land use explained ~ 31% of observed variability in groundwater DOC, whilst aquifer age explained an additional 16%. We identify a 19% increase in DOC associated with urban land cover. We predict major groundwater DOC increases following changes in precipitation and temperature in key areas relying on groundwater. Climate change and conversion of natural or agricultural areas to urban areas will decrease groundwater quality and increase water treatment costs, compounding existing threats to groundwater resources

Insight on the fundamentals of advanced oxidation processes. Role and review of the determination methods of reactive oxygen species

Advanced oxidation processes (AOPs) have known increased application to treat wastewaters containing recalcitrant compounds that are hardly degraded by conventional technologies. AOPs are characterized by the formation of strong oxidants such as hydroxyl radicals, superoxide anions, hydroperoxyl radicals and singlet oxygen, which react with the contaminant, contributing to its degradation. This paper provides an overview of the determination methods of reactive oxygen species, ROS, in the application of AOPs; the methods developed in the available literature for the detection and quantification of ROS are reviewed as a first step in the assessment and detailed description of the mechanisms involved in the oxidation reactions, focusing on the critical analysis of the main strengths and weaknesses presented by the probe molecules employed in the evaluated studies.This research was supported by the Ministry of Economy and Competitiveness (MINECO/SPAIN) and European Regional Development Fund (ERDF) under the project CTQ2011-25262