Socioeconomic Inequalities and Toothbrushing Frequency among Schoolchildren Aged 6 to 12 Years in a Multi-Site Study of Mexican Cities: A Cross-Sectional Study

Periodic toothbrushing is the most common, effective, and reliable way to mechanically remove biofilm from oral tissues. The objective of the present study was to determine the association between toothbrushing frequency and socioeconomic position for schoolchildren between 6 and 12 years of age in four cities in Mexico. A cross-sectional study was conducted on 500 Mexican schoolchildren between 6 and 12 years of age from public schools in four Mexican cities. Questionnaires were administered to the parents/guardians of the schoolchildren to obtain the variables included in the study. The dependent variable was toothbrushing frequency, dichotomized as: 0 = less than twice a day and 1 = at least twice a day. The analysis was performed in Stata. The average age of the schoolchildren was 8.9 1.9 years; 50.4% were female. The prevalence of toothbrushing was 52.8% (at least twice a day) (95% CI = 48.457.1). In the multivariate model, the variables associated (p < 0.05) with toothbrushing frequency were older age of the schoolchild (OR = 1.14); younger age of the mother (OR = 0.93); being a girl (OR = 1.70); being enrolled in Seguro Popular (OR = 0.69); being in a household that was owned (OR = 2.43); and being a schoolchild who lived in a home that owned a car (OR = 1.31). The prevalence of toothbrushing at least twice a day was just over 50% in these Mexican children. We found demographic and socioeconomic variables to be associated with toothbrushing. Based on socioeconomic variables that were associated with toothbrushing frequency—such as health insurance, home ownership and the household owning a car—the results of the present study confirm the existence of health inequalities in toothbrushing frequency

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

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

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

Principales razones de extracción de dientes permanentes en una muestra de adultos mexicanos

Background. Tooth extractions are one of the most common procedures in oral surgery. The objective of this study was to identify the reasons for tooth extraction in adult patients seeking care at teaching dental clinics. Material and methods. A cross-sectional study was carried out in 331 subjects between 18 and 85 (45.37± 13.85) years of age seeking dental care in dental clinics of the Universidad Autónoma del Estado de Hidalgo, from January 2009 to December, 2009. Data pertaining to age, sex, tooth number and the reason for extraction according to Kay & Blinkhorn were analyzed with non-parametric tests. Results. 779 extractions were undertaken. The main reason for extraction was dental caries (43.1%), periodontal disease (PD) (27.9%), and prosthetic reasons (21.5%). There was no significant difference across sex for reasons of extraction (p › 0.05). Significant differences (p ‹ 0.001) were found for age (extraction due to periodontal disease increased with age); in patients attending in a single visit vs. patients attending a series of dental appointments (caries reasons were more common in patients having a single appointment vs. PD in those attending a series of appointments); for type of teeth (upper, posterior, and molars were extracted primarily because of caries, while lower, anterior and incisors were more often extracted because of PD). Conclusions. Dental caries was the most common reason for tooth extraction, followed by periodontal disease. Differences in the reasons for extraction were observed across patient characteristics and type of tooth

Impacto de la posición socioeconómica sobre los defectos de desarrollo del esmalte en dentición primaria

