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Lima RB, Vilela LD, Nelson-Filho P, Silva LABD, Silva RABD. Caries-related hospital morbidity in the Brazilian Unified Health System from 2008 to 2022. Braz Oral Res 2023; 37:e129. [PMID: 38126473 DOI: 10.1590/1807-3107bor-2023.vol37.0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/17/2023] [Indexed: 12/23/2023] Open
Abstract
Dental caries is an important Public Health issue. However, the treatment of this disease in tertiary dental care requires further investigation. Therefore, the objective of this study was to evaluate caries-related hospital morbidity in the Brazilian Unified Health System (SUS) from 2008 to 2022. An ecological study was conducted with secondary data on caries-related Hospital Admission Authorizations (AIH) and in-hospital dental procedures (IDP). Data were collected nationwide and statistical analysis was performed with a significance level (p) of 5%. In the last 15 years, 3,474 caries-related AIH and 63,657 IDP were approved within SUS. There was a significant upward trend in the number of caries-related AIH (p = 0.018) and a stationary trend in the number of caries-related IDP (p = 0.841). Moreover, from 2008 to 2022, R$ 1,160,843.09 was allocated for caries-related AIH. Hospital mortality was 0.29% (10 deaths), and 75.1% were elective inpatient admissions. Among SUS users, adults constituted the majority (49%), with a higher frequency of males (59.8%) and whites (46.2%). The most frequent type of caries-related IDP was restoration of permanent teeth (55.3%). Nonetheless, during the COVID-19 pandemic years, significant reductions in caries-related AIH and IDP within the SUS were observed (all p <0.05). Thus, within the SUS, caries-related tertiary dental care has shown a specific pattern over the last 15 years, including an increase in hospitalizations and a high number of in-hospital dental procedures, especially before the COVID-19 pandemic onset.
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Affiliation(s)
- Ricardo Barbosa Lima
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto , Graduate Program in Pediatric Dentistry , Ribeirão Preto , SP , Brazil
| | - Larissa Dias Vilela
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto , Graduate Program in Pediatric Dentistry , Ribeirão Preto , SP , Brazil
| | - Paulo Nelson-Filho
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto , Department of Pediatric Clinics , Ribeirão Preto , SP , Brazil
| | - Léa Assed Bezerra da Silva
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto , Department of Pediatric Clinics , Ribeirão Preto , SP , Brazil
| | - Raquel Assed Bezerra da Silva
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto , Department of Pediatric Clinics , Ribeirão Preto , SP , Brazil
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Frichembruder K, Prass TS, Hugo FN. [Times series of dental emergency attendance in Brazil between 2008 and 2015]. CIENCIA & SAUDE COLETIVA 2022; 27:3215-3226. [PMID: 35894332 DOI: 10.1590/1413-81232022278.22302021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/06/2022] [Indexed: 11/22/2022] Open
Abstract
The option to use emergency dental services is dependent upon the social, epidemiological and organizational conditions of the health services. In order to evaluate the specific emergency indicators in the care network for understanding access and performance, a time series study of emergency dental care according to the codes of care by health facilities in Brazil from 2008 to 2015 was carried out. Health services were grouped into primary and secondary care points and total services. Secondary services were subdivided into specialized and hospital services. The primary care group accounted for 72.75% of the emergency care and the mean of the standardized rate of total emergencies was 0.04 visits per inhabitant. The trend for total services was stable, though there was growth in primary health care services (5.58%/year). The results highlight the participation of primary health care services in the care of dental emergencies, followed by specialized and hospital services, which is in line with the assumption of the inverse relationship between the capacity of emergency dental care service and its technological density.
