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OBJECTIVE: This study aimed to explore the cross-sectional and prospective associations between self-reported functionality of complete dentures (FCD), satisfaction with complete dentures (SCD) and the ability to chew hard food (ACHF) on the one hand and the frailty index (FI) on the other hand among edentulous community-dwelling older Japanese people. METHODS: The study examined 770 edentulous participants of the Nihon University Japanese Longitudinal Study of Aging. The self-reported FCD, SCD and ability to chew six groups of food (from hardest to softest) with complete dentures were the independent variables at the baseline. The FI was computed including 40 deficits as the dependent variable at the baseline and 4 years later. Cross-sectional and prospective generalized linear regression models were fitted controlling for age, gender, marital status, education, working status and area of residence. RESULTS: The use of non-functional complete dentures and dissatisfaction with complete dentures were both associated with a higher FI cross-sectionally (3.9% [95% CI 2.2-5.6] and 3.2% [95% CI 1.5-4.9], respectively) and prospectively (3.9% [95% CI 2.0-6.0] and 3.3% [95% CI 1.3-5.3], respectively). Regarding the ability to chew, a higher FI at baseline was observed among those able to chew food of Group 2 (1.9%, [95% CI 0.1-3.7]) and Groups 4-6 (1.9%, [95% CI 0.1-3.7]), and a progressive increment in the FI, as the participants reported being able to chew softer groups of food at the follow-up (Group 2: 2.2% [95% CI 0.05-4.3]; Group 3: 3.6% [95% CI 1.2-6.0]; and Groups 4-6: 3.4 [95% CI 0.7-6.1]). CONCLUSION: Self-reported use of non-functional complete dentures, dissatisfaction with dentures and a reduced ACHF with complete dentures were associated with a higher FI both cross-sectionally and prospectively.
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Prótese Total , Boca Edêntula , Humanos , Masculino , Feminino , Idoso , Estudos Prospectivos , Japão/epidemiologia , Estudos Transversais , Prótese Total/estatística & dados numéricos , Boca Edêntula/epidemiologia , Fragilidade/epidemiologia , Mastigação/fisiologia , Idoso de 80 Anos ou mais , Satisfação do Paciente , Autorrelato , Estudos Longitudinais , População do Leste AsiáticoRESUMO
The objective of this study was to determine the experience of tooth loss and associated factors in older adults and elderly residing in nursing homes. A cross-sectional study was conducted in Mexican older adults and elderly aged ≥60 years living in four nursing homes (two in Mexico City, Mexico: one in Cuernavaca, Morelos, and one in Oaxaca, Oaxaca). The data were collected at the facility (home nursing) by two dentists in 2019. To determine the number of tooth loss and DMFT, a clinical oral examination was performed. In addition, a questionnaire was applied to determine diverse independent variables (demographic, socioeconomic, and behavioral). The analysis was performed using nonparametric tests and negative binomial regression (p < 0.05). 257 subjects were included. The mean age was 81.25 ± 9.02 years, and 60.7% were women. The mean number of lost teeth was 18.78 ± 9.05 (women = 19.43 ± 8.59 and men = 17.77 ± 9.68; p > 0.05). In the multivariate negative binomial regression model, it was found that, for each one-year increase in age, the mean tooth loss increased 0.92% (p < 0.05). In current smokers (p < 0.01) and in those who brush their teeth < 2 times a day (p < 0.01), the average of tooth loss increased 22.04% and 61.46%, respectively. The experience of tooth loss in Mexican older adults and elderly was high. Demographic (age) and habit of behavior (tobacco use and less frequent tooth brushing) were associated with increased tooth loss. It is important to promote oral health programs for institutionalized older adults.
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Perda de Dente , Dente , Masculino , Idoso , Humanos , Feminino , Idoso de 80 Anos ou mais , Estudos Transversais , México , Casas de SaúdeRESUMO
OBJECTIVES: To analyse the relationship between the Frailty Index and 10 oral conditions controlling for nutritional status among Mexican community-dwelling older people. BACKGROUND: Studies suggest that the association between frailty and oral conditions are mediated by nutrition. MATERIALS AND METHODS: This cross-sectional analysis includes 487 community-dwelling men and women aged ≥70 years old. Interview and clinical examinations were performed at participants' homes. Objective (number of natural teeth, root remnants, dental condition, utilisation and functionality of removable dental prostheses and periodontitis) and subjective (utilisation of dental services, self-rated oral health, chewing difficulties and xerostomia) oral variables were collected by trained personnel. The Frailty Index was calculated considering 35 deficits. Nutritional status measured with the Mini-Nutritional assessment (MNA), age, sex, education, and marital status were included as covariates. We fitted 11 multivariate generalised linear models (one for each oral condition), assuming gamma distribution for Frailty Index as the outcome. RESULTS: Participants average age was 78.1 years, 52.1% were women. We observed a higher Frailty Index among those rating their oral health as worse than others their age (5.1%), reporting chewing difficulties often (4.9%) and fairly and very often (7.0%), and xerostomia (4.8%). Age, gender and MNA were consistently associated with the Frailty Index. CONCLUSION: Subjective oral conditions are compatible with the Frailty Index after controlling for older people's nutritional status and covariates.