Introduction and objective Developmental enamel defects (DED) can be defined as any alteration of tooth enamel resulting from variousdisturbancesduringamelogenesis. Theobjectiveofthisreportwastodeterminetheimpactof socioeconomic position (SEP) on the DEDin primary teeth of 6 to 9 year old school children. Material and Methods A cross-sectional study in 925 school children from six to nine years old was carried out. The diagnostic criteriausedforDEDwasproposedbytheFDI, specificallymarkedanddiffuseopacitiesandhypoplasia, excludingdentalfluorosisandotherdiscolorations, throughaclinicalexaminationconductedbythree trained and calibrated examiners (kappa> 0,80). Sociodemographic and socioeconomic variables were collectedthroughaquestionnairedirectedtomothers/ guardiansofchildren. Socioeconomicposition (SEP) wasdeterminedwiththeparentaloccupationandschooling. Statisticalanalysiswasperformedby calculating odds ratios with logistic regression in STATA 9.0. Results The mean age was 7,56±1,13 years and 50,3% were male. Average DED was 0,17 ± 0,75, and the prevalenceof9,9%. MultivariatelogisticregressionanalysisindicatedthattheoddspresentingDEDin primaryteethincreased(p<0,05) inchildrenbetween8-9yearsold, visitingthedentistmoreoftenand the worst SEP. Conclusions This study has shown that the PSE has an impact on the presence of DED in the primary dentition. Further studies, which are preferably longitudinal, are needed to confirm this association and clarify the relationship.Introducción y Objetivo Los defectos de desarrollo del esmalte (DDE) son alteraciones del esmalte dental que resulta de diversos disturbios durante la amelogénesis. Determinar el impacto de la posición socioeconómica (PSE) sobre los DDE en la dentición primaria de niños escolares de 6 a 9 años de edad. Material y Métodos Se realizó un estudio transversal en 925 escolares de seis a nueve años de edad. El criterio utilizado para DDEfueelpropuestoporlaFederaciónDentalInternacional, específicamentelasopacidadesmarcadas ydifusasehipoplasias, excluyendofluorosisdentalyotrasdecoloraciones, atravésdeunexamenclínico realizadoportresexaminadorespreviamenteestandarizados(kappa> 0,80). Seutilizóuncuestionario dirigido a las madres/tutores de los niños se recogieron diversas variables sociodemográficas y socioeconómicas. La PSE fue determinada con la ocupación y escolaridad de los padres. El análisis estadístico se realizó calculando razones de momios con regresión logística en STATA 9.0. Resultados La edad promedio fue 7,56±1,13 años y 50,3% fueron varones. El promedio de DDE fue 0,17±0,75, y la prevalencia de 9,9%. En el análisis multivariado de regresión logística, se observó que los momios de presentarDDE en los dientes primarios aumentaron (p<0,05) en los niños de 8-9 años, enlos que visitan al dentista con mayor frecuencia y los de peor PSE. Conclusiones Este estudio permitió identificar que la PSE tiene un impacto en la presencia de DDE en la dentición primaria. Es necesario realizar más estudios que confirmen esta asociación y clarifiquen la relación, preferentemente de tipo longitudinal

Dental pain and associated factors in Mexican adolescents and young adults: a cross-sectional study

Objective: To identify the factors associated with the prevalence of dental pain in Mexican adolescents and young adults. Material and methods: This is a cross-sectional study in which data from 638 Mexican subjects, 16–25 years of age, who were randomly selected from college applicants, were analysed. Questionnaires were administered to collect sociodemographic, economic and behavioural variables. Clinical examinations were carried out to determine the decayed, missing and filled teeth (DMFT) index. The outcome variable was dichotomised as 0 (no dental pain in the last 12 months) or 1 (dental pain in the last 12 months). Statistical analyses included binary logistic regression. Results: Average age was 18.76 ± 1.76 years, and 49.2% of participants were women. Prevalence of dental pain was 34.0%. In the final model, variables significantly (P < 0.05) associated with the experience of dental pain were the use of preventive dental services (OR = 0.34), being a former smoker (OR = 2.37), self-report of very poor/poor oral health (OR = 1.94) or fair oral health (OR = 1.94), self-reported dental disease (OR = 2.06) or gingival disease (OR = 2.84). Conclusions: The prevalence of dental pain was associated with self-reported oral health status, preventive dental visits and smoking; these results have implications for dental practice. We found that recent experience of dental pain was common in young adults, being reported by one out of three subjects

Principales razones de extracción de dientes permanentes de adultos mexicanos en un Centro de Salud