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Affiliation(s)
- Karla Frichembruder
- Centro de Pesquisas em Odontologia social, Universidade Federal do Rio Grande do Sul (UFRGS). R. Ramiro Barcelos 2492, sala 402, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
| | - Taiane Schaedler Prass
- Programa de Pós-Graduação em Estatística, Instituto de Matemática e Estatística, UFRGS. Porto Alegre RS Brasil
| | - Fernando Neves Hugo
- Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, UFRGS. Porto Alegre RS Brasil
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Effectiveness of and Patient’s Satisfaction with Dental Emergency Unit in Pitié Salpêtrière Hospital (Paris), Focusing on Pain and Anxiety. Int J Dent 2022; 2022:8457608. [PMID: 35637654 PMCID: PMC9148244 DOI: 10.1155/2022/8457608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/02/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background The Dental Emergency Unit (DEU) of the Pitié Salpêtrière Hospital receives mainly painful emergencies. This study aimed at evaluating the suppression of pain and anxiety as well as the patient's satisfaction after a visit to the DEU. Patients and Methods. A prospective study was carried out in 2019 (NCT03819036) in adult patients. Data was collected on D0 on site and then on D1, D3, and D7 by phone, during daytime. The main objective and secondary objectives were, respectively, to assess the intensity of pain on D1; the intensity of pain on D3 and D7; the evolution of anxiety on D1, D3, and D7; and the patients' satisfaction. They were evaluated with a 0–10 numeric scale (NS) on D1, D3 and D7; mean scores were compared with nonparametric statistics (ANOVA, Dunn's test). Results 814 patients were contacted and 581 patients included; 87 were lost to follow-up. 376 patients completed all the questionnaires. In the final sample (59% men, 40 ± 16 y.o.), 86% had health insurance. The mean pain scores were as follows: D0: 6.36 ± 0.12; D1: 3.49 ± 0.13; D3: 2.23 ± 0.13; D7: 1.07 ± 0.11—indicating a significant decrease of 45%, 65%, and 93% on D1, D3, and D7, respectively, compared to D0 (p < 0.0001) between D0 and D1, D3, D7. The mean NS anxiety scores were as follows: D0: 3.32 ± 0.15; D1: 3.69 ± 0.16; D3: 2.75 ± 0.16; D7: 1.98 ± 0.15. The decrease was significant between D0 and D7 (p < 0.0001). The perception of general heath improved between D1 and D7. The overall score of satisfaction was 8.64 ± 0.06. Conclusion DEU enabled a significant reduction in pain and anxiety with high overall satisfaction.
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FRICHEMBRUDER K, ANTUNES DS, HILGERT JB, NAIDOO S, MYBURGH N, FISHER PD, HUGO FN. Occurrence of dental emergency events in Primary Health Care services. Braz Oral Res 2022; 36:e133. [DOI: 10.1590/1807-3107bor-2022.vol36.0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
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Rodriguez I, Zaluski D, Jodelet PA, Lescaille G, Toledo R, Boucher Y. Effectiveness and patient satisfaction of dental emergencies in Pitié Salpêtrière Hospital, Paris, during the COVID 19 pandemic. J Dent Anesth Pain Med 2022; 22:255-266. [PMID: 35991364 PMCID: PMC9358271 DOI: 10.17245/jdapm.2022.22.4.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 11/24/2022] Open
Abstract
Background A previous study reported the effectiveness and patient satisfaction in the dental emergency unit (DEU) of the Pitie Salpetrière Hospital in Paris before coronavirus disease 2019 (COVID-19). The same methodology was used during the COVID-19 pandemic to compare pain, anxiety, and patient satisfaction during the two periods. Methods This prospective study was conducted in 2020 (NCT04354272) on adult patients. Data were collected on day zero (D0) on site and then by phone during the daytime on day one (D1), day three (D3), and day seven (D7). The primary objective was to assess the pain intensity at D1. Secondary objectives were to assess pain intensity at D3 and D7, anxiety intensity at D1, D3, and D7, and patient satisfaction. Patients were evaluated on a 0-10 numeric scale on D1, D3, and D7; mean scores were compared with non-parametric statistics (ANOVA, Dunn’s). Results A total of 445 patients were given the opportunity to participate in the study, and 370 patients consented. Seventy-one were lost during follow-up. Ultimately, 299 patients completed all the questionnaires and were included in the analysis. In the final sample (60% men, 40% women, aged 39 ± 14 years), 94% had health insurance. The mean pain scores were: D0, 6.1 ± 0.14; D1, 3.29 ± 0.16; D3, 2.08 ± 0.16; and D7, 1.07 ± 0.35. This indicates a significant decrease of 46%, 67%, and 82% at D1, D3, and D7, respectively, when compared to D0 (P < 0.0001). The mean anxiety scores were D0, 4.7 ± 0.19; D1, 2.6 ± 0.16; D3, 1.9 ± 0.61; and D7, 1.4 ± 0.15. This decrease was significant between D0 and D7 (ANOVA, P < 0.001). Perception of general health improved between D1 and D7. The overall satisfaction was 9.3 ± 0.06. Conclusion DEU enabled a significant reduction in pain and anxiety with high overall satisfaction during COVID-19, which was very similar to levels observed pre-COVID-19 pandemic.
