Out-Of-Pocket Expenditures on Dental Care for Schoolchildren Aged 6 to 12 Years: A Cross-Sectional Estimate in a Less-Developed Country Setting

Aim: The objective of this study was to estimate the Out-Of-Pocket Expenditures (OOPEs) incurred by households on dental care, as well as to analyze the sociodemographic, economic, and oral health factors associated with such expenditures. Method: A cross-sectional study was conducted among 763 schoolchildren in Mexico. A questionnaire was distributed to parents to determine the variables related to OOPEs on dental care. The amounts were updated in 2017 in Mexican pesos and later converted to 2017 international dollars (purchasing power parities-PPP US $). Multivariate models were created: a linear regression model (which modeled the amount of OOPEs), and a logistic regression model (which modeled the likelihood of incurring OOPEs). Results: The OOPEs on dental care for the 763 schoolchildren were PPP US$53,578, averaging a PPP of US $70.2 ± 123.7 per child. Disbursements for treatment were the principal item within the OOPEs. The factors associated with OOPEs were the child's age, number of dental visits, previous dental pain, main reason for dental visit, educational level of mother, type of health insurance, household car ownership, and socioeconomic position. Conclusions: The average cost of dental care was PPP US$70.2 ± 123.7. Our study shows that households with higher school-aged children exhibiting the highest report of dental morbidity-as well as those without insurance-face the highest OOPEs. An array of variables were associated with higher expenditures. In general, higher-income households spent more on dental care. However, the present study did not estimate unmet needs across the socioeconomic gradient, and thus, future research is needed to fully ascertain disease burden

Gingival recession and associated factors in a homogeneous Mexican adult male population : a cross-sectional study

Background: Diverse variables are implicated in the pathogenesis of gingival recession; more detailed knowledge about the relationship between the clinical presentation of gingival recession and assorted risk indicators may lead to improved patient monitoring, early intervention, and subsequent prevention. The objective was to evaluate clinically gingival recession in a homogeneous Mexican adult male population and to determine the strength of association with related factors. Method: A cross-sectional study was carried out in a largely homogeneous group in terms of ethnic background, socioeconomic status, gender, occupation, and medical/dental insurance, in Campeche, Mexico. Periodontal examinations were undertaken to determine diverse clinical dental variables. All periodontal clinical examinations were assessed using the Florida Probe System, a dental chair and one examiner. Questionnaires were used to collect diverse risk indicators. Statistical analyses were undertaken with negative binomial regression models. Results: The mean number of sites with gingival recession per subject was 6.73±5.81; the prevalence was 87.6%. In the negative binomial regression model we observed that for (i) each year of age, and (ii) each percentage unit of increase in sites with plaque, and (iii) with suppuration, mean sites with gingival recession increased 2.9%, 1.0% and 13.0%, respectively. Having a spouse was associated with gingival recession. Conclusions: We observed association between gingival recession, and sociodemographic and clinical parameters. Patients need to be educated about risk indicators for gingival recession as well as the preventive maneuvers that may be implemented to minimize its occurrence. The potential of improved oral self-care to prevent a largely benign condition such as gingival recession is important, given the associated disorders that may ensue root exposure, such as root caries and root hypersensitivity

Dental caries’ experience, prevalence and severity in mexican adolescents

Objective Determining dental caries’ experience, prevalence and severity in students applying for degree courses at San Luis Potosi University (UASLP). Material and Methods A cross-sectional study was carried out involving adolescents and young adults (16 to 25 years old) applying for undergraduate courses at UASLP (~10 %, n=1 027). Two standardized examiners undertook dental examinations; DMFT index, prevalence (DMFT and gt;0), severity (DMFT and gt;3 and DMFT and gt;6) and significant caries index (SiC) were calculated. STATA 9.0 non-parametric tests were used for statistical analysis.Results Mean age was 18.20±1.65; 48.0% were female. The DMFT index was 4.04±3.90 and caries prevalence was 74.4%. Regarding caries’ severity, 48.8% had MDFT and gt;3 and 24% DMFT and gt;6. The SiC index was 8.64. Females had higher caries experience than males (4.32±4.01 cf 3.78±3.78; p0.05). Age was associated with both experience (

