Oral pathologies in pediatric patients related to juvenile systemic lupus erythematosus and considerations in stomatological management. A review

Introducción: El lupus eritematoso juvenil (LESj) es una enfermedad reumática que afecta el funcionamiento de los órganos internos y es multisistémico. Se trata de un padecimiento crónico y suele asociarse con una morbilidad muy significativa, la cual es más elevada en edad infantil y adolescente que en edades adultas. Objetivo: Describir e identificar los conceptos más actuales del LESj, etiología, epidemiologia de la enfermedad, semiología, manifestaciones orales, así como el tratamiento, consecuencias y diferencias con el lupus eritematoso sistémico en adultos (LESa). Materiales y métodos: Se realizó búsqueda de la literatura en PubMed, Ebsco, SciELO, Elsevier, utilizando las palabras claves “juvenile lupus erythematosus”, “dental caries”, “oral manifestation”, “children dentistry”. Dirigida a estudios realizados en humanos entre 2010 y 2023, y se analizaron los tópicos más relevantes relacionados a esta enfermedad. Resultados: La información que se recopiló corresponde a los últimos 13 años, con la finalidad de realizar una actualización sobre el tema de estudio, se revisaron 750 artículos que fueron analizados con los criterios de inclusión y exclusión por lo que solo cumplieron estos criterios 50 artículos. Conclusión: La atención dental en pacientes con LESj constituye un reto, ya que existen diferentes consideraciones que debemos tomar en cuenta antes de realizar cualquier tratamiento, puesto que presentan alteraciones en articulaciones, glándulas salivales y fallas de múltiples órganos. Es de suma importancia conocer los distintos diagnósticos diferenciales para una inequívoca detección de la enfermedad. Ante la presencia de signos y síntomas basados en los criterios de LESj o de inicio precoz, se recomienda una interconsulta con el área de inmunología para confirmar o descartar esta enfermedad.Introduction: Juvenile lupus erythematosus (jSLE) is a rheumatic disease that affects the functioning of internal organs and is multisystemic. It is a chronic condition and is usually associated with very significant morbidity, which is higher in children and adolescents than in adults. Objectives: Describe and identify the most current concepts of jSLE, etiology, epidemiology of the disease, semiology, oral manifestations, as well as treatment, consequences and differences with systemic lupus erythematosus in adults (aSLE). Materials and methods: A literature search was carried out in PubMed, Ebsco, SciELO, and ELSEVIER, using the key words, “Juvenile lupus erythematosus”,“dental caries”, “oral manifestation”, “children dentistry”. Aimed at studies carried out in humans between 2010 to 2023 and the most relevant topics related to this disease were analyzed. Results: The information that was collected corresponds to the last 13 years, with the purpose of making an update on the topic of study, 750 articles were reviewed which were analyzed with the inclusion and exclusion criteria but only 50 met these criteria articles. Conclusion: Dental care in patients with SLEj is a challenge, since there are different considerations that we must take into account before carrying out any treatment, since they present alterations in the joints, salivary glands and failures of multiple organs. It is important to know the different differential diagnoses for unequivocal detection of the disease. In the presence of signs and symptoms based on the criteria of jSLE or early onset, a consultation with the immunology area is recommended to confirm or rule out this disease

Tooth-Loss Experience and Associated Variables among Adult Mexicans 60 Years and Older

Objective: This study was conducted to determine the experience of tooth loss, as well as its associated variables, in a sample of adult Mexicans, aged 60 years and older. Materials and Methods: This cross-sectional study was part of a larger project to measure diverse oral health indicators in a convenience sample: it included 139 adult Mexican seniors (69.1% of whom were women), ages 60 years and older, either living in long-term care facilities or living independently and participating in adult day care services. Each participant underwent an oral examination to determine the number of missing teeth. Questionnaires were administered to collect sociodemographic, socioeconomic, and behavioral data. Statistical analyses were performed using nonparametric tests and negative binomial regression. Results: The mean age was 79.06 (±9.78 years). The mean number of missing teeth was 20.02 (±8.61; median, 24); 99.3% of the participants had at least 1 missing tooth, and only 14 had 20 teeth or more. Using a negative binomial regression multivariate model, we found that for each year’s increase in age, the mean number of teeth lost increased by 1% (p<0.05). In individuals who brushed their teeth fewer than two times a day, who had received radiotherapy, or who were currently smokers, the average tooth loss increased 49.2%, 22.6%, and 19.0%, respectively (p<0.01). Conclusion: Tooth-loss experience in these Mexican seniors was very high (20.02±8.61). Older age (within the range of this group of seniors), tooth-brushing patterns, the receipt of radiation therapy, and (current) tobacco use were associated with higher experience of tooth loss