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Fragilidade , Doenças da Boca , Xerostomia , Masculino , Humanos , Feminino , Idoso , Estudos de Coortes , Estudos Transversais , Fragilidade/epidemiologia , Doenças da Boca/epidemiologia , Saúde Bucal , Estado Nutricional , Xerostomia/complicações , Xerostomia/epidemiologia , Avaliação Geriátrica , Idoso FragilizadoRESUMO
Background: Several investigations have determined whether the use of a dental operating microscope (DOM) in combination with selective dentine removal with ultrasonic tips increases the percentage of location of the Mesiobuccal 2 (MB2) root canal in maxillary first molars (MFM). However, these studies did not report the performance of in vivo measurements with the comparison with a gold standard. The aim of this study was to determine the validity of the DOM and selective dentin removal with ultrasonic tips to locate the MB2 root canal in MFM using Cone Beam Computed Tomography (CBCT) as the gold standard. Material and Methods: The initial sample size was 91 patients, but 7 were excluded, so the sample size was 84 patients who signed the informed consent. Inclusion criteria: MFM indicated for root canal treatment. An expert blinded observer identified the MB2 in the CBCT. Two standardized examiners (Kappa=91%) performed the clinical assessment in three stages: Stage 1, canal location with an endodontic explorer and a mirror; Stage 2, use of DOM and Stage 3, use of DOM plus selective dentine removal with ultrasonic tips. The validity of each stage was calculated. Results: The prevalence of MB2 using CBCT was 79%, by clinical location was 68%. Sensitivity was 79%, 82%, 86% for stage 1, 2 and 3, respectively. Specificity and Positive Predictive Values were 100% for all methods. Negative Predictive Value was 56%, 60%, 67%, respectively. Positive Likelihood Ratio tends to infinity for all methods, Negative Likelihood Ratio= 0.21, 0.18 and 0.14 and Accuracy= 83%, 86% and 89%, respectively. Conclusions: The use of DOM with selective dentine removal with ultrasonic tips is the most valid method for locating MB2 canal in MFM. There was an increase in the location of the MB2 root canal with the DOM and ultrasonic tips, which definitely help the clinician. Key words:Cone beam computed tomography, microscopy, second mesiobuccal canal, sensitivity and specificity, validity.
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Large-scale school-based programs effectively provide health education and preventive strategies. SaludARTE is a school-based program, including supervised tooth brushing, implemented in 51 elementary schools in Mexico City. OBJECTIVES: To assess the three-month efficacy of supervised tooth brushing in reducing dental plaque, gingival inflammation, and bleeding on probing in schoolchildren participating in SaludARTE. STUDY DESIGN: This was a pragmatic cluster randomized intervention, with two parallel branches. Four randomly selected schools participating in SaludARTE (n=200) and one control school, which did not participate in the program (CG) (n=50), were assessed. Clusters were not randomly allocated to intervention. The main outcomes were as follows: mean percentage gingival units with no inflammation, dental surfaces with no dental plaque, and gingival margins with no bleeding. The independent variable was supervised tooth brushing at school once a day after a meal. Guardians and children responded to a questionnaire on sociodemographic and oral hygiene practices, and children were examined dentally. Mean percentage differences were compared (baseline and follow-up). RESULTS: A total of 75% of guardians from the intervention group (IG) and 77% from the CG answered the questionnaire. Of these, 89.3% were women, with a mean age of 36.9±8.5 years. No differences in sociodemographic variables were observed between groups, and 151 children from the IG and 35 from the CG were examined at baseline and follow-up. Mean percentage differences for plaque-free surfaces (8.8±28.5%) and healthy gingival units (23.3%±23.2%) were significantly higher in the IG. CONCLUSION: The school-supervised tooth brushing program is effective in improving oral hygiene and had a greater impact on plaque and gingivitis than on gingival bleeding. It is necessary to reinforce the oral health education component of the program.