Treatment Needs for Dental Caries, Restorative Care Index, and Index of Extractions in Adolescents 12 and 15 Years Old

Objective: To determine the Treatment Needs Index (TNI) for dental caries, the restorative Care Index (CI), and to introduce a Tooth Extractions Index (TEI) to estimate past and current treatment needs among Mexican adolescents. Subjects and methods: A descriptive cross-sectional study was carried out on 1538 adolescents aged 12 and 15 years in the state of Hidalgo, Mexico, to collect decayed, missing, filled teeth (DMFT) data to describe TNI, CI and TEI indices. Results: Higher TNI was identified in younger male teenagers who had always lived in the same community, without dental visits in the last year, and who had poorer socio-economic markers. Higher CI was found in older, female subjects who had moved in their lifetimes to a new community in the area, with dental visits in the last year and who had better socio-economic markers. Higher TEI was found in older, female teenagers who had moved in their lifetimes to a new community in the area, without dental visits in the last year, and who had worse socio-economic markers. Conclusions: We observed high rates of treatment needs for dental caries and little experience of restorative treatment. While dental extractions due to advanced caries should ideally be zero, relatively few adolescents had this treatment experience. Despite the fact that the overall background of these adolescents is rather homogeneous, it was still possible to find that treatment needs' indices (past and present needs) appeared to be modified by sociodemographic and socio-economic variables

Fluoride Consumption and Its Impact on Oral Health

Objective. The purpose of this study was to evaluate caries and dental fluorosis among Mexican preschoolers and school-aged children in a non-endemic zone for fluorosis and to measure its biological indicators. Methods. DMFT, DMFS, dmft, dmfs, and CDI indexes were applied. Fluoride urinary excretion and fluoride concentrations in home water, table salt, bottled water, bottled drinks, and toothpaste were determined. Results. Schoolchildren presented fluorosis (CDI = 0.96) and dental caries (DMFT = 2.64 and DMFS = 3.97). Preschoolers presented dmft = 4.85 and dmfs = 8.80. DMFT and DMFS were lower in children with mild to moderate dental fluorosis (DF). Variable fluoride concentrations were found in the analyzed products (home water = 0.18–0.44 ppm F, table salt = 0–485 ppm F, bottled water = 0.18–0.47 ppm F, juices = 0.08–1.42 ppm F, nectars = 0.07–1.30 ppm F, bottled drinks = 0.10–1.70 ppm F, toothpaste = 0–2,053 ppm F). Mean daily fluoride excretion was 422 ± 176 µg/24 h for schoolchildren and 367 ± 150 µg/24 h for preschoolers. Conclusions. Data from our study show that, despite values of excretion within an optimal fluoride intake range, the prevalence of caries was significant in both groups, and 60% of the 11- to 12-year-old children presented with dental fluorosis. In addition, variable fluoride concentrations in products frequently consumed by children were found

Edentulism and other variables associated with self-reported health status in Mexican adults

Background: To determine if edentulism, controlling for other known factors, is associated with subjective self-report health status (SRH) in Mexican adults. Material and methods: We examined the SRH of 13 966 individuals 35 years and older, using data from the National Survey of Performance Assessment, a cross-sectional study that is part of the technical collaboration between the Ministry of Health of Mexico and the World Health Organization, which used the survey instrument and sampling strategies developed by WHO for the World Health Survey. Sociodemographic, socioeconomic, medical, and behavioral variables were collected using questionnaires. Self-reported health was our dependent variable. Data on edentulism were available from 20 of the 32 Mexican states. A polynomial logistic regression model adjusted for complex sampling was generated. Results: In the SRH, 58.2% reported their health status as very good/good, 33.8% said they had a moderate health status, and 8.0% reported that their health was bad/very bad. The association between edentulism and SRH was modified by age and was significant only for bad/very bad SRH. Higher odds of reporting moderate health or poor/very poor health were found in women, people with lower socio-economic status and with physical disabilities, those who were not physically active, or those who were underweight or obese, those who had any chronic disease, and those who used alcohol. Conclusions: The association of edentulism with a self-report of a poor health status (poor/very poor) was higher in young people than in adults. The results suggest socioeconomic inequalities in SRH. Inequality was further confirmed among people who had a general health condition or a disability. Dentists and health care professionals need to recognize the effect of edentulism on quality of life among elders people