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Affiliation(s)
- Isabelle Rodriguez
- UFR d’Odontologie, Université Paris Cité, France
- Service d’Odontologie, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | | | | | - Géraldine Lescaille
- UFR d’Odontologie, Université Paris Cité, France
- Service d’Odontologie, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Rafael Toledo
- Service d’Odontologie, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Yves Boucher
- Service d’Odontologie, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
- Université Paris Cité, LabNOF, Paris, France
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Silva HGE, Móra PMPK, Zajkowski LA, Celeste RK, Scarparo RK. Urgent dental care in the Brazilian public health system: learning lessons from the COVID-19 pandemic for future situations. CAD SAUDE PUBLICA 2022; 38:e00013122. [DOI: 10.1590/0102-311xen013122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 10/13/2022] [Indexed: 11/27/2022] Open
Abstract
This ecological study described the effect of the COVID-19 pandemic and socioeconomic development on the use and profile of urgent dental care (UDC). UDC rates per 100,000 inhabitants before (from March to June 2019) and during (from March to June 2020) the COVID-19 pandemic in 4,062 Brazilian municipalities were compared. Data were collected from official sources. COVID-19 mortality and hospitalization rates were indicative of levels of lockdown and Human Development Index (HDI) indicated socioeconomic development. Multiple logistic regression and relative excess risk due to interaction (RERI) were used for statistical analyses. The Student t-test was used to compare changes in the profile of UDC causes and procedures in the two periods. Lower UDC rates were found in 69.1% of municipalities and were associated with higher HDI (OR = 1.20; 95%CI: 1.01; 1.42). Mortality had OR = 0.88 (95%CI: 0.73; 1.06) for municipalities with HDI < 0.70 and OR = 1.45 (95%CI: 1.07; 1.97) for municipalities with HDI > 0.70. RERI between HDI and COVID-19 was 0.13 (p < 0.05). Municipalities with greater primary health care coverage had a smaller reduction in emergency rates. Endodontic treatment and dental pain were the most frequent factors both before and during the pandemic. The percentage of UDCs due to pain and soft tissue damage, as well as temporary sealing and surgical procedures, increased. Socioeconomic variables affected UDC rates during the most restrictive period of the COVID-19 pandemic and should be considered in the planning of health actions in future emergencies.
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Brondani M, Cua D, Maragha T, Shayanfar M, Mathu-Muju K, von Bergmann H, Almeida F, Villanueva J, Alvarado AAV, Learey S, Donnelly L. A Pan-Canadian narrative review on the protocols for reopening dental services during the COVID-19 pandemic. BMC Oral Health 2020; 20:352. [PMID: 33267811 PMCID: PMC7708888 DOI: 10.1186/s12903-020-01340-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/22/2020] [Indexed: 12/23/2022] Open
Abstract
The current coronavirus disease 2019 (COVID-19) pandemic is impacting the way in which dental services are provided. The aim of this narrative review was twofold: to summarize key areas from the Canadian protocols available for the reopening and restructuring of dental services across the country and to critically review these protocols based on existing evidence. A narrative review of the existing Canadian protocols, written in English and French, was undertaken between April 15 and July 13, 2020. The protocols were obtained by searching through regulatory bodies and websites from professional organizations, and from personal contacts through academic institutions and policy leaders. The data extraction form focused only on protocols related to dentistry, and the information was compiled by a hired assistant. Content was categorized via group discussions with the research team on eight areas: office management and procedures, patient and staff screening, treatment procedures, office layout, risk reduction, personal protective equipment, supporting information, and length and readability. Thirteen protocols were identified and offered substantial variation in the level of details provided. All but two protocols specified proper donning/doffing of personal protective equipment, while all protocols recommended daily monitoring of COVID-19 related signs and symptoms in staff and patients. They varied in terms of recommended mask types, eye and face shield protection, and head coverings. While all protocols aimed at restructuring emergency dental services, their recommendations were often not based on the published evidence. This narrative review summarized key areas from 13 provincial and territorial protocols in Canada to help oral health care providers plan the reopening of their services. The information conveyed across all documents was clear, but variance highlights the need for a coordinated effort to develop an evidence-based document for dental practitioners.
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Affiliation(s)
- Mario Brondani
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, 116/2199 Wesbrook Mall, Vancouver, V6T 1Z3, Canada.
| | - Denise Cua
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Tala Maragha
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, 116/2199 Wesbrook Mall, Vancouver, V6T 1Z3, Canada
| | - Melody Shayanfar
- Department of Psychology, Faculty of Science, University of British Columbia, Vancouver, Canada
| | - Kavita Mathu-Muju
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, 116/2199 Wesbrook Mall, Vancouver, V6T 1Z3, Canada
| | - HsingChi von Bergmann
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, 116/2199 Wesbrook Mall, Vancouver, V6T 1Z3, Canada
| | - Fernanda Almeida
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, 116/2199 Wesbrook Mall, Vancouver, V6T 1Z3, Canada
| | | | | | | | - Leeann Donnelly
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
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