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Serviços de Saúde Escolar , Escovação Dentária , Adolescente , Criança , Placa Dentária/prevenção & controle , Feminino , Gengivite/prevenção & controle , Humanos , Masculino , México , Higiene Bucal/educaçãoRESUMO
BACKGROUND: Poor oral health has been associated with some components of frailty. The objective of this study was to identify the association between clinical measures of oral health and the incidence of frailty among community-dwelling older adults aged 70 or older in Mexico City. METHODS: A 3-year cohort study with a probabilistic representative sample of home-dwelling elders of one district of Mexico City was performed. Baseline and follow-up interview and oral clinical evaluations were carried out by standardized examiners in participants' homes. Dependent variable was incident frailty defined according to the frailty phenotype. Independent variables were the utilization of dental services, the presence of xerostomia, the number of natural teeth, use of removable dental prostheses, presence of severe periodontitis, and presence of root remnants. Sociodemographic, behavioral, and health measures were included as confounders. The association between oral health conditions and incident frailty was modeled using Poisson regression models with robust variance estimators. The models were adjusted for confounders and interactions. RESULTS: We identified a 14.8% cumulative incidence of frailty. Each additional tooth was associated with a lower probability of developing frailty by 5.0% (risk ratio = 0.90; 95% CI 1.02-1.10). The 3-year risk ratio of developing frailty was 2.13 times higher (95% CI 1.01-4.50) among participants having severe periodontitis. CONCLUSIONS: The number of teeth and the presence of severe periodontitis are associated with the development of frailty after controlling for confounders. Further studies are needed on this topic.
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Doenças da Boca/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Idoso Fragilizado/estatística & dados numéricos , Avaliação Geriátrica/métodos , Disparidades nos Níveis de Saúde , Humanos , Incidência , Masculino , México/epidemiologia , Saúde Bucal/estatística & dados numéricos , Medição de Risco , Fatores de Risco , Estatística como AssuntoRESUMO
PURPOSE: The purpose of this study was to evaluate the impact of caries and fluorosis on oral health-related quality of life (OHRQoL) among schoolchildren living in areas with high concentrations of fluoride in water. METHODS: Five hundred and twenty-four schoolchildren (8-12 year olds) residing in rural communities in central Mexico were examined for oral hygiene, caries (International Caries Detection and Assessment System, ICDAS II), and fluorosis (Thylstrup and Fejerskov Index, TFI). OHRQoL was evaluated with the Child Perceptions Questionnaire for two age groups (CPQ8-10 and CPQ11-14). Generalized structural equation models were constructed for data analysis. RESULTS: Overall prevalence of caries was 88.5% and fluorosis 46.9%. In the group of 8-10 year olds, 48% of the children had advanced carious lesions in primary or permanent teeth (ICDAS ≥4), 22.6% had moderate/severe fluorosis, and 59.9% of children had an impact on OHRQoL. Schoolchildren with ICDAS ≥4 were more likely [OR = 1.75, (95% CI 1.34-2.28)] to suffer a negative impact on OHRQoL. In the group of 11-12 year olds, 19.9% of children had advanced carious lesions and 23.2% showed moderate/severe fluorosis; 67.3% of children reported had an impact on OHRQoL. Children 11-12 year olds with fluorosis (TFI ≥4) [OR = 2.39 (95% CI 2.12-2.69)], caries (ICDAS ≥4) [OR = 2.18 (95% CI 2.13-2.24)], and low brushing frequency [OR = 2.04 (95% CI 1.21-3.44)] were more likely to have deterioration on OHRQoL. CONCLUSION: A negative impact on OHRQoL was observed in children with caries and fluorosis. CLINICAL RELEVANCE: Deterioration on OHRQoL found in children as a sequel of caries and fluorosis should be considered when designing health policies leading to prevention and effective health promotion programs and incorporated to clinical guidelines for timely dental treatment.