Prevalencia de fluorosis dental en ocho cohortes de mexicanos nacidos durante la instauración del Programa Nacional de Fluoruración de la Sal Doméstica

Objective: to determine the effect of birth cohort on dental fluorosis in Mexican schoolchildren during the implementation of the national program to fluoridate domestic salt. Material and methods: in a cross-sectional study we examined 1,644 schoolchildren 6-13 years old born between 1985-1992 in Campeche, México; a community where there is negligible naturally available fluoride in water supplies. Dental fluorosis was assessed with the Dean’s index in the permanent dentition. Questionnaires were used to identify diverse socio-demographic and socio-economic variables. In the statistical analysis logistic regression was used. results: the prevalence of fluorosis was 15.5%. In the multivariate model, we observed fluorosis was associated with larger family sizes (OR: 0.91; 95% CI: 0.84-0.99) and female sex (OR: 0.74; 95% CI: 0.57-0.98). Furthermore, using the cohort of 1985 as a comparison group, no significant dental fluorosis differences were found with those born between 1986-1987; in contrast, in the cohorts born between 1989-1992 the risk of dental fluorosis increased by almost four times (p < 0.05). conclusion: the prevalence of fluorosis was low compared to other studies in Mexico. In this community with negligible fluoride in water supplies the likelihood of dental fluorosis increased as the windows of susceptibility in birth cohorts were closer to the chronologic beginning of the national domestic salt fluoridation program in 1991. This trend was more apparent after 1991

Dental fluorosis: a review

Ingesting fluoride for prolonged periods or in doses higher than those recommended during enamel formation produces changes from the appearance of very thin white lines to serious structural defects, resulting in a pathological entity known as dental fluorosis. The severity of the changes depends on the amount of fluoride ingested; it is a disease that has an epidemiological behavior with endemic characteristics. The indicated management for TF1 and TF2 lesions is dental whitening or infiltrating resin; for TF3 and TF4 micro abrasion and/or whitening and in TF5 combined technique with macro, micro abrasion and dental whitening. It is essential that public health actions be prioritized to mitigate potential complications due to fluorosis, especially in areas identified as endemic

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

Mis casos clínicos de especialidades odontológicas

Libro que muestra la atención de casos clínicos particulares referente a las diferentes especialidades odontológicasLibro que muestra la atención de casos clínicos particulares referente a las diferentes especialidades odontológicasUniversidad Autónoma de Campeche Universidad Autónoma del Estado de Hidalgo Universidad Autónoma del Estado de Méxic

Experience and Prevalence of Dental Caries in 6 to 12-Year-Old School Children in an Agricultural Community: A Cross-Sectional Study

Objective: To describe the experience and prevalence of dental caries in schoolchildren aged 6–12 years belonging to agricultural manual worker households. Material and Methods: A comparative cross-sectional study was conducted in two groups of schoolchildren: One considered “children of agricultural worker migrant parents” (n = 157) and the other “children of agricultural worker non-migrant parents” (n = 164). Epidemiological indices for dental caries were calculated for primary (dmft) and permanent (DMFT) dentitions, and compared in terms of age, sex, and the Simplified Oral Hygiene Index (SOHI). Two binary logistic regression models for caries prevalence in primary and permanent dentitions were generated in Stata. Results: For primary dentition, we observed the following dmft index: Non-migrants = 1.73 ± 2.18 vs. migrants = 1.68 ± 2.14. Additionally, we recorded the following caries prevalence: Non-migrants = 59.1% vs. migrants = 51.3%. For permanent dentition, we observed the following DMFT index: Non-migrants = 0.32 ± 0.81 vs. migrants = 0.29 ± 0.95. Further, we recorded the following caries prevalence: Non-migrants = 17.6% vs. migrants = 12.8%. No differences were observed for either dentition (p &gt; 0.05) in caries indices and their components or in caries prevalence. When both caries indices (dmft and DMFT) were combined, the non-migrant group had a higher level of caries experience than the migrant group (p &lt; 0.05). No relationship (p &gt; 0.05) with migrant status was observed in either multivariate models of caries prevalence. However, age did exhibit an association (p &lt; 0.05) with caries. Only the plaque component of SOHI was associated (p &lt; 0.05) with caries in permanent dentition. Conclusions: Although over half of school children from agricultural manual worker households had caries in either or both dentitions and a considerable proportion were untreated lesions, the prevalence levels were somewhat lower than other reports from Mexico in similar age groups. No statistically significant differences were found in caries experience or prevalence in either dentition between non-migrant and migrant groups

Caries dental en escolares de 6 a 12 añios de edad en Navolato, Sinaloa, México: experiencia, prevalencia, gravedad y necesidades de tratamiento.

