Encuesta de salud oral en la población infantil de la Comunidad Valenciana. 2018

Introducción: El presente estudio ha sido llevado a cabo siguiendo las recomendaciones del documento The Brussels Statement on the Future Needs for Caries Epidemiology and Surveillance in Europe - based on the position at 2015 para una muestra representativa de escolares de 6, 12 y 15 años de la Comunidad Valenciana. El trabajo de campo se ha llevado a cabo en escuelas de primaria y secundaria, recogiendo, tanto el estado de salud oral como variables socioeconómicas. Para valorar los niveles de caries se ha utilizado el criterio diagnóstico ICDAS II y para determinar el estado de salud periodontal se ha utilizado el Índice Periodontal Comunitario simplificado. Además también se han recogido datos sobre fluorosis, necesidades de tratamiento de la población de estudio o uso de servicios odontológicos. Además, en las cohortes de 12 y 15 años se recogieron cuestionarios auto-cumplimentados con datos sobre hábitos de higiene oral y dietéticos. Objetivos: Determinar el estado de salud bucodental en la población infantil de la Comunidad Valenciana en el año 2018. Determinar la prevalencia de la caries dental tanto en dentición permanente como en temporal en los escolares. Cuantificar la gravedad de la caries dental empleando para ello índices epidemiológicos (CAOD, CAOS, cod y cos). Determinar los hábitos de higiene oral y los conocimientos en salud oral de los escolares valencianos. Relacionar la caries con diferentes variables socio-económicas para determinar grupos de riesgo. Comparar los resultados con los anteriores estudios realizados en 1998, 2004 y 2010 y analizar las tendencias epidemiológicas. Metodología: Han sido explorados un total de 1722 escolares de los cuales 828 eran varones y 894 mujeres. La muestra obtenida para la cohorte de 6 años ha sido de 556, para los 12 años de 632 y para la de 15 de 534. Para asegurar la comparabilidad de los resultados de este estudio con anteriores estudios que utilizaron el criterio diagnóstico de caries de la OMS, se ha establecido un punto de corte en el código 4 del criterio ICDAS II. Resultados: En la dentición temporal a los 6 años de edad, el índice cod ha sido de 1,23 y la prevalencia de caries se ha situado en el 37,4%. En la dentición permanente, a los 12 años, el índice CAOD ha sido de 0,66 y la prevalencia de caries del 30,1%. A los 15 años, el CAOD en dentición permanente se ha situado en 1,21 y la prevalencia en 44,6%. El índice de restauración en dentición temporal a los 6 años ha sido de 27,6%, mientras que en la dentición permanente, a los 12 y 15 años se ha situado en 71,2% y 85,1% respectivamente. La clase social sigue siendo un factor de riesgo para la caries dental en la dentición temporal. Los niños de 6 años de clase social baja tienen 1,8 veces más caries respecto a los de clase social alta. Con respecto al Índice Significativo de Caries (SiC), a los 12 años se sitúa en 1,97. La media del índice Periodontal Comunitario (IPC), ha sido de 0,38 a los 12 años y de 0,37 a los 15 años. En cuanto al porcentaje de niños que posee algún diente sellado a los 6 años es el 11,5%, a los 12 años el 16,9% y a los 15 el 16,3%. La fluorosis dental sólo se ha evidenciado en un 5,7% de los niños de 12 años, siendo las formas discutibles o muy leves. Respecto del uso de servicios odontológicos, el 57,9% y el 69,5% de los niños de 12 y 15 años afirma que asiste a servicios privados. En cuanto al hábito de cepillado, el 84,3% afirma cepillarse con pasta al menos una vez al día. Conclusiones: La dentición temporal a los 6 años de edad presenta un empeoramiento, tanto en los índices de caries como en la prevalencia. En las cohortes de 12 y 15 años los valores se mantienen similares a los recogidos en la anterior encuesta de 2010 en la Comunidad Valenciana. Se ha producido un aumento significativo en el índice de restauración en los 3 grupos de edad. La clase social continua siendo un marcado factor de riesgo para la dentición temporal a los 6 años, mientras que en las cohortes de 12 y 15 años este no es tan evidente. El estado de salud periodontal ha mostrado una clara mejora respecto a los valores registrados en 2010, aunque se debe continuar reforzando la medidas de higiene en los jóvenes, especialmente a los 15 años. Los tratamientos preventivos incluidos en el programa de salud pública de la Comunidad Valenciana, han mostrado un descenso en la media de dientes sellados a los 12 y 15 años. Sin embargo, aumenta el porcentaje de niños que afirma realizar enjuagues de flúor semanalmente en los colegios, aunque esta práctica sólo alcanza a 2 de cada 3 niños. El cepillado dental así como, los conocimientos en salud oral han mejorado sustancialmente comparados con los resultados de 2010. De los 3 grupos de edad analizados, la cohorte de 6 años en la dentición temporal no cumple los