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Cárie Dentária/prevenção & controle , Cárie Dentária/psicologia , Fluoretação/métodos , Fluorose Dentária/psicologia , Saúde Bucal , Qualidade de Vida , Criança , Estudos Transversais , Cárie Dentária/epidemiologia , Feminino , Fluorose Dentária/epidemiologia , Humanos , Masculino , México/epidemiologia , Prevalência , Inquéritos e QuestionáriosRESUMO
AIM: Oral health in old persons is frequently poor; non-functional prostheses are common and negatively affect quality of life. The objective of this study was to estimate the impact of oral health problems on oral health related quality of life in a sample of home dwelling Mexican elders. METHODS: Household survey in 655 persons 70 years old and over residing in one county in Mexico City. VARIABLES: Oral Health Related Quality of Life (Short version of the Oral Health Impact Profile validated in Mexico-OHIP-14-sp), self-perception of general and oral health, xerostomia, utilization of dental services, utilization and functionality of removable dental prostheses, dental and periodontal conditions, age, gender, marital status, schooling, depression, cognitive impairment and independence in activities of daily living (ADL). A negative binomial regression model was fitted. RESULTS: Mean age was 79.2 ± 7.1 years; 54.2% were women. Mean OHIP-14-Sp score was 6.8 ± 8.7, median was 4. The final model showed that men (RR = 1.30); persons with xerostomia (RR = 1.41); no utilization of removable prostheses (RR = 1.55); utilization of non-functional removable prostheses (RR = 1.69); fair self-perception of general health (RR = 1.34); equal (RR = 1.43) or worse (RR = 2.32) self-perception of oral health compared with persons of the same age; and being dependent for at least one ADL (RR = 1.71) increased the probability of higher scores of the OHIP-14-sp. Age, schooling, depression, cognitive impairment and periodontal conditions showed no association. CONCLUSIONS: Oral rehabilitation can improve quality of life, health education and health promotion for the elder and their caregivers may reduce the risk of dental problems. Geriatr Gerontol Int 2017; 17: 744-752.
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Nível de Saúde , Vida Independente , Saúde Bucal , Doenças Periodontais/epidemiologia , Qualidade de Vida , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Feminino , Idoso Fragilizado/estatística & dados numéricos , Humanos , Incidência , Masculino , México/epidemiologia , Razão de Chances , Doenças Periodontais/psicologia , Inquéritos e QuestionáriosRESUMO
Abstract: there has been a significant growth in the elderly population of developing countries. This growth leads health systems in those countries to face an increase in consultations for oral diseases for this age group. Therefore, the biopsychosocial approach is essential for healthy aging in the elderly. The objectives of this review article are to identify the psychological factors that have a relationship with most prevalent oral diseases in elderly people (dental caries and periodontal disease), and then describe how tooth loss, the principal consequence of caries and periodontal disease, impacts the mental health of older people. Finally, some proposals for dental work in the elderly are discussed, considering the psychological factors related to oral health.
Resumen: este último tiempo, ha existido un aumento significativo de los adultos mayores en los países en desarrollo. Este aumento lleva a estas naciones a enfrentar un crecimiento en las consultas dentales para este grupo etáreo. Bajo este contexto, es que la aproximación biopsicosocial es esencial para el envejecimiento saludable en la tercera edad. El objetivo de este artículo de revisión sería, en primer lugar, dentificar los factores psicológicos que tienen relación con las enfermedades más prevalentes en el adulto mayor (caries dental y enfermedad periodontal), para luego describir como la pérdida de dientes, principal consecuencia de la caries y enfermedad periodontal, impacta en la salud mental del adulto mayor. Finalmente, se discuten algunas propuestas para el trabajo dental en el adulto mayor, considerando los factores psicológicos relacionados a la salud oral.
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Humanos , Masculino , Feminino , Idoso , Cárie Dentária/psicologia , Doenças Periodontais/psicologia , Saúde Bucal , Perda de Dente/psicologiaRESUMO
BACKGROUND: Oral health is an important component of general well-being for the elderly. Oral health-related problems include loss of teeth, nonfunctional removable dental prostheses, lesions of the oral mucosa, periodontitis, and root caries. They affect food selection, speaking ability, mastication, social relations, and quality of life. Frailty is a geriatric syndrome that confers vulnerability to negative health-related outcomes. The association between oral health and frailty has not been explored thoroughly. This study sought to identify associations between the presence of some oral health conditions, and frailty status among Mexican community-dwelling elderly. METHODS: Analysis of baseline data of the Mexican Study of Nutritional and Psychosocial Markers of Frailty, a cohort study carried out in a representative sample of people aged 70 and older residing in one district of Mexico City. Frailty was defined as the presence of three or more of the following five components: weight loss, exhaustion, slowness, weakness, and low physical activity. Oral health variables included self-perception of oral health compared with others of the same age; utilization of dental services during the last year, number of teeth, dental condition (edentate, partially edentate, or completely dentate), utilization and functionality of removable partial or complete dentures, severe periodontitis, self-reported chewing problems and xerostomia. Covariates included were gender, age, years of education, cognitive performance, smoking status, recent falls, hospitalization, number of drugs, and comorbidity. The association between frailty and dental variables was determined performing a multivariate logistic regression analysis. Final models were adjusted by socio-demographic and health factors RESULTS: Of the 838 participants examined, 699 had the information needed to establish the criteria for diagnosis of frailty. Those who had a higher probability of being frail included women (OR = 1.9), those who reported myocardial infarction (OR = 3.8), urinary incontinence (OR = 2.7), those who rated their oral health worse than others (OR = 3.2), and those who did not use dental services (OR = 2.1). For each additional year of age and each additional drug consumed, the probability of being frail increased 10% and 30%, respectively. CONCLUSIONS: Utilization of dental services and self-perception of oral health were associated with a higher probability of being frail.
