Dental local anesthesia in Family Health Units: use, pain and associated factors

ABSTRACT BACKGROUND AND OBJECTIVES: In spite of the relevance of controlling pain during dental procedures and of the fundamental role of Family Health Units in the Brazilian health system, there are few studies integrating both subjects. So, this study aimed at analyzing some aspects of dental anesthesia in Family Health Units of the city of Caruaru-PE. METHODS: We have interviewed 372 adolescent and adult patients from 12 units, in the waiting room or close to it, after dental treatment, using a form with 14 questions. Pain was investigated with a numerical scale of 21 points (0 to 10 with 0.5 intervals). RESULTS: Anesthesia was used in 16.1% of procedures. There has been pain during most anesthesias (58.3%), with intensity of 1±1.2, being more frequent when procedures were in the anterior oral region. For non-surgical invasive procedures, anesthesia was more used in adolescents, in procedures in the posterior oral region, when there was previous pain in the treated region and when the dentist asked patients about their preference. Also for these procedures, pain during treatment as a whole was more frequent and more severe when anesthesia was used. CONCLUSION: Dental anesthesia is rarely used in these units and pain during anesthesia is frequent, however of low intensity. During non-surgical invasive procedures, its use is associated to some characteristics of patients and treatments, but not to a painless or less painful treatment.摘要：背景与研究目的 尽管牙科诊疗过程中的疼痛控制至关重要，且家庭健康单元（Family Health Units）在巴西医疗体系中发挥着基础性作用，但目前鲜有研究将这两个主题相结合。为此，本研究旨在分析巴西佩南布哥州卡鲁阿鲁市各家庭健康单元内牙科麻醉（dental anesthesia）的相关情况。 研究方法：本研究于12个家庭健康单元内，在牙科诊疗结束后于候诊室或其附近区域，采用包含14个问题的调查问卷，对372名青少年及成年患者进行了访谈。疼痛评估采用21分度数值评分量表（区间范围为0至10，分度间隔0.5）。 研究结果：本次研究中，仅16.1%的牙科诊疗操作使用了牙科麻醉。多数麻醉操作过程中出现了疼痛（占比58.3%），疼痛评分为1±1.2，且在前牙区诊疗操作中疼痛发生频率更高。针对非手术侵入性诊疗操作，牙科麻醉的使用更常见于以下情况：诊疗对象为青少年、操作部位为后牙区、患区术前存在疼痛，以及牙医询问了患者的偏好。此外，针对此类操作，若使用了牙科麻醉，整体诊疗过程中的疼痛发生频率更高、程度更严重。 研究结论：上述家庭健康单元内牙科麻醉的使用频率较低，麻醉过程中疼痛频发，但疼痛程度较轻。在非手术侵入性诊疗操作中，牙科麻醉的使用与患者及诊疗的部分特征相关，但并未实现无痛或减轻诊疗疼痛的效果。