Percepção, conhecimento e experiência de cirurgiões-dentistas da Estratégia Saúde da Família do estado do Rio de Janeiro em relação ao manejo clínico da Hipomineralização Molar Incisivo

Abstract

Molar Incisor Hypomineralization (MIH) is a qualitative defect of dental enamel that affects first permanent molars, often associated with permanent incisors also affected. The objective of this study is to evaluate the perception and experience of dentists from the Family Health Strategy (ESF) of the state of Rio de Janeiro in relation to MIH. The study has an observational cross-sectional character and was carried out through the application of a self-administered questionnaire, through the Google Forms platform (Google LLC, Mountain View, CA, USA). ESF dentists from municipalities in the interior of the state of Rio de Janeiro were eligible for the study. The questionnaire was designed with questions about sociodemographic data (1); Clinical experience with MIH (2); Permanent education in the ESF (3). A score was assigned to the final instrument to define the "Perception of MIH as a clinical problem’s scale", totaling 36 points. This study was approved by the Research Ethics Committee of Hospital Universitário Pedro Ernesto (CAAE: 48541921.4.0000.5259). The data obtained were tabulated in SPSS version 25 (IBM Institute Inc. Armonk, NY, USA). Associations between the mean score of the questionnaire and the independent variables were tested using Student's T test (dichotomous independent variable) or ANOVA (ordinal independent variable of three or more categories), assuming a normal distribution of the data. From the bivariate analysis, the independent variables were selected for the Poisson regression analysis with robust variance. 370 responses from dentists were obtained after 2 reminders, and 304 responses from dentists were included. 95,8% of dentists have already encountered cases of MIH but 58,6% reported that they never had access to MIH teaching materials. In the ESF environment, the most prevalent treatment was spatulating glass-ionomer cement, for case 1 (65,1%) and case 2 (48,4%); and topical fluoride for case 3 (54,6%). In free choice, the most prevalent treatments were indirect restorations for case 1 (38,9%) and composite restorations for case 2 (37,2%); and for the treatment of case 3 it was topical fluoride (47,4%). 91,1% reported never used the Hall Technique, however, 52% would indicate it to severe MIH. The average perception value of the respondent dentists was 22,74 (SD=5,117), a value considered significant for the perception of HMI as a clinical problem. The multivariate analysis, in terms of prevalence ratio and 95% confidence interval, were individuals in the category “Postgraduate in Pediatric Dentistry” (PR: 1,226; 95% CI: 1,12 – 1.33; p<0,001) and dentists working in the "Serrana Region" (PR: 1,087; 95% CI: 1,001 – 1,179, p<0,001). The analysis of the questionnaire responses showed that most dentists encounter HMI relatively frequently, observe relevant clinical implications and perceive HMI as a clinical challenge in the ESF environment.