Influencia de variables predisponentes, facilitadoras y de necesidades sobre la utilización de servicios de salud bucal en adolescentes mexicanos en un medio semirrural

Objetivo: El propósito de este estudio fue identificar las variables predisponentes, facilitadoras y de necesidades de salud que influyen sobre las visitas al dentista que realizan adolescentes mexicanos. Material y Métodos: Se trata de un estudio de diseño transversal analítico en el que se incluyeron 1,538 adolescentes mexicanos de 12 y 15 años de edad. La variable dependiente fue la utilización de servicios de salud bucal (USSB) en el año previo al estudio. Los datos fueron recogidos a través de un cuestionario e incluyeron variables sociodemográficas, socioeconómicas y conductuales. El estudio también incluyó un examen clínico bucal. El análisis incluyó estadística no paramétrica y se generó un modelo de regresión logística. Resultados: De los 1538 adolescentes, 688 tenían 12 años de edad y 850 15 años. Las niñas representaron 49.9%. La prevalencia de USSB fue 15%. En el modelo final se asociaron a la USSB (p<0.05) haber cambiado de residencia donde se nació (RM=1.24), comprar agua purificada para consumo en lugar de usar agua intra-domiciliaria (RM=1.52), mejor escolaridad de la madre (RM=1.39) y del padre (RM=1.87), así como el número de dientes sanos (RM=0.96) y tener al menos un diente con caries (RM=1.10). Conclusiones: El porcentaje de sujetos con USSB en el último año fue bajo comparado con otros estudios. Nuestra cuantificación de las variables indicadoras muestran que algunas se encuentran asociadas a la USSB (predominantemente las de posición socioeconómica), lo que indica la existencia de desigualdades en salud bucal y la necesidad de establecer estrategias para reducir las brechas observadas

Dental plaque, preventive care, and tooth brushing associated with dental caries in primary teeth in schoolchildren ages 6–9 years of Leon, Nicaragua

Background: Our study aimed to evaluate the effect of various risk indicators for dental caries on primary teeth of Nicaraguan children (from Leon, Nicaragua) ages 6 to 9, using the negative binomial regression model. Material/Methods: A cross-sectional study was carried out to collect clinical, demographic, socioeconomic, and behavioral data from 794 schoolchildren ages 6 to 9 years, randomly selected from 25 schools in the city of León, Nicaragua. Clinical examinations for dental caries (dmft index) were performed by 2 trained and standardized examiners. Socio-demographic, socioeconomic, and behavioral data were self-reported using questionnaires. Multivariate negative binomial regression (NBR) analysis was used. Results: Mean age was 7.49±1.12 years. Boys accounted for 50.1% of the sample. Mean dmft was 3.54±3.13 and caries prevalence (dmft >0) was 77.6%. In the NBR multivariate model (p<0.05), for each year of age, the expected mean dmft decreased by 7.5%. Brushing teeth at least once a day and having received preventive dental care in the last year before data collection were associated with declines in the expected mean dmft by 19.5% and 69.6%, respectively. Presence of dental plaque increased the expected mean dmft by 395.5%. Conclusions: The proportion of students with caries in this sample was high. We found associations between dental caries in the primary dentition and dental plaque, brushing teeth at least once a day, and having received preventive dental care. To improve oral health, school programs and/or age-appropriate interventions need to be developed based on the specific profile of caries experience and the associated risk indicators

Ciencia Odontológica 2.0

Libro que muestra avances de la Investigación Odontológica en MéxicoEs para los integrantes de la Red de Investigación en Estomatología (RIE) una enorme alegría presentar el segundo de una serie de 6 libros sobre casos clínicos, revisiones de la literatura e investigaciones. La RIE está integrada por cuerpos académicos de la UAEH, UAEM, UAC y UdeG