CONTEXT AND OBJECTIVES: Anxiety is usually classified as a disorder of neurotic nature and is often related to contexts of stress, which may include worries, motor tension and autonomic hyperactivity. The aim of this study was to assess the influence of mothers’ anxiety on their children’s anxiety during dental care. DESIGN AND SETTING: Analytical cross-sectional study conducted at in a private dentistry school in the south of Brazil. METHODS: Convenience sampling was used. All mothers of children undergoing treatment were invited to participate in this study. Data to investigate anxiety related to dental treatment among the children were collected through applying the Venham Picture Test (VPT) scale. For the mothers, the Corah scale was applied. A self-administered sociodemographic questionnaire with questions about demographic, behavioral, oral health and dental service variables was also used. RESULTS: 40 mother-child pairs were included in the study. The results showed that 40% of the children were anxious and 60% of the mothers were slightly anxious. Local anesthesia was the procedure that caused most anxiety among the mothers, making them somewhat uncomfortable and anxious (60%). Family income higher than R$ 1,577.00 had an influence on maternal anxiety (75.6%). Maternal anxiety had an influence on child anxiety (81.3%). CONCLUSION: Most of the children showed the presence of anxiety, which ranged from fear of dental care to panic, inferring that maternal anxiety has an influence on children’s anxiety. Dental procedures did not interfere with the mothers’ anxiety, but caused positive feelings, whereas they affected the children more.

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Influence of maternal anxiety on child anxiety during dental care: cross-sectional study

Predictors of dental anxiety in Brazilian 5-7years old children.

® . Results: The prevalence of clinical symptomatology of fear and dental anxiety was 77.1% (IC 95% 73.3-81) and 62.8% (IC 95% 58.3-67.2) respectively. Statistically significant dental fear associated with the female sex was recorded (OR=1.9; IC95% 1.2-2.9) and previous traumatic experience in the dental surgery (OR=3.2; IC95% 1.73-6.28) and anxiety in the dental surgery with the female sex (OR=2; IC95% 1.3-2.9), previous traumatic experience in the den- tal surgery (OR=2.2; IC95% 1.4-3.6), negative influence from members of the family (OR=1.5; IC95% 1.07-2.2), patient's perception of dental health (OR= 1.5; IC95% 1.04-2.2), and fear in the dental surgery (OR=39.8 IC95% 19.2- 82.5). Conclusions: Prevalence of dental fear and anxiety in the subjects was high; the female sex, negative influence from members of the family and previous traumatic experiences in the dental surgery are risk factors causing fear and anxiety in the dental surgery

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Factores asociados a sintomatología clínica de miedo y ansiedad en pacientes atendidos en Odontología

There is little evidence on the long-term effects of pharmacological management in children undergoing dental treatment. This study aimed to assess children's behavior in consecutive dental sessions following oral rehabilitation using different pharmacological regimens for behavioral control. Participants were preschoolers who were previously treated for caries under one of the following: no sedative, oral sedation with midazolam, oral sedation with midazolam/ketamine, or general anesthesia. The children's behavior in the follow-up sessions was assessed using the Ohio State University Behavioral Rating Scale (OSUBRS); higher scores represented less cooperative behavior (range 5-20). Follow-up assessments were conducted on 50 children under four years old for up to 29 months. Data were analyzed by the Friedman/Wilcoxon tests and Cox regression model. OSUBRS mean (standard deviation) scores for the whole sample decreased from 11.9 (5.4) before treatment to 6.8 (3.2) at the final recall session (p < 0.001). Moderate sedation with midazolam (OR 2.9, 95%CI 1.2-6.9) or midazolam/ketamine (OR 4.3, 95%CI 1.6-11.4) improved children's future behavior. The general anesthesia group (n = 4) had a small sample size and the results should be considered with caution. Although invasive dental treatment negatively affected the child's behavior in the dental chair, they became more cooperative over time. Moderately sedated children showed better prospective behavior than those in the non-sedation group.

