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

Prevalence of Functional Dentition in a Group of Mexican Adult Males

Objective: To determine the prevalence of functional dentition and associated periodontal variables in a sample of Mexican adult males. Methods: A cross-sectional study of 161 policemen in Campeche, Mexico, was carried out. A clinical examination using an electronic probe was used to collect variables (dental plaque, periodontal pockets, gingival recession, suppuration, and bleeding on probing) on 6 periodontal sites (a maximum of 168 sites, excluding third molars). Sociodemographic, socioeconomic, and behavioral variables were collected through a self-administered survey. Functional dentition was defined as having 21 or more natural teeth. Data were analyzed with STATA 11.0, using logistic regression models. Results: Mean age was 38.3 (±10.9) years. The prevalence of having a functional dentition was 83.8% in the sample. The odds of having a functional dentition declined with age (odds ratio [OR] = 0.93), having diabetes (OR = 0.27) and with having a high percentage of sites with plaque (OR = 0.77), with bleeding on probing (OR = 0.97), and with gingival recession (OR = 0.82). Conclusion: While a large proportion of subjects had a functional dentition in this community-dwelling sample of adult Mexican males, the likelihood of their having a functional dentition decreased with age, with their having been diagnosed with diabetes, and with assorted negative indicators of periodontal/gingival status

Usporedba dviju vrsta smola za pečaćenje fisura i jamica u smanjenju incidencije zubnog karijesa primjenom dizajna podijeljenih usta

Objectives: To evaluate the effectiveness of two pit and fissure sealants (PFS) in reducing the incidence of dental caries in schoolchildren. Material and Methods: A randomized split-mouth experimental design was used in a sample of 140 subjects assigned to two groups. The sealants used were Clinpro©3M and BeautiSealant©Shofu placed in first permanent molars (FPMs). Each sealant was compared to molars in the controls to determine effectiveness over a period of 6 months. The study had a 12.9% loss to follow-up. No statistically significant differences (p>0.05) were observed for sex, age, baseline dmft, or type of sealants. Nonparametric tests were used for statistical analysis. Results: Average dmft index at baseline was 4.10±3.16. Lower incidence of caries was observed in FPMs with pit and fissure sealants (p 0,05) za spol, dob, početni DMFT ili vrstu smole. Za statističku analizu upotrijebljeni su neparametrijski testovi. Rezultati : Prosječni DMFT indeks bio je na početku 4,10 ± 3,16. Manja incidencija karijesa zabilježena je na zapečaćenim prvim trajnim kutnjacima (p < 0,01), bez obzira na vrstu smole. Kada su smole ostale intaktne, incidencija karijesa bila je manja u usporedbi s djelomično ili potpuno nestalim pečatima, no razlika je bila statistički značajna samo za prve trajne kutnjake 16. Incidencija karijesa bila je veća kod zuba zapečaćenih smolom BeautiSealant u usporedbi sa smolom Clinpro, ali je statistički značajna bila samo kod prvih trajnih kutnjaka 16, 36 i 46 (p < 0,05). Incidencija karijesa bila je veća u slučajevima s višim početnim DMFT-om, ali je statistički značajna samo za prve trajne kutnjake 26 i 36. Relativni rizik od karijesa bio je niži kod zapečaćenih zuba (p < 0,01). Zaključak: Smole za pečaćenje fisura i jamica učinkovite su u prevenciji karijesa tijekom šestomjesečnog razdoblja praćenja školske djece od 6 do 8 godina, bez obzira na vrstu smole. Smola s većom učinkovitošću, kad je riječ o prevenciji i retenciji, bio je Clinpro © 3M

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

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

Subgingival Microbiota of Mexicans with Type 2 Diabetes with Different Periodontal and Metabolic Conditions

Background: Type-2-Diabetes (T2D) and Periodontitis are major inflammatory diseases. However, not much is known about the specific subgingival microbiota in Mexicans with diabetes and metabolic dysbiosis. The aim of this study was to describe the subgingival microbiota of Mexicans with T2D and the different periodontal and metabolic conditions, through &ldquo;Checkerboard&rdquo; DNA&ndash;DNA hybridization. Methods: Subjects were divided into two groups&mdash;periodontal-health (PH) (PH_non-T2D; n = 59, PH_T2D; n = 14) and generalized-periodontitis (GP) (GP_non-T2D; n = 67, GP_T2D; n = 38). Obesity (BMI &ge; 30 kg/m2) and serum levels of glycated-hemoglobin (HbA1c), total-lipids, triglycerides, total-cholesterol, high-density-lipids, and low-density-lipids were measured for the T2D individuals. Subgingival microbial identification was processed for 40 species through DNA-probes. Results: Subjects with T2D harbored significantly higher mean total levels (PH: p &lt; 0.001, and GP_NS), a lower proportion of &ldquo;red&rdquo; complex (GP: p &lt; 0.01), a higher proportion of &ldquo;yellow&rdquo; (GP; p &lt; 0.001), and &ldquo;orange&rdquo; (GP; p &lt; 0.01) complex than the non-T2D. GP_T2D individuals exhibited a greater proportion of putative-species&mdash;Campylobacter gracilis and S. constellatus (p &lt; 0.001), and Parvimonas micra and Prevotella nigrescens (p &lt; 0.01), than GP_non-T2D. T2D individuals with HbA1c &gt; 8% had presented significantly higher mean pocket-depth and higher levels of G. morbillorum (p &lt; 0.05) and those with obesity or dyslipidemia harbored higher levels, prevalence, or proportion of Streptococcus sp., Actinomyces sp., and Capnocytophaga sp. Conclusions: T2D individuals harbored a particular microbial profile different to non-T2D microbiota. Metabolic control was related to dysbiosis of microbiota&mdash;HbA1c&gt;8% related to periodontitis and obesity or dyslipidemia with the predominance of saccharolytic bacteria, irrespective of their periodontal condition

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

Desigualdades socioeconómicas en la utilización de servicios de salud bucal: estudio en escolares mexicanos de 6 a 12 años de edad

El objetivo del estudio fue evaluar la asociación entre diversos indicadores socioeconómicos y la utilización de servicios de salud bucal. Se realizó un estudio transversal en 3.048 escolares. La variable utilización de servicios de salud bucal y las variables sociodemográficas y socioeconómicas se colectaron a través de un cuestionario dirigido a las madres. Para determinar las necesidades de salud se realizó un examen clínico bucal a los niños. Las asociaciones ajustadas fueron evaluadas con regresión logística politómica. Las variables asociadas a servicios preventivos y curativos fueron mayor edad, mayor frecuencia de cepillado y menor edad al inicio de cepillado dental, tener seguro público o privado, y mejor nivel socioeconómico. Además, sólo para los servicios preventivos, también se asoció estar inscrito en una escuela privada, y sólo para los servicios curativos, la posesión de automóvil y tener necesidades de salud bucal entre moderadas y muy altas. Los resultados sugieren la existencia de desigualdades socioeconómicas en la utilización de servicios de salud bucal en niños mexicanos