Objective:The International Caries Classification and Management System (ICCMS™), a comprehensive, evidence-informed, best clinical practice system, comprises a 4D cycle: 1D-Determine risk; 2D-Detect and assess lesions; 3D-Decide on a personalized care plan; and 4D-Do preventive and tooth-preserving care. The aim of this study was to establish how Colombian dental practitioners, educators and students diagnose and manage caries risk and caries lesions using the COM-B model and the ICCMS™ system. Methods: A total of 1094 participants (practitioners: n = 277; educators: n = 212; students: n = 605) completed a previously validated 79-item questionnaire which explores, based on the COM-B model, the practitioners' self-reported caries diagnosis and management behaviours. Descriptive statistics, Welch's ANOVAs and multiple linear regressions were computed.Results: All groups generally performed the behaviours within the 4-D categories 'Most of the time' to 'Always' (students: 4.06 ± 0.95; educators: 3.94 ± 0.98; practitioners: 3.86 ± 1.01). The most frequently performed diagnosis behaviours (1D/2D) were for practitioners assessing initial/moderate lesions (4.09 ± 1.01) and for educators and students cleaning teeth before lesion assessment (4.41 ± 0.80 and 4.38 ± 0.77 respectively). The least frequently performed decision/management (3D/4D) behaviour was non-operative care for moderate-caries lesions (when applicable) (practitioners: 2.64 ± 1.23; educators: 2.68 ± 1.17; students: 3.22 ± 1.41).Opportunity (Resources and Relevance) was the best COM-B predictor for diagnostic behaviours, whereas capability and opportunity (Relevance) were the strongest predictors for management behaviours. Conclusion:Colombian practitioners, educators and students diagnose and manage caries risk and caries lesions implementing best practice with a high to very high frequency.
Resumen. Introducción: la Constitución Política de Colombia define como uno desus principios fundamentales el reconocimiento y la protección de la diversidadétnica y cultural de la nación, afirmación que implica la garantía de sus derechos,entre ellos el derecho a la salud, concebido desde sus particularidades culturales.Objetivo: comprender las tradiciones culturales y las prácticas de cuidado bucalen un grupo de indígenas zenúes. Métodos: estudio de corte cualitativo realizado enel 2011. Retoma elementos del enfoque y método etnográfico. En la construcciónde los datos participaron diez personas de la comunidad indígena Zenú. Se llevóa cabo observación participante, diarios de campo, entrevistas en profundidad ygrupos focales. El análisis consistió en un proceso de condensación de los datos apartir de un ejercicio descriptivo e interpretativo que se organizó en tres categoríasde análisis, de las cuales emergieron varias tendencias. Resultados: a pesar de losprocesos de occidentalización, se conservan prácticas tradicionales que se relacionancon mitos y concepciones mágico-religiosas amplias y positivas acerca de lasalud y del cuidado bucal. Está vigente la transmisión intergeneracional y la utilizacióndel servicio odontológico se da solamente cuando los problemas bucales nose solucionan mediante tratamientos tradicionales. Conclusión: la conservación detradiciones y prácticas ancestrales en salud bucal constituye un llamado a reorientarlos procesos de formación de los profesionales de la salud bucal, para ampliar laconcepción de ciencia y, de esta manera, facilitar el reconocimiento de las diferenciasculturales y los procesos de inclusión social de grupos diversos.
Molar incisor hypomineralization (MIH) affects the first permanent molars and permanent incisors whose formative embryological process develops around birth and the first year of life. This study’s main objective is to assess the relationship between MIH, on the one hand, with the administration during childbirth of epidural bupivacaine, intramuscular meperidine with haloperidol, synthetic intravenous oxytocin, and prostaglandins such as dinoprostone vaginally, and on the other hand, with suffered pathologies during the first year of life. Cross-sectional retrospective study was carried out on 111 children who attended dental check-ups. Oral examination was carried out to determine MIH involvement. Data on the administration of medications during delivery and the illnesses suffered by the children in the first year of life were taken from the hospital records. Significant relationship with Pearson's chi-square was found between the presence of MIH and the administration of meperidine with haloperidol intramuscularly and the vaginal administration of dinoprostone during labour. Also in children who have suffered serious infections and those who have received antibiotics in early childhood. In recent years there has been a growing trend in many countries to medicalize childbirth even above what the World Health Organization recommends. Some of the drugs used in these protocols could be involved in the appearance of dental mineralization alterations of the MIH type and this would help to explain the increase in its prevalence.
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