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Moderate sedation helps improve future behavior in pediatric dental patients - a prospective study

Background No longitudinal study has evaluated the mutual relationship between dental fear and oral health in the same investigation. Aim To evaluate the reciprocal longitudinal relationship between dental fear and oral health in schoolchildren. Design This longitudinal study monitored 416 Brazilian children aged 5-7 years of age at baseline for 2 years. The decayed, filled and missing teeth were clinically assessed for each child. Dental fear was evaluated by Dental Anxiety Question. Multilevel mixed-effects linear and logistic regressions analysed the reciprocal relationship between dental fear and oral health. Results Children with caries experience had 1.8 times higher odds of dental fear compared to children who were caries free. The presence of a carious tooth increased the odds of dental fear by 1.2 times. Children with dental fear had 0.46 additional carious tooth; an additional 0.22 tooth indicated for extraction; and a 0.67 higher caries experience score compared to children without dental fear. Conclusions We observed a reciprocal relationship between dental fear and poor oral health. Both parents and dentists should provide realistic information for the children, discouraging biased negative expectations regarding dental treatment. Ultimately, the child would acquire positive perceptions of the dental environment, reducing their phobia and consequently improving oral health.

Reciprocal longitudinal relationship between dental fear and oral health in schoolchildren.

Considering the negative impact anxiety can exert over dental treatment, the scope of this study was to determine the prevalence of predictors of anxiety regarding dental treatment among Brazilians. A cross-sectional study was carried out using the Corah dental anxiety scale to assess the degree of anxiety regarding dental treatment among 3000 patients. The results reveal that two out of every eight Brazilian patients manifest moderate to severe anxiety regarding dental treatment. In this sample, the degree of anxiety was higher among females (p=0.007), over 20 years of age (p=0.006), without access to the Internet and/or newspapers (p=0.016), with a low frequency of oral hygiene (p=0.001), for whom the reason for the dental appointment was curative treatment, pain or another problem rather than a check up (p=0.047) and those suffering from toothache (p<0.001). Fear and anxiety regarding dental treatment indeed exist in the Brazilian population and the findings of this study suggest that, besides the lack of economic resources, negligence with respect to oral health, gender and age may increase the degree of anxiety.

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Ansiedade frente ao tratamento odontológico: prevalência e fatores predictores em brasileiros

The more death is studied, the more it remains a mystery Dealing with death is no easy matter and for that reason it is so frightening All the fears of human beings are fundamentally related to the fear of death This is because it is a mystery about which we know little or nothing, although it is natural to die In view of this, religions give this topic a primary focus Therefore, in this article an attempt is made to deal with the taboo surrounding death and reflect on issues associated with it These themes are present in people's lives, especially when they have the experience of losing someone in their family or circle of friends Among these subjects, the aspects of the Anointing of the Sick, the Funeral Mass, the Seventh Day Mass and the tradition of praying for the dead are all touched upon These are all themes that help to deal with the taboo of death or losing a loved one

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Procedimentos para lidar com o tabu da morte

