Camila Pinelli

Reproducibility and validity of self-perceived oral health conditions

The reproducibility and validity of self-perceived periodontal, dental, and temporomandibular joint (TMJ) conditions were investigated. A questionnaire was applied in interview to 200 adults aged from 35 to 44, who were attending as casual patients at Araraquara School of Dentistry, São Paulo State University, São Paulo, Brazil. Clinical examination was based on the guidelines of the World Health Organization manual. The interview and the clinical examination were performed in two occasions, by a calibrated examiner. Reproducibility and validity were, respectively, verified by kappa statistics (κ) and sensitivity (Sen) and specificity (Spec) values, having clinical examination as the validation criterion. The results showed an almost perfect agreement for self-perceived TMJ (κu2009=u20090.85) and periodontal conditions (κu2009=u20090.81), and it was substantial for dental condition (κu2009=u20090.69). Reproducibility according to clinical examination showed good results (κu2009=u20090.73 for CPI index, κu2009=u20090.96 for dental caries, and κu2009=u20090.74 for TMJ conditions). Sensitivity and specificity values were higher for self-perceived dental (Senu2009=u20090.84, Specu2009=u20091.0) and TMJ conditions (Senu2009=u20091.0, Specu2009=u20090.8). With regard to periodontal condition, specificity was low (0.43), although sensitivity was very high (1.0). Self-perceived oral health was reliable for the examined conditions. Validity was good to detect dental conditions and TMJ disorders, and it was more sensitive than specific to detect the presence of periodontal disease.

Biossegurança e odontologia: crenças e atitudes de graduandos sobre o controle da infecção cruzada

Este estudo teve o objetivo de investigar as percepcoes de graduandos de Odontologia sobre a fidelidade as diretrizes de biosseguranca e acerca do preservar-se. Nove questoes abertas, que abordaram aspectos de interesse para o tema, foram aplicadas em entrevista com 14 academicos, que realizavam atendimento odontologico de pacientes da Faculdade de Odontologia de Araraquara da Unesp. Utilizou-se a metodologia de pesquisa qualitativa e a estrategia metodologica para analise das entrevistas foi a Discurso do Sujeito Coletivo (DSC). Tres figuras metodologicas foram obtidas, sendo ideias-centrais, expressoes-chave e o DSC propriamente dito. A analise dos discursos permitiu avaliar a fala natural da coletividade. Verificou-se a adesao dos entrevistados aos protocolos de biosseguranca, embora houvesse a queixa de que, na rotina diaria, as precaucoes fossem negligenciadas por nao serem muito praticas. Entre as medidas de protecao individual e coletiva, rotineiramente utilizadas, foram apontados o uso de Equipamento de Protecao Individual (EPI) e as barreiras protetoras, bem como as atividades de desinfeccao e esterilizacao. O risco de contagio foi visto por alguns com pavor e por outros com total indiferenca porque acreditavam ser algo do qual e possivel de se ter controle por meio da adesao as precaucoes padrao. Entre as doencas de maior preocupacao, a aids e as hepatites B e C foram as mais temidas. Diante do discurso obtido, salienta-se a necessidade de se aperfeicoar as estrategias educacionais, com intuito de motivar a fiel adesao as normas de biosseguranca, essenciais no trato de pacientes odontologicos.The aim of the present study was to investigate dental students perceptions in relation to adherence to Biosecurity guidelines and self-preservation. Nine open questions that approached aspects regarding the issue were asked in interview to 14 dental students who assisted dental patients at the Araraquara School of Dentistry - UNESP. The qualitative methodology was used and the Collective Subject Discourse (CSD) was the methodological strategy for interview analysis. Three methodological figures were obtained: central ideas, key expressions and the CSD itself. The natural collective discourse was obtained. Adherence to Biosecurity protocols was reported, although the students complained that, in the daily routine, the precautions were neglected because they are not practical. Among collective and individual precautions were the use of Personal Protective Equipment (PPE), protective barriers, and disinfection and sterilization processes. Danger of contagion was reported as dreadful by some or as indifferent by others who thought that it was something that could be controlled and minimized by using standard precautions. HIV and Hepatitis B and C were the most feared diseases. Based on the discourses, it is possible to emphasize the need to improve the educational strategies, aiming to motivate adherence to Biosecurity guidelines, which are essential when dealing with dental patients.

Effect of drying on the reproducibility of DIAGNOdent to detect caries-like lesions

The aim of this study was to verify the drying effect on the reproducibility of DIAGNOdent (Dd) devices to detect caries-like lesions. Three areas were created in each of the 34 bovine incisors: sound (S), demineralized (DE) and remineralized (RE). One examiner measured each area with two Dd devices (denominated X and Y), twice under humid, and twice under dry condition. Intra-rater agreement according each device and inter-device agreement were estimated by kappa statistics (k). Intra-rater agreement for device Y was substantial under humid (κ (DE)=0.68 and κ (RE+S)=0.68) and dry condition (k DE=0.64 and k RE+S=0.67). For device X, it was substantial under humid condition (k DE=0.57 and k RE+S=0.49), and it was almost perfect after air drying (κ (DE)=1.0 and κ (RE+S)=1.0). Inter-device agreement was slight (k =0.17) under humid condition, and it was substantial under dry condition (k =0.62). As reproducibility increased under dry condition, drying is advised to detect caries-like lesions on free smooth surfaces when different devices are used.