Objective: To identify the main reasons why dental extractions are performedin adult patients who come to one Urban Health Center fromMexico. Material and Methods: A cross-sectional study in 61 adult patientsaged 18 and older who attended to an Urban Health Center from Hidalgo, Mexico. The dependent variable was the main reason why the tooth wasextracted using the classification of Kay & Blinkhorn. Independent variables includedwere age, sex, education, number of missing teeth, previous tooth restoration,prior endodontic treatment, location of tooth, diagnosis of diabetes and smoking.Stata 9.0 software was used for statistical analysis. Results: The mean age was50.90±16.18, and 50.8% were women. Only we observed two reasons why teethwere extracted: dental caries and its sequelae (62.3%) and periodontal disease(37.7%). In logistic regression model we observed that, for every year of schoolingthe possibility of extraction performed by periodontal disease decreased (OR =0.68; 95% CI = 0.53 to 0.88). If the tooth was restored, the odds of being extractedfor periodontal reasons increased 2.62 times (95% CI = 1.15 - 5.97). In patientswith diabetes, the possibility that the tooth was extracted for periodontal reasonswas higher (OR = 5.87; 95% CI = 1.52 - 22.63). Conclusions: Dental caries and periodontaldisease were the main reasons why teeth are extracted in this group ofpatients. Schooling, restored tooth and diagnosis of diabetes were associated withperiodontal disease extraction.Objetivo: Identificar los principales motivos por los que se realizan extraccionesdentales en pacientes adultos que acuden a un Centro de SaludUrbano de México. Material y Métodos: Se realizó un estudio transversalen 61 pacientes adultos de 18 años y más que acudieron a unCentro de Salud Urbano de Hidalgo, México. La variable dependiente fueel motivo principal por la que se extrajo el diente utilizando la clasificaciónde Kay & Blinkhorn. Las variables independientes que se incluyeronfueron: edad, sexo, escolaridad, dientes perdidos, restauración previa deldiente, tratamiento de conductos previo, ubicación del diente, diagnósticode diabetes y tabaquismo. En el análisis estadístico se utilizó el paqueteStata 9.0. Resultados: El promedio de edad fue 50.90±16.18, y 50.8% fueronmujeres. Sólo observamos dos motivos por los que se extrajeron losdientes: caries dental y sus secuelas (62.3%) y enfermedad periodontal(37.7%). En el modelo de regresión logística observamos que, por cadaaño de escolaridad la posibilidad de realizarse la extracción por enfermedadperiodontal disminuyó (RM=0.68; IC95%=0.53-0.88). Si el dienteestaba restaurado, los momios de ser extraído por razones periodontalesaumentaron 2.62 veces (IC 95%=1.15-5.97). En los pacientes que teníandiabetes, la posibilidad de que el diente fuera extraído por causas periodontalesfue mayor (RM=5.87; IC95%=1.52-22.63). Conclusiones: Lacaries dental y la enfermedad periodontal fueron las principales causaspor las que se extraen los dientes en este grupo de pacientes. La escolaridad,si existía restauración y el diagnóstico de diabetes estuvieronasociadas a la extracción por enfermedad periodontal

Socioeconomic Inequalities in Visits to the Dentist to Receive Professionally Applied Topical Fluoride in a Developing Country

Objective: To determine the frequency and associated factors of visits to the dentist in the last year by Nicaraguan schoolchildren to receive professionally applied topical fluoride (PATF). Material and Methods: A cross-sectional study was designed in children from public schools in the city of León, Nicaragua, were included. A series of socioeconomic, sociodemographic, and behavioural variables were collected through a questionnaire. The dependent variable was the visit to the dentist to receive professionally applied topical fluoride in the last year, which was dichotomised as (0) Did not receive PATF and (1) Yes received PATF. In the statistical analysis, binary logistic regression was used. Results: The mean age of the students included was 9 years, and 49.9% were girls. The prevalence of visits to the dentist in the last year to receive PATF was 3.1%. In the multivariate model, the associated characteristics (p &lt; 0.05) were: female (OR = 2.73, 95% CI = 1.34–4.50); the positive attitude of the mother to the oral health of her child (OR = 2.15, 95% CI = 1.03–4.50); and the best socioeconomic position (OR = 2.68, 95% CI = 1.36—5.31). Conclusions: The prevalence of visits to the dentist in the last year to receive professionally applied topical fluoride was very low (3.1%). The results of the socioeconomic position suggest the existence of certain inequalities in oral health. It is necessary to implement policies and programs aimed at improving this scenario