objetivos de niños libres de caries prepuestos por SESPO para 2015, esto está relacionado con el efecto de la clase social, lo que convierte a esta cohorte en una acción de prioridad en las poblaciones. Es necesario reforzar la aplicación de sellados de fosas y fisuras y la educación en salud oral además del cepillado.Oral Health Survey of the Child Population in Valencia Region 2018. Introduction: The present study has been carried out following the recommendations published in the report The Brussels Statement on the Future Needs for Caries Epidemiology and Surveillance in Europe - based on the position at 2015. On a representative sample of the child population of 6-, 12- and 15-years old. Field work has been carried out in schools, recording sociodemographic variables together with the oral health status with respect to caries, using ICDAS II criteria, the periodontal health status, using the simplified version of the Periodontal Index Community (IPC), dental fluorosis, estimation of assistance needs, as well as user preferences in the use of dental services. In addition, a self-completed questionnaire was collected by children of 12- and 15- years old about hygienic and dietary habits related to oral health. Objectives: To determine the oral health status in child population of Valencia Region at 6-, 12- and 15-years. To obtain caries prevalence, DMFT and dft data in 2018, to assess oral hygiene and dietary habits of children, to study the association between dental caries and social class and to compare current data with previous studies in the same region. Methods: A total of 1722 school children have been explored, which 828 are male and 894 are female. The sample size obtained for the 6-year cohort was 556, for the 12-years 632, and 534 for the 15-years. To ensure comparability between this study data and previous studies using the WHO criteria, the cut-off point for the ICDAS II codes was set at code 4, grades 4, 5 and 6 are considered equivalent to the WHO definition of caries. Results: In primary dentition at the age of 6 years, caries prevalence is 37.4% and dft index is 1.23. In permanent dentition at the age of 12 years caries prevalence is 30.1% and DMFT index 0.66, while at 15 years, caries prevalence is 44.6 and DMFT 1.21. The Restoration index in temporary dentition at 6 years is 27.6%, while for the permanent dentition it is 71.2% at 12-year and 85.1% at 15-years-old. Social class is still as a major risk factor for the prevalence of caries in the primary dentition, it’s 1.8 times higher in the low social class than in the high social class. Regarding the SCI (Significant Caries Index), at 12-years stands in 1.97. Community Periodontal index (CPI) average has been 0.38 at 12-years and 0.37 at 15-years old. 11.5% of children aged 6 have at least one tooth sealed, at 12-years 16.9% and at 15 years 16.3%. Dental fluorosis has only been evidenced in 5.7% of children of 12 years, predominating mild and very mild forms. Regarding the use of dental services, 57.9% and 69.5% of children aged 12 and 15 have gone to the private dentist. 84.3% of children aged 12 and 15 brush their teeth at least once a day. Conclusions: Temporary dentition shows a worsening both in the prevalence and caries indexes, while in the permanent dentition at 12- and 15-years values similar to those of the last survey carried out in 2010 are maintained. Significant increase in restoration index has been at three age groups studied. The social class continues to be a marked risk factor for caries in temporary dentition in the 6-year cohort, while in the cohorts of 12 and 15 years it is not so evident. Periodontal health has shown a clear improvement over the results of 2010, although it should continue to be strengthened to reach a greater number of children free of gingivitis or tartar (currently around 35%). Preventive treatments included in the benefits of the Public Oral Health Program of the Valencia region, has shown a decrease in the number of sealants average and in the percentage of children carrying them. On the other hand, there has been a slight increase in the percentage of children who perform weekly fluoride rinses in schools, although this practice only reaches 2 out of 3 children. Toothbrushing, as well as knowledge in oral health, have improved slightly compared to the results obtained in the previous study in 2010. At the three age groups analyzed, it should be noted that the 6-year cohort does not meet the health objectives regarding caries in temporary dentition set by the SESPO (Spanish Society of Epidemiology and Oral Public Health) for the Spanish school population in 2015/20, this and significant association with social class places them as a priority objective of community action. It should be encouraged the pit and fissure sealants application and health education in relation to toothbrushing