Introducción. La caries dental es una de las enfermedades más prevalentes en los niños. Objetivo. Determinar la experiencia, prevalencia y gravedad de caries en la dentición temporal y permanente; establecer igualmente el índice de caries significativa (SiC, por sus siglas en inglés), en escolares de Navolato, Sinaloa, México, así como sus necesidades de tratamiento. Materiales y métodos. Se realizó un estudio transversal en 3.048 niños de 6 a 12 años de edad. Los sujetos fueron examinados clínicamente por tres examinadores (índice k > 0,85), de acuerdo a los lineamientos establecidos por la Organización Mundial de la Salud (OMS). Para la detección de caries se empleó el criterio de la OMS y la lesión d1 de Pitts. Resultados. La media de edad fue de 8,81±1,79 años y el porcentaje de niñas fue de 52,2%. En la dentición temporal, el ceod (Promedio de dientes cariados, extraídos/perdidos y obturados) fue de 4,68±3,21 y la prevalencia de caries 90,2% (ceod > 3 = 60,8%). El índice significativo de caries fue de 10,52 para los niños de seis años de edad. Las lesiones no cavitadas (d1) representaron 37,1% del componente ""cariados"". En la dentición permanente, el índice CPOD (Promedio de dientes permanentes cariados, perdidos y obturados) fue de 3,24±2,72 y la prevalencia de caries, 82% (CPOD > 3 = 47,8%). El índice de caries significativa fue de 10,87 para los niños de 12 años. Las lesiones no cavitadas representaron 63,4% del componente ""cariados"". Al menos 81,1% de los niños necesitó la restauración de una superficie dental y 89,6%, de dos. Las niñas presentaron más caries que los niños en su dentición permanente. Se observó que conforme aumentó la edad se incrementó la experiencia de caries. Conclusiones. Se observaron altos índices de caries, así como alta prevalencia, gravedad y necesidad de tratamiento. Las lesiones no cavitadas constituyeron el principal porcentaje en la dentición permanente, no así en la dentición temporal

Caries dental en escolares de 6 a 12 añios de edad en Navolato, Sinaloa, México: experiencia, prevalencia, gravedad y necesidades de tratamiento.

Introduction. Dental caries is the most prevalent disease in children.Objective. To determine the caries experience, prevalence, and severity in temporal and permanent dentition, likewise to establish the significant caries index in schoolchildren of Navolato, Sinaloa, Mexico as well as their treatment needs.Material And Methods. A cross sectional study in 3048 schoolchildren aged 6 to 12 years. All subjects were clinically examined by three examiners (kappa>0.85), according to World Health Organization (WHO) guidelines. Caries detection criteria used were the WHO's criteria and Pitts' lesion d1.Results. The mean age was 8.81 +/- 1.79 years old and 52.2% were girls. In the temporal dentition; the dmft was 4.68 +/- 3.21 and caries prevalence of 90.2% (dmft>3 was 60.8%, and dmft>6 was 27.4%). The overall significant caries index was 10.52 for 6 year olds. The noncavitated lesions (d1) represented 37.1% of the ""decay"" component. In the permanent dentition; the DMFT was 3.24 +/- 2.72 and caries prevalence was 82.0% (DMFT>3 was 47.8%, and DMFT>6 was 9.0%). The overall significant caries index was 10.87 for 12 year olds. The noncavitated lesions (d1) represented 63.4% of the ""decay"" component. The majority, 89.6% and 81.1% of children needed at least one restoration of one and two dental surfaces, respectively. Girls were more affected by caries than boys in permanent dentition, but not in temporal dentition. The caries experience increased with age.Conclusions. We observed high indices of caries, and high prevalence, severity and treatment needs. Noncavitated lesions were higher in permanent dentition that in primary dentition.Introducción. La caries dental es una de las enfermedades más prevalentes en los niños. Objetivo. Determinar la experiencia, prevalencia y gravedad de caries en la dentición temporal y permanente; establecer igualmente el índice de caries significativa (SiC, por sus siglas en inglés), en escolares de Navolato, Sinaloa, México, así como sus necesidades de tratamiento. Materiales y métodos. Se realizó un estudio transversal en 3.048 niños de 6 a 12 años de edad. Los sujetos fueron examinados clínicamente por tres examinadores (índice k > 0,85), de acuerdo a los lineamientos establecidos por la Organización Mundial de la Salud (OMS). Para la detección de caries se empleó el criterio de la OMS y la lesión d1 de Pitts. Resultados. La media de edad fue de 8,81±1,79 años y el porcentaje de niñas fue de 52,2%. En la dentición temporal, el ceod (Promedio de dientes cariados, extraídos/perdidos y obturados) fue de 4,68±3,21 y la prevalencia de caries 90,2% (ceod > 3 = 60,8%). El índice significativo de caries fue de 10,52 para los niños de seis años de edad. Las lesiones no cavitadas (d1) representaron 37,1% del componente ""cariados"". En la dentición permanente, el índice CPOD (Promedio de dientes permanentes cariados, perdidos y obturados) fue de 3,24±2,72 y la prevalencia de caries, 82% (CPOD > 3 = 47,8%). El índice de caries significativa fue de 10,87 para los niños de 12 años. Las lesiones no cavitadas representaron 63,4% del componente ""cariados"". Al menos 81,1% de los niños necesitó la restauración de una superficie dental y 89,6%, de dos. Las niñas presentaron más caries que los niños en su dentición permanente. Se observó que conforme aumentó la edad se incrementó la experiencia de caries. Conclusiones. Se observaron altos índices de caries, así como alta prevalencia, gravedad y necesidad de tratamiento. Las lesiones no cavitadas constituyeron el principal porcentaje en la dentición permanente, no así en la dentición temporal

