Análise do risco médico apresentado pelos pacientes observados por médicos dentistas formados na Universidade Católica Portuguesa

Abstract

Introduction: The population seeking dental care has been changing over the recent years. The frequency of treatments in medically compromised patients has increased. To prevent complications, dentists should know the health status of their patients by performing a complete and systematic medical history. Objective: To evaluate the prevalence of medical background (systemic diseases and drug therapy) and identify the level of medical risk of patients seeking dental care by using ASA classification. Material and methods: The questionnaire EMRRH was applied to patients treated by 24 graduated dentists from Universidade Católica Portuguesa between 2006 and 2010. The frequency of diseases, medications and the level of medical risk according to ASA were determined. The tests: Mann-Whitney, T, Kolmogorov-Smirnov, Spearman Rho, Kendall’s
tau-b, Levéne, Phi and Cramer’s V were included in the statistical analysis of the collected information. Results: A total number of 796 patients were registered. From these, 54.8% (n=437) had an important medical background for the dental care practice. There were significant differences
between the average age of the population with or without former medical problems (p<0,001) and a positive correlation between the number of antecedents and the age of the participant. The analysis of risk according to the ASA classification showed that out of 796 patients, 45.2% (n=359) were within ASA I group; 32.0% (n=255) were classified in group II; 10.9% (n=87) in group III and 11.9% (n=95) in group IV. It was observed that the highest ASA values were associated to the increasing age of the participant. Among the diverse pathologies the one with the highest percentage was hypertension (16.1%) followed by cardiac arrhythmia (10.2%), angina (8.7%) and allergies to drugs or medical devices (8.2%).
The prevalence of drug treatments was 35.5%, mostly related to antihypertensive therapy (12.2%). Conclusion: A complete and systematic medical history, combined with the medical risk assessment of each patient, allows the identification of pathophysiological conditions that require modifications of the dental treatment plan to prevent medical emergencies. The questionnaire EMRRH, holds together the valences mentioned therefore it is considered a useful tool for good practice of dentistry.

Date of Award	10 Oct 2011
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Jorger Galvão Martins Galvão (Supervisor), José María Suárez Quintanilla (Co-Supervisor) & Helder José Martins Esteves (Co-Supervisor)