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Idoso Fragilizado , Instituição de Longa Permanência para Idosos , Saúde Bucal , Idoso , Idoso de 80 Anos ou mais , Intervalos de Confiança , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Modelos Logísticos , Masculino , México , Razão de Chances , Saúde Bucal/estatística & dados numéricosRESUMO
BACKGROUND AND OBJECTIVE: The Oral Health Impact Profile is the most frequently used and validated of the Oral Health Quality of Life instruments. Several short versions have been developed; and a validation of the OHIP-49 in Spanish has been published. The objective was to develop the short version of the Oral Health Impact Profile in Spanish (OHIP-EE-14). METHODS: Cross-sectional study. One hundred and thirty-one persons aged ≥60 years attending a social centre for the elderly, residents of a nursing home and persons seeking dental care at a dental school in Mexico City were interviewed and examined. The validity of each of the 49 questions was evaluated, and, to construct the short version, 14 items were selected. The perceived need for dental treatment, number of teeth, presence of coronal caries, root caries, presence of dental plaque and utilisation of removable prosthesis were measured. Internal consistency, repeatability and discriminant validity were calculated. RESULTS: The OHIP-EE-14 was reliable (Cronbach's-α = 0.918, ICC = 0.825). Significant associations were found between OHIP-EE-14 and the number of teeth and perceived need for dental treatment. CONCLUSIONS: The OHIP-EE-14 is a reliable and valid instrument and can be used in subjects aged 60 years and over from Mexico City.
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Idioma , Saúde Bucal , Qualidade de Vida , Inquéritos e Questionários , Atividades Cotidianas , Idoso , Atitude Frente a Saúde , Estudos Transversais , Assistência Odontológica/psicologia , Cárie Dentária/psicologia , Placa Dentária/psicologia , Dentaduras/psicologia , Escolaridade , Feminino , Humanos , Arcada Parcialmente Edêntula/psicologia , Masculino , Estado Civil , México , Pessoa de Meia-Idade , Avaliação das Necessidades , Medição da Dor , Cárie Radicular/psicologia , Autoimagem , Fatores SexuaisRESUMO
OBJECTIVE: Translate, culturally adapt, and validate a new Spanish version of the Oral Health Impact Profile (OHIP) for older persons in Mexico City, Mexico. METHODS: A validation study of the new version of OHIP-Mx-49 was carried out through interviews and clinical examinations of people aged 60 or older in the southern area of Mexico City. The following variables were analyzed: sociodemographic (age, sex, marital status, level of schooling, and whether the subject lived alone), clinical (current number of teeth, coronal and root caries, dental hygiene, and the use of removable prostheses and dentures), and self-perception (of the need for dental and general health care). The OHIP-Mx-49 value was calculated as the sum of the scores in seven dimensions: functional limitation, pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. The internal consistency (Cronbach's alpha coefficient), replicability (intraclass correlation coefficient), and convergent and discriminant validity (Mann-Whitney and Kruskal-Wallis tests) were assessed. RESULTS: Of the 131 people interviewed (average age: 73.8 +/- 8.3 years), 77.9% were women. High internal consistency values were obtained for the OHIP-Mx-49 (0.96) and the dimensions (0.79-0.86), and replicability in the instrument (0.877) and all the dimensions except social disability (0.176). The average OHIP-Mx-49 score was 37.1 +/- 35.3; higher scores were observed in people with 1-9 teeth (P = 0.02), people who did not have coronal caries (P = 0.02), and people who perceived a need for dental care (P = 0.01). CONCLUSIONS: The OHIP-Mx-49 is a reliable and valid instrument that can be used with older Mexicans.
