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

Lipomas da Região Oral e Maxilofacial: Estudo Retrospectivo de 16 Anos no Brasil

Among the severe reactions to medications, immune-mediated Mucocutaneous Disorders are widely represented. Steven-Johnson’s syndrome, or great multiform erythema, appears as a systemic disturbance, involving the skin and mucous membranes, and is related to several factors, such as, viral or bacterial infections and particularly the administration of medicines, in general painkillers and antibiotics. The objective of this article is report the onset of ulcerative vesicle –blister lesions in the regions of the lips, gums, tongue and genital mucosa membrane in a 26 year-old patient, a leukoderm man, being treated with sulfamethoxazole trimethoprim for a respiratory infection, after being diagnosed as having the Steven-Johnson syndrome. SSJ1 558187121279. Indexing terms : Steven-Johnson syndrome; multiform erythema; autoimmune disease

Paulo Germano de Carvalho Bezerra Falcão

Papers

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

Lipomas da Região Oral e Maxilofacial: Estudo Retrospectivo de 16 Anos no Brasil

Síndrome de Stevens-Johnson associada ao uo de antimicrobiano

Assessment of factors associated with surgical difficulty during removal of impacted lower third molars

Alterações bioquímicas do líquido sinovial nas disfunções têmporomandibulares