Oral hygiene in 6-13 year old schoolchildren from Campeche, México

El objetivo de este trabajo fue identificar la distribución, mediante diferentes variables, del nivel de la higiene bucal en escolares de 6 a 13 años de edad. Se realizó un estudio transversal en 1.644 niños de la ciudad de Campeche, México. Las variables sociodemográficas y socioeconómicas se recogieron utilizando un cuestionario dirigido a las madres/tutores. Para evaluar la higiene, se construyó el Índice de Higiene Clínico-Conductual, formado por la frecuencia de cepillado (parte conductual) y la placa dentobacteriana (índice de Silness y Löe, parte clínica). El nivel socioeconómico (NSE) fue determinado de acuerdo con la ocupación y escolaridad de los padres. El análisis se realizó utilizando pruebas no paramétricas. La distribución de la higiene bucal fue: 22,7% adecuada, 45,8% regular, y 31,5% inadecuada. Se observaron peores niveles de higiene bucal conforme disminuye el NSE (p<0.01), en los niños, en quienes no visitan al dentista, quienes presentaron defectos de desarrollo del esmalte, y a mayor tamaño de la familia (p<0.001). Como conclusión podemos decir que pocos niños presentaron higiene bucal adecuada. Se encontraron variables sociodemográficas y socioeconómicas asociadas a la higiene bucal. El hallazgo de la asociación entre el NSE y la higiene bucal, hace necesario diseñar medidas para disminuir las brechas de las conductas de salud entre los grupos sociales.21-30The objective of this study was to identify the distribution, through different variables, of the oral hygiene level in schoolchildren aged 6-13 years. A cross-sectional study was carried out in 1644 children from Campeche, Mexico. The socioeconomic and sociodemographic variables were collected using questionnaires administered to mothers/tutors. It was built the Clinical-behavioural Scoring System for oral hygiene, conformed by toothbrushing frequency (behavioural aspect) and dental plaque (Silness and Löe index, clinical aspect), to evaluate the oral hygiene in an ordinal scale as adequate, regular and inadequate. The socioeconomic status (SES) was determined according to the occupation and schooling of parents. Statistical analysis was performed using non-parametric test. The distribution of oral hygiene was: 22.7% adequate, 45.8% regular and 31.5% inadequate. It was observed that when the SES increase, diminish the percentage of inadequate hygiene (p<0.01). The subjects that realized at least one dental visit in the year previous to study have higher percentage of adequate hygiene (p<0.001). When the number of enamel defects and the family size increases, it were observed poorest level of oral hygiene (p<0.001). As conclusion, a low prevalence of adequate oral hygiene was observed, and the relation found between sociodemographic and socioeconomic variables and oral hygiene, make necessary the adoption of measures to reduce the health behaviour gaps between social groups