Relación entre caries y tabaquismo pasivo entre los escolares de 12 y 15 años de la Comunidad valenciana.

Se ha estudiado la prevalencia de caries tanto en dentición temporal (DT) como en permanente (DP) y los valores de los índices CAO.D y co.d de los escolares de la Comunidad Valenciana (CV) teniendo en consideración la variable tabaquismo pasivo dentro del hogar familiar. Se diseñó un estudio transversal descriptivo y analítico en el que se incluyeron escolares de 12 y 15 años en un muestreo representativo por conglomerados. En total fueron 456 escolares de 12 años y 433 escola- res de 15 años, a los que se les realizó un examen intraoral y posteriormente cumplimentaron un cuestionario de hábitos y atención bucodental. En los niños que conviven con un familiar fumador no se han encontrado diferencias estadísticamente significativas, tanto en la caries que afecta a la DP, a DT o a ambas denticiones, excepto para la edad de 15 años en la DT (p=0,018). La obtención de evidencia científica de calidad, sobre la relación de caries dental y tabaquismo pasivo en los niños, hace necesaria la realización de estudios longitudinales que incluyan más detalles en las preguntas de la encuesta y la comprobación de niveles de cotinina, en sangre u orina, así como un examen dental con procedimientos más sensibles en la detección de las lesiones de caries. Keywords: children, dental caries, household smoking, passive smoking

Need for Orthodontic Treatment in Pupils Aged between 12 and 15 in the Valencian Region (Spain)

The World Health Organization recommends carrying out periodic epidemiological studies in order to provide a basis for the evaluation of the state of health of the population at any given time; in doing so, action strategies can be established for the treatment of different pathologies. The objective of this study is to evaluate the need for orthodontic treatment in adolescents at school aged between 12 and 15 in the Spanish autonomous region known as Comunidad Valenciana (hereafter: Valencian Region). A cross-sectional study was carried out on a sample of 539 12-year-old schoolchildren and 460 15-year-olds, respectively, selected by cluster sampling and representative of the school-aged population of the Valencian Region, using the IOTN-DHC, IOTN-AC, and DAI indices. The need for specific orthodontic treatment according to the IOTN-DHC was 12.6% at 12 years and 7% at 15. For the IOTN-AC and DAI indices, the treatment needs were 4.3% and 0.9% at 12 years and 30.1% and 20.9% at the age of 15. These results were similar to those obtained in the previous study carried out on the same target population. There was no significant association between the need for treatment and gender or social class. We conclude that the need for orthodontic treatment presents values similar to those obtained in 2010

Recommendations by the Spanish Society of Epidemiology and Oral Public Health (SESPO) for the healthcare adaptation of public health dental clinics in Spain during the COVID-19 pandemic

In March 2020, the World Health Organization (WHO) declared the COVID-19 pandemic and, a few days later, the Spanish Government declared a State of Emergency and the population lockdown. This crisis situation crisis forced deep changes in health care. A