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Saúde Bucal/normas , Qualidade de Vida , Perfil de Impacto da Doença , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Cultura , Inquéritos de Saúde Bucal , Prótese Total/estatística & dados numéricos , Prótese Parcial Removível/estatística & dados numéricos , Escolaridade , Características da Família , Feminino , Humanos , Idioma , Masculino , México , Pessoa de Meia-Idade , Fatores Sexuais , Estatísticas não ParamétricasRESUMO
OBJETIVOS: Traducir, adaptar culturalmente y validar una nueva versión en español del instrumento denominado perfil de impacto de la salud bucal (OHIP) en adultos mayores de la Ciudad de México, México. MÉTODOS: Estudio de validación de la nueva versión OHIP-Mx-49 mediante entrevistas y exámenes clínicos a personas de 60 años o más del sur de la Ciudad de México. Se analizaron variables sociodemográficas (edad, sexo, estado civil, nivel de escolaridad y si vive solo), clínicas (número de dientes presentes, caries coronal y radicular, higiene de la dentadura, y uso de prótesis removible y dentadura total) y de autopercepción (necesidad de tratamiento dental y de salud general). Como valor del OHIP-Mx-49 se tomó la suma de las puntuaciones alcanzadas en sus siete dimensiones: limitación funcional, dolor, incomodidad psicológica, inhabilidad física, inhabilidad psicológica, inhabilidad social e incapacidad. Se evaluó la consistencia interna (coeficientes a de Cronbach), la repetibilidad (coeficiente de correlación intraclase) y la validez convergente y discriminativa (pruebas de Mann-Whitney y de Kruskal-Wallis). RESULTADOS: De las 131 personas entrevistadas (edad promedio: 73,8 ± 8,3 años), 77,9 por ciento eran mujeres. Se obtuvieron valores elevados de consistencia interna, tanto del OHIP-Mx-49 (0,96) como de las dimensiones (0,79-0,86), y de repetibilidad en el instrumento (0,877) y todas las dimensiones, excepto inhabilidad social (0,176). La puntuación promedio del OHIP-Mx-49 fue de 37,1 ± 35,3; se observaron mayores puntuaciones en las personas con 1-9 dientes (P = 0,02), las que no presentaron caries coronal (P = 0,02) y las que percibían necesitar tratamiento dental (P = 0,01). CONCLUSIONES: El OHIP-Mx-49 es un instrumento confiable y válido que puede aplicarse en adultos mayores mexicanos.
OBJECTIVE: Translate, culturally adapt, and validate a new Spanish version of the Oral Health Impact Profile (OHIP) for older persons in Mexico City, Mexico. METHODS: A validation study of the new version of OHIP-Mx-49 was carried out through interviews and clinical examinations of people aged 60 or older in the southern area of Mexico City. The following variables were analyzed: sociodemographic (age, sex, marital status, level of schooling, and whether the subject lived alone), clinical (current number of teeth, coronal and root caries, dental hygiene, and the use of removable prostheses and dentures), and self-perception (of the need for dental and general health care). The OHIP-Mx-49 value was calculated as the sum of the scores in seven dimensions: functional limitation, pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. The internal consistency (Cronbach's alpha coefficient), replicability (intraclass correlation coefficient), and convergent and discriminant validity (Mann-Whitney and Kruskal-Wallis tests) were assessed. RESULTS: Of the 131 people interviewed (average age: 73.8 ± 8.3 years), 77.9 percent were women. High internal consistency values were obtained for the OHIP-Mx-49 (0.96) and the dimensions (0.79-0.86), and replicability in the instrument (0.877) and all the dimensions except social disability (0.176). The average OHIP-Mx-49 score was 37.1 ± 35.3; higher scores were observed in people with 1-9 teeth (P = 0.02), people who did not have coronal caries (P = 0.02), and people who perceived a need for dental care (P = 0.01). CONCLUSIONS: The OHIP-Mx-49 is a reliable and valid instrument that can be used with older Mexicans.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Saúde Bucal/normas , Qualidade de Vida , Perfil de Impacto da Doença , Fatores Etários , Cultura , Inquéritos de Saúde Bucal , Prótese Total , Prótese Parcial Removível , Escolaridade , Características da Família , Idioma , México , Fatores Sexuais , Estatísticas não ParamétricasRESUMO
OBJECTIVE: To estimate the prevalence and to determine if there is an association between anterior open bite and the presence of speech disorders in a group of Mexican children with Down syndrome (DS). MATERIALS AND METHODS: The subjects were a group of Mexican children with Down syndrome (DG) and a control group (CG) of Mexican pediatric patients without disabilities matched by age. The children in both groups came from families having children with anterior open bite and children without it. A parental questionnaire, dental study casts, and a speech test were used to measure the studied variables. Data were analyzed using the chi-square test (chi(2) test), and one-way analyses of variance (ANOVA), followed by the Tukey post hoc test. RESULTS: Prevalence of anterior open bite was 31.6% in the DG and 22.8% in the CG. The total speech errors by omissions, substitutions, distortions, and additions indicated that there were significant differences between both groups (F = 31.68, P < .001). In general, no significant difference in speech disorders was observed between the DG and the CG regardless of the presence of anterior open bite. CONCLUSIONS: No association existed between speech disorders and anterior open bite in the samples studied.