As lesoes fibro-osseas fazem parte de um grupo heterogeneo composto por lesoes de desenvolvimento, processos displasicos e reativos bem como neoplasias. A doenca de Paget e uma alteracao esqueletico idiopatica cronica que consiste na alteracao da atividade osteoclastica de um ou mais grupos de ossos, que desencadeia uma formacao ossea desordenada, gerando a hipertrofia ossea, sendo mais frequente nos ossos do crânio e coluna vertebral. Possui maior prevalencia em individuos da terceira idade, de etiologia ainda desconhecida, sendo descoberta incidentalmente, por exames radiologicos, devido ao aumento da taxa de hidroxiprolina na urina ou o achado de niveis sericos de fosfatase alcalina elevados. O espectro clinico da doenca de Paget e muito variavel, dependendo dos locais acometidos, do grau das deformidades e da intensidade da atividade metabolica. Pacientes com dor ou deformidades osseas devem ser investigados quanto a possibilidade de doenca de Paget devido a sua pouca especificidade. Neste trabalho, os autores produziram a revista de literatura, enfocando os aspectos clinicos, imaginologicos, laboratoriais, histopatologicos e tratamento da doenca de Paget, enfatizando a divulgacao desta afeccao que, rotineiramente, se apresenta com sinais subclinicos._________________________________________________________________________________________ ABSTRACT: The fibro-osseous lesions are part of a heterogenous group of developing lesions, dysplasic, reactive processes, and neoplasms. Paget's disease is an idiopathic skeletal chronic modification that consists of an alteration in the osteoclastic activity of one or more groups of bones that causes a disordered bone formation, initiating hypertrophy of the bone , and is most frequently found in cranial bones and the vertebral column. It has a higher prevalence in the elderly and its etiology is unknown. It is often discovered by chance in routine radiographic examinations, by the increase in the hydroxiproline rate i in the urine or high levels of alkaline phosphatase in the blood. The clinical expression of Paget's disease is very variable, depending on the parts affected , the seriousness of the deformity and the intensity of the metabolic activity. Patients with pain or osseous deformities have to be investigated as to the possibility of having Paget's disease because of the low specificity. In this paper, the authors make a literature review, focusing on the clinical aspects, radiographic examinations, laboratory dosages, histologic features and treatment, and emphasize specific aspects of the disease frequently present subclinical signs.

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Doença de Paget do complexo crânio-maxilo-facial: revisão crítica da literatura

The authors report a case of a 17-year-old female patient who sustained head and facial trauma and developed the classical features of the superior orbitaria fissure syindrome. She was coiiservatively managed and three months after injnry presented with partial recovery of ocular movements.

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Síndrome da fissura orbitária superior pós-traumática: Relato de caso

O texto ora proposto analisa um conjunto de informacoes que, alem de revelar as fronteiras das religioes na regiao metropolitana de Sao Paulo, retratam distintos indicadores de exclusao social, sendo que todos estes indicadores estao relacionados, direta ou indiretamente com o fator religioso. Atraves de uma sequencia de mapas e possivel visualizar como sao ocupados os territorios desta metropole e quais as religioes que predominam entre as diversas camadas sociais que a povoam. O objetivo desta pesquisa foi demonstrar o poder que a religiao exerce na vida social e revelar sua influencia no processo de exclusao e inclusao social. Apresentamos essa abordagem por meio de um Atlas das principais religioes que compoem o campo religioso da metropole paulistana e suas configuracoes de espaco, com fronteiras bem delimitadas. Atraves de um conjunto de estudos e operacoes cientificas e tecnicas desenvolvidas por diversos orgaos de pesquisa, foi possivel elaborar uma carta geografica da distribuicao das religioes na metropole de Sao Paulo, identificando com precisao os limites de ocupacao territorial de catolicos, pentecostais, evangelicos tradicionais, espiritas, os sem religiao, entre outros, identificando, assim, as distintas manifestacoes do fenomeno da exclusao social na metropole. Mesmo com todo o paradoxo que as religioes representam, descobrimos que ela e um elemento poderoso no processo de inclusao social. Para completar o mapa da distribuicao das religioes na metropole, suas fronteiras geograficas e confirmar a tese da exclusao e inclusao social, apresentamos outros mapas que trazem fatores que ajudam a determinar a opcao religiosa. Quesitos como cor da pele, migracao, escolaridade, renda, privacao social e taxa homicidio foram importantes para tratar da religiao como uma questao de fronteira.

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José Carlos Pereira

Papers

Ansiedade frente ao tratamento odontológico: prevalência e fatores predictores em brasileiros

Procedimentos para lidar com o tabu da morte

Doença de Paget do complexo crânio-maxilo-facial: revisão crítica da literatura

Síndrome da fissura orbitária superior pós-traumática: Relato de caso

As fronteiras da religião na metrópole