Delivery of Health Care by Spanish Dental Hygienists in Private and Public Dental Services during the COVID-19 De-Escalation Phase (June 2020): A Cross-Sectional Study

Background: The first wave of the COVID-19 pandemic in Spain posed a major challenge for Spanish dental professionals. The objective of this work is to describe the dental hygienists’ work status and employment patterns during the de-escalation phase in order to analyse the standards of knowledge, compliance with official recommendations, and dental activities both in the public health service and in the private sector. Material and Methods: A cross-sectional questionnaire was answered by Spanish dental hygienists via WhatsApp, Facebook, and Instagram. The questionnaire was piloted before it was distributed and carried out during June 2020. Results: Here, 517 dental hygienists were surveyed, of which 86.2% followed the official recommendations to avoid contagion and 63.8% agreed with the gradual return to work by limiting the use of aerosols. Private dental hygienists identified more with returning to work without restrictions (14.5%) versus those working for the public service (1.2%) (p < 0.005). Conclusions: Dental hygienists’ return to work has involved different strategies, aimed at controlling infection and guaranteeing the safety of patients and the rest of the dental team. The availability of personal protective equipment, the adaptation of clinical infrastructure, and patient care management have differed between professionals working in the private and public sectors

The COVID-19 pandemic and its global effects on dental practice : An International survey

Objectives: A multicentre survey was designed to evaluate the impact of COVID-19 outbreak on dental practice worldwide, estimate the COVID-19 related symptoms/signs, work attitudes and behaviour and the routine use of protective measures and Personal Protective Equipment (PPE). Methods: A global survey using a standardized questionnaire with research groups from 36 countries was designed. The questionnaire was developed and pretested during April 2020 and contained three domains: 1) Personal data; 2) COVID-19 positive rate and symptoms/signs presumably related to the coronavirus; 3) Working conditions and PPE adopted after the outbreak. Countries' data were grouped by the Country Positive Rate (CPR) during the survey period and by Gross-National-Income per capita. An ordinal multinomial logistic regression model was carried out with COVID-19 self-reported rate referred by dental professionals as dependent variable to assess the association with questionnaire items. Results: A total of 52,491 questionnaires were returned with a male/female ratio of 0.63. Out of the total respondents, 7,859 dental professionals (15%) reported symptoms/signs compatible with COVID-19. More than half of the sample (n = 27,818; 53%) stated to use FFP2/N95 masks, while 21,558 (41.07%) used eye protection. In the bivariate analysis, CPR and N95/FFP2 were significantly associated (OR = 1.80 95% =5.20 95% 95% CI = 1.60/2.82 and OR CI = 1.44/18.80, respectively), while Gross-National-Income was not statistically associated with CPR (OR = 1.09 CI = 0.97/1.60). The same significant associations were observed in the multivariate analysis. Conclusions: Oral health service provision has not been significantly affected by COVID-19, although access to routine dental care was reduced due to country-specific temporary lockdown periods. While the dental profession has been identified at high-risk, the reported rates of COVID-19 for dental professionals were not significantly different to those reported for the general population in each country. These findings may help to better plan oral health care for future pandemic events

Relationship between caries, body mass index and social class in Spanish children

Objective: To determine the association between caries, body mass index (BMI) and social class in child population of the Valencia region (Spain) at 6, 12 and 15 years, and study. Methods: In a cross sectional study of 1326 children aged 6 (n = 488), 12 (n = 409) and 15 years (n = 433) who took part in the 2010 Oral Health Survey of the Valencia region, the ICDAS II criteria were employed for diagnosing and coding all the teeth examined. The quantitative BMI values on a continuous scale were grouped into 3 categories (normal weight, overweight, obese) based on a table adjusted for age and gender. The highest-ranking occupation of the parents was taken to indicate the social class of the child. Results: The mean BMI was 17.21 at 6 years, 21.39 at 12 years and 22.38 at 15 years. No significant differences in caries indexes (DMFT or dft) by degree of obesity stratified by social class were found in any of the age groups studied. There was no significant correlation between BMI and DMFT-dft in any of the age groups. Conclusions: Obesity is not associated with dental caries in schoolchildren of this populatio