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Síndrome de Down/complicações , Mordida Aberta/etiologia , Distúrbios da Fala/complicações , Adolescente , Análise de Variância , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Feminino , Humanos , Masculino , México , Fonética , Testes de Articulação da FalaRESUMO
This study sought to determine the prevalence of bruxism in a Mexican community of children with Down syndrome, and to evaluate bruxism's relationship with age, sex, intellectual disability level, and type of chromosomal abnormality of trisomy 21. Using a cross-sectional design, 57 boys and girls (3 to 14 years old) were examined. Three approaches to establish presence or absence of bruxism were employed: parental questionnaire, clinical examination, and dental study casts. Data were analysed using bivariate analyses and conditional logistic regression. We found that the overall prevalence of bruxism was 42%. No statistically significant associations between bruxism and age, sex, or intellectual disability level were found. There was, however, a significant association between bruxism and type of chromosomal abnormality, with mosaicism being more frequently associated with bruxism.
Assuntos
Bruxismo , Síndrome de Down , Adolescente , Bruxismo/epidemiologia , Bruxismo/etiologia , Criança , Pré-Escolar , Aberrações Cromossômicas , Estudos Transversais , Síndrome de Down/complicações , Síndrome de Down/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , México/epidemiologia , Prevalência , Bruxismo do Sono/epidemiologia , Bruxismo do Sono/etiologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: To determine the experience, prevalence, and severity of dental caries in adolescents naturally exposed to various fluoride concentrations. METHODS: A cross-sectional census was conducted on 1,538 adolescents aged 12 and 15 years living at high altitude above sea level (> 2,000 m or > 6,560 ft) in above-optimal fluoridated communities (levels ranging from 1.38 to 3.07 ppm) of Hidalgo, Mexico. Sociodemographic and socioeconomic data were collected using questionnaires. Two previously trained and standardized examiners performed the dental exams. RESULTS: Caries prevalence was 48.6 percent and mean of decay, missing, and filling teeth (DMFT) for the whole population was 1.15 +/- 1.17. In terms of severity, 9.6 percent of the adolescents had DMFT > or = 4, and 1.7 percent had > or = 7. The significant caries index (SiC) was 2.41 in the group of 12-year-olds, and 3.46 in the 15-year-olds. Higher experience and prevalence were observed in girls, in children with dental visit in the past year, those in the wealthiest socioeconomic status (SES) (quartiles 2, 3, and 4), those whose locale of residence is in San Marcos and Tula Centro, and in fluorosis-free children and those with moderate/severe fluorosis. In an analysis of caries severity (DMFT > or = 4), both adolescents with very mild/mild and moderate/severe dental fluorosis have higher caries severity. CONCLUSIONS: The results indicated that caries experience, prevalence, and severity as well as SiC index among 12- and 15-year-old adolescents were relatively low. Sociodemographic and socioeconomic variables commonly associated with dental caries were also observed in Mexican adolescents. Unlike other studies, we found that caries increased with higher SES. Fluoride exposure (measured through fluorosis presence) does not appear to be reducing the caries prevalence (DMFT > 0) or caries severity (DMFT > or = 4) in these high-altitude communities.
Assuntos
Cárie Dentária/epidemiologia , Fluoretação , Adolescente , Análise de Variância , Criança , Índice CPO , Cárie Dentária/patologia , Feminino , Fluorose Dentária/epidemiologia , Humanos , Modelos Logísticos , Masculino , México/epidemiologia , Prevalência , Classe Social , Inquéritos e QuestionáriosRESUMO
AIM: The objective of this study was to determine whether an association existed between chronic systemic diseases/conditions, risk factors common in old age, and the extent and severity of chronic periodontal disease. MATERIALS AND METHODS: Sociodemographic and lifestyle characteristics were examined by contrasting rural, urban-marginal, and urban social environments in Central Mexico. Data were analysed with Analysis of Variance, chi2 tests, and multivariable logistic regression. RESULTS: A total of 473 adults 60 years old and over were interviewed; 315 were also examined and underwent laboratory assays (participation rate, 66%); women, 62%; mean age 73+/-8 years; 23% edentulous. The distribution of periodontitis by sociodemographic variables showed differences across locales (73% low-urban, 57% middle-urban, 29% rural). The regression model indicated that periodontitis was more frequently associated with low-urban locale, higher systolic blood pressure, higher body mass index, and worse calculus readings, with an interaction whereby being obese and having a high calculus index was associated with a high probability of having periodontitis. CONCLUSIONS: Overall periodontal conditions were fair. While we identified oral, systemic, and social variables that modulated the experience of periodontitis, it would appear that urban, low social class elders appeared to have worse periodontal conditions.
