Uso da anestesia computadorizada em Odontopediatria e tradução e adaptação transcultural de um instrumento para avaliar estilos de enfrentamento durante o atendimento odontológico

Abstract

Pediatric Dentistry and child care are full of particularities and challenges, as children can react in different ways to dental appointments, showing fear/anxiety or manifesting on-collaborative behavior. Adequate pain control is essential during dental treatment. Thus, computerized local anesthesia administration systems have been developed, aiming to minimize the perception of pain. Its use, however, does precede the use of behavior management techniques. Furthermore, assessing the children’s coping style with regard to dental care and their preferences can help dentists to adequately control pain and manage behavior. This dissertation aimed to develop a protocol for a randomized clinical trial (RCT) evaluating the use of computerized anesthesia in pediatric dental care and the translation and cross-cultural adaptation of The Monitor Blunter Dental Scale (MBDS), aiming at its inclusion in the RCT. For objective 1, a protocol was prepared, written in accordance with the SPIRIT and approved by the Research Ethics Committee of the Faculty of Dentistry of the Federal University of Pelotas (nº 5.299.880). Two groups will be compared: patients who will receive conventional anesthesia – control group, and patients who will receive computerized anesthesia – intervention group. The sample will consist of 92 children. To measure the child's anxiety, the VENHAM Picture Test will be performed, as well as verification of the heart rate by the oximeter, trait/state anxiety and monitoring/inattention. The child’s behavior will be assessed using the Brazilian version of the VENHAM Scale and pain will be assessed using the Faces Pain Scale – Revised for self-report and Face, Legs, Activity, Cry and Consolability for manifestation. The cortisol level will be evaluated in the morning, before and after the appointment. Operators will also be assessed using the visual analogue scale for their stress. For objective 2, the following processes were initially carried out: 1) translation; 2) back-translation into English; 3) review by an expert review committee; and 4) pretest. The MBDS assesses preferences regarding the use of “monitoring” or “inattention” strategies by children during care, in order to identify specific “coping styles”. The scale consists of four scenarios: 1. Having to go to the dentist the next day; 2. Sit in the waiting room to have a procedure; 3. Being about to drill a tooth and; 4. Being about to have a gum injection. The pre-test was performed on 20 children, with the sample divided equally between the ages of 8-9 and 10-12 years. All items were understood by at least 85% of the children. The results generated from the planned randomized clinical trial are expected to increase knowledge about the effectiveness of strategies to reduce pain perception, anxiety and improve behavior during local anesthesia in Pediatric Dentistry. The MBDS scale was duly translated into Brazilian Portuguese and adapted to the cultural context of the evaluated population and can be used in this and other clinical trials, aiming to assess the influence of coping style on the perception of pain, fearnd anxiety.