Llibre de les dents

Se presentan una serie de fichas dirigidas a niños de 0 a 6 años, cuyo objetivo es mejorar su nivel de higiene buco-dental. Las actividades del programa pueden clasificarse en dos grandes grupos, atendiendo a su contenido : 1- Promoción de hábitos alimentarios saludables : se realiza mediante actividades dirigidas a la supresión de hábitos dietéticos nocivos y la promoción de una dieta sana y equilibrada. 2- Promoción de la higiene oral : se trata de un conjunto de actividades dirigidas a motivar a los niños en la práctica del cepillado dental.ValenciaBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5; 28014 Madrid; Tel. +34917748000; [email protected]

Knowledge and perception regarding molar incisor hypomineralisation among dental students and dental hygienist students in Spain: a cross-sectional study

Abstract Background Molar incisor hypomineralisation (MIH) has a high prevalence in the Spanish pediatric population and is a precursor of carious lesions in teeth in which it is present. Although this pathology is included in the curricula of the Degree in Dentistry and the Training Cycle in Oral Hygiene in our country, the contents currently taught seem to be insufficient in relation to the level of knowledge that we have today about this condition. Methods A digital questionnaire of 18 questions was sent to a sample of 448 students attending the 4th and 5th year of the Degree in Dentistry and 2nd year of the Training Cycle in Oral Hygiene from different universities and vocational training centers in the Valencian Community. Descriptive and multivariate statistical analysis of the data was subsequently performed. Results Of the 290 questionnaires that were obtained, 53.8% were from students attending the 2nd year of a training course in oral hygiene and 46.2% were from students pursuing a degree in dentistry. Most of the respondents had heard about MIH (75.2%), mainly through master classes. However, most students had difficulties distinguishing MIH lesions from other lesions (58.3%). The degree of knowledge about MIH was greater among dental students in all the aspects evaluated: prevalence, diagnosis, prevention, and treatment. Of all the students, 83.8% were interested in increasing their training on MIH, especially in the areas of diagnosis and treatment. Conclusion The results of the present study justify the need to expand the content on MIH, both theoretical and practical, in the educational curricula of the Degree in Dentistry and Integrated Vocational Training Centers in Spain

Association between passive tobacco exposure and caries in children and adolescents. A systematic review and meta-analysis.

To examine the available evidence on the association between exposure to tobacco use in the womb and in infancy and the presence of caries in primary and permanent dentition in children and adolescents. A systematic review was conducted through searches in 4 data bases (Pubmed, Scopus, Embase and Web of Science), complemented by hand-searching. Of the 559 articles identified, 400 were duplicates. Finally, 28 articles were included in the qualitative review and 21 in the meta-analysis. Their quality was assessed using the Newcastle-Ottawa scale. The quality was medium in 44% of the articles included and high in 56%. The overall meta-analysis gave a significant odds ratio (OR = 1.53, 95% confidence interval 1.39-1.68, Z test p-value = 0.000) and high heterogeneity (Q = 200.3, p = 0.000; I2 = 86.52%). Separate meta-analyses were also performed for three subgroups: exposure in the womb (prenatal) and caries in primary dentition, which resulted in a significant OR = 1.46 with a 95% CI of 1.41-1.52 (Z test p = 0.000), without heterogeneity (Q = 0.91, p = 0.824; I2 = 0%); exposure in infancy (postnatal) and caries in primary dentition, with OR = 1.72 (95% CI 1.45-2.05) and high heterogeneity (Q = 76.59, p = 0.00; I2 = 83.01%); and postnatal exposure and caries in permanent dentition, with OR = 1.30 (95% CI 1.25-1.34) and no heterogeneity (Q = 4.48, p = 0.880; I2 = 0%). In children and adolescents, a significant though moderate association was found between passive tobacco exposure and caries