Assuntos
Periodontite/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Cálculos Dentários/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Estilo de Vida , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Boca Edêntula/epidemiologia , Obesidade/epidemiologia , Pobreza/estatística & dados numéricos , Prevalência , Fatores de Risco , Saúde da População Rural/estatística & dados numéricos , Classe Social , Meio Social , Saúde da População Urbana/estatística & dados numéricosRESUMO
OBJECTIVE: To explore whether dentists' beliefs and attitudes to providing preventive and restorative dental care for young children can form a barrier to the provision of care. BASIC RESEARCH DESIGN: The Barriers to Childhood Caries Treatment (BaCCT) Questionnaire, a standardised international measure was developed and applied. PARTICIPANTS: Through a research consortium, each site was asked to recruit 100 dentists. The sample participating was not intended to be nationally representative. Dentists were mainly randomly selected and contacted by mail with one or more mailings depending on site. RESULTS: 2,333 dentists in 14 countries and 17 sites participated. Factor analysis identified four factors as potential barriers. Two factors were found to be barriers in many sites. First, in most countries, dentists agreed that young children's coping skills limit their ability to accept dental care. Secondly, dentists with negative personal feelings, for example, that providing care can be stressful and troublesome and that they feel time constrained. Differences in dentists' beliefs can be partly explained by their work profile, with those treating children often, and those working under systems where they feel they can provide quality care being least likely to identify barriers to providing care for children. CONCLUSIONS: The BaCCT Questionnaire was determined to be a valid psychometric measure. Separately, it was found that health systems do impact on dentists' ability to deliver preventive and restorative care for children but that these effects vary across countries and further work is needed to determine how best these should be examined.
Assuntos
Atitude do Pessoal de Saúde , Cárie Dentária/terapia , Odontólogos , Acessibilidade aos Serviços de Saúde , Atitude Frente a Saúde , Criança , Comportamento Infantil , Pré-Escolar , Comportamento Cooperativo , Atenção à Saúde , Cárie Dentária/prevenção & controle , Restauração Dentária Permanente , Relações Dentista-Paciente , Feminino , Humanos , Masculino , Relações Profissional-Família , Qualidade da Assistência à Saúde , Estresse Psicológico/psicologia , Fatores de Tempo , Dente Decíduo/patologiaRESUMO
OBJECTIVES: To compare the extent and severity index (ESI) with a gold standard represented by actual readings of loss of attachment on six sites around all teeth present (excluding third molars). METHODS: Five standardized dentists (kappa=0.6) examined 712 subjects > or =20 years of age at a dental school (1993-1995). Sensitivity, specificity, positive and negative predictive values, and true and apparent prevalence were established. RESULTS: True severe periodontitis prevalence was 95.8%. ESI underestimated the severity (0.1 mm), extent (4%), and prevalence (16%) of periodontitis. The severity, as established by ESI, coincided 23.4% with the gold standard. ESI failed to identify 16.7% of subjects with severe periodontal disease, but specificity and positive predictive value were very high. CONCLUSIONS: The underestimation of severe periodontitis through ESI may lead to inadequate recommendations for further treatment. Accurately identifying subjects with severe periodontitis requires a full-mouth examination. Because the ESI relies on measurements taken on only 28 periodontal sites to estimate the periodontitis status of the entire mouth, the validity and reliability of ESI may be modified by the prevalence of severe periodontal disease and the distribution of disease according to age and operational definitions.
Assuntos
Índice Periodontal , Periodontite/classificação , Adulto , Fatores Etários , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/classificação , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: The teaching of infection control (IC) was introduced at dental schools in Mexico during the 1990s. A 1992 survey indicated that some dentists had limited access to current IC standards. Deficient knowledge of bloodborne pathogens may influence dentists' attitudes about infected individuals and reduce compliance with IC recommendations. OBJECTIVE: To update the 1992 appraisal of attitudes about persons infected with HIV or the hepatitis B virus (HBV) and IC knowledge and practices in a nonrepresentative sample of dentists in Mexico City. METHOD: One hundred eighty dentists were interviewed in 1999 (response rate, 84.1%) with the same methods used in 1992. RESULTS: Seventy-nine percent of respondents perceived the risk of HIV infection as "considerable" to "very strong." The risk of HBV infection was considered higher than that of HIV. Only 32% of respondents had not been immunized against HBV. Reported use of personal protective equipment remained high. Dry heat was the preferred method for sterilization in 1992, but by 1999 it had been displaced by steam under pressure. Reported preference for more effective disinfectants was also evident overall. CONCLUSIONS: We found certain improvements in IC knowledge and practices between 1992 and 1999, and the results suggest targets for educational and regulatory efforts that are needed to promote better adherence to current IC standards.