Development and validation of a questionnaire to evaluate infection control in oral radiology

OBJECTIVESnTo create and validate a questionnaire to evaluate infection control in oral radiology.nnnMETHODSnThe questionnaire was developed after review of the literature, which included published articles and the biosafety protocols available from healthcare agencies. The initial version of the questionnaire was composed of 14 multiple choice questions and was divided into 3 domains on handwashing, disinfection/protection of surfaces and disinfectant used. Content validity was assessed by two expert committees, which reviewed the content and scope of the questionnaire and the relevance of each item, respectively. Reliability was evaluated using test-retest and internal consistency methods with 115 undergraduate dentistry students. Construct validity was assessed using the known-groups technique and factor analysis. The known-groups technique involved 641 undergraduate dentistry students, 20 PhD students and 15 oral radiology professors. In the factor analysis, 3 radiology technicians also participated in addition to the 641 undergraduates, 20 PhD students and 15 oral radiology professors.nnnRESULTSnThe content validity results were found to be satisfactory to excellent for the ordinal variables (intraclass correlation coefficientu2009=u20090.722-1.000) and good to great for the yes/no questions (kappau2009=u20090.662-0.913) in terms of reliability and good internal consistency (Cronbachs alphau2009=u20090.88). After a factor analysis, some questions were excluded, and the questions were grouped into new domains. Significant differences were observed between answers from different groups. The final version of the questionnaire was composed of nine domains.nnnCONCLUSIONSnThe questionnaire created was found to exhibit good psychometric properties for assessing infection control in oral radiology.

Reliability of marginal microleakage assessment by visual and digital methods

Objective: The aim of this study was to investigate the reliability of visual and digital methods to assess marginal microleakage in vitro. Materials and Methods: Typical Class V preparations were made in bovine teeth and filled with composite resin. After dye penetration (0.5% basic fuchsin), teeth were sectioned and the 53 obtained fragments were assessed according to visual (stereomicroscope) and digital methods (Image Tool Software ® -ITS) (University of Texas Health Science Center-San Antonio Dental School, USA). Two calibrated examiners (A and B) evaluated dye penetration, by means of a stereomicroscope with ×20 magnification (scores), and by the ITS (millimeters). The intra- and inter-examiner agreement was estimated according to Kappa statistics (κ), and intraclass correlation coefficient (ρ). Results: In relation to the visual method, the intra-examiner agreement was almost perfect (κA = 0.87) and substantial (κB = 0.76), respectively to the examiner A and B. The inter-examiner agreement showed an almost perfect reliability (κ = 0.84). For the digital method, the intra-examiner agreement was almost perfect for both examiners and equal to ρ = 0.99, and so was the inter-examiner agreement value. Conclusion: Visual (stereomicroscope) and digital methods (ITS) showed high levels of intra- and inter-examiner reproducibility when marginal microleakage was assessed.

Dental students’ reports of occupational exposures to potentially infectious biological material in a Brazilian School of Dentistry

Introduction Occupational exposures to contaminated biological material in dental teaching settings can place students at higher risk of bloodborne infections. Methods This cross sectional study was conducted using a self-administered questionnaire culturally adapted to Portuguese language, Brazil. In total, 173 undergraduate dental students agreed to participate in the study, answered the questionnaire, and filled in the details about their own occupational exposures. The association of these factors was analyzed by the chi-square test or Fishers exact test using Stata® software. Results High prevalence of occupational exposures (40%) was observed among the participants, and 52% of the accidents were not reported to the clinical instructor. The most frequent type of accident was related to “puncture/cut/abrasion” (56%). Significant correlation was observed between number of exposures and academic year (p=0.002), age (p=0.012), gender (p=0.010), and between number of injuries in the last 6 months and academic year (p=0.003). No significant correlation was observed between number of exposures and dominant hand, use of protective eyewear or Hepatitis B vaccination status (p>0.05). Conclusion Additional teaching strategies need to be developed to motivate adherence to occupational post-exposure protocols regarding biological material, improving the notification of the occupational exposures that occur among dental students.

Behavior and perceptions of hand hygiene practices among dental students

ABSTRACT ObjectiveTo investigate behavior and perception of hand hygiene practices among undergraduate students in a School of Dentistry.MethodsThe study adopted a qualitative technique called Collective Subject Discourse (CSD). The sample comprised students enrolled in a Public School of Dentistry, in Sao Paulo State, Brazil (n=54). Semi-structured interviews were recorded in a digital voice recorder. Data analysis was carried out by means of a quali-quantitative approach with the help of Qualiquantisoft® software.ResultsStudents showed adequate knowledge regarding guidelines about hand hygiene practices. However, they considered their procedure gloves as an effective way to avoid crossed-infection, and mentioned inadequate infrastructure of sinks and sometimes lack of consumables undermined their adherence to hand hygiene practices. They reported health professionals and professors at the Institution as being reckless with handwashing, especially before donning gloves or after removal. Students reported the school properly guided them in relation to teaching hand hygiene practices, but they stated they were careless with the recommendations. Students were very concerned if they would hypothetically be treated by professionals who did not wash their hands.ConclusionThis study identified some of the hand hygiene compliance failures among dental students. Educational strategies by means of an increase in motivation to perform hand hygiene properly, and by adjusting professor’s practices in front of the students would be crucial to improve adherence. Additionally, the improvement on the infrastructure in this institution by means of new washbasins and more available consumables would benefit hand hygiene adherence.Indexing terms: Behavior. Hand hygiene. Health human resource training. Qualitative research. Perception.