Cumplimiento de las metas de salud bucal para 2015 en un consultorio del médico de la familia / Fulfilment of the oral health goals for 2015 in a Family Physician's Office

RESUMEN Introducción: la epidemiología en salud bucal es fundamental para comprender el impacto de la enfermedad y contribuir con la organización de los servicios de salud. Objetivo: determinar el grado de cumplimiento de las metas de salud bucal propuestas para 2015, en el Consultorio del Médico de la Familia no. 3. Materiales y métodos: se realizó un estudio observacional descriptivo transversal en el Consultorio del Médico de la Familia no. 3, del área Centro del municipio Sancti Spíritus, entre septiembre y noviembre de 2019. El universo estuvo constituido por toda la población del consultorio, y la muestra -150 pacientes- por un muestreo aleatorio simple. Se estudiaron las variables: edad, prevalencia de caries dental, enfermedad periodontal y maloclusiones. Se emplearon métodos empíricos y estadísticos. Resultados: el grupo más afectado resultó el de 60 a 74 años, con un índice CPO-D de 14,12 a expensas de los dientes perdidos. El 71,3 % de la muestra no estuvo enfermo periodontalmente; de los afectados, el grupo de 60 a 74 años mostró una prevalencia del 68 %. El 27 % de la población menor de 19 años presentó algún tipo de anomalía oclusiva, predominando el grupo de 18 años. Solo se incumplió con el porcentaje de población sin afección periodontal (63 % enfermos) respecto a las proyecciones propuestas para el año 2015. Conclusiones: se incumplió con el propósito relacionado con el porcentaje de población sin afección periodontal; el resto de los propósitos fueron cumplidos, incluso superando lo obtenido en la provincia y el país en el año 2015.

ABSTRACT Introduction: epidemiology in oral health is essential to understand the impact of the disease and contribute to the organization of health services. Objective: to determine the degree of fulfilment of the proposed health goals for 2015, in the Family Physician's Office Nr. 3. Materials and methods: a cross-sectional descriptive observational study was conducted in the Family Physician's Office Nr. 3, ot the area Centro of the municipality of Sancti Spiritus, between September and November 2019. The universe was formed by the entire population of the physician's office, and the sample -150 patients- by a simple random sampling. The variables studied were: age, prevalence of dental caries, periodontal disease and malocclusions. Empiric and statistical methods were used. Results: the most affected group was the 60 to 74-year-old age group, with a COP-D index of 14.12 at the expense of the lost teeth. 71.3 % of the sample did not have periodontal disease. Of those affected, the age group aged 60 to 74 years showed a prevalence of 68 %. 27 % of the population under 19 years had some kind of occlusive anomaly, predominating the 18-year-old age group. Only the percentage of population with without periodontal disease (63 % sick) was not accomplished with respect to the projections for 2015. Conclusions: it was no accomplished the purpose related to the percentage of population without periodontal disease; the rest of the purposes were achieved, even surpassing the achievements in the province and the country in 2015.

Living with Family Is Directly Associated with Regular Dental Checkup and Indirectly Associated with Gingival Status among Japanese University Students: A 3-Year Cohort Study.

Although some studies showed that lifestyle was associated with oral health behavior, few studies investigated the association between household type and oral health behavior. The aim of this prospective cohort study was to investigate the association between household type, oral health behavior, and periodontal status among Japanese university students. Data were obtained from 377 students who received oral examinations and self-questionnaires in 2016 and 2019. We assessed periodontal status using the percentage of bleeding on probing (%BOP), probing pocket depth, oral hygiene status, oral health behaviors, and related factors. We used structural equation modeling to determine the association between household type, oral health behaviors, gingivitis, and periodontitis. At follow-up, 252 students did not live with their families. The mean ± standard deviation of %BOP was 35.5 ± 24.7 at baseline and 32.1 ± 25.3 at follow-up. In the final model, students living with their families were significantly more likely to receive regular dental checkup than those living alone. Regular checkup affected the decrease in calculus. The decrease in calculus affected the decrease in %BOP over 3 years. Living with family was directly associated with regular dental checkups and indirectly contributed to gingival status among Japanese university students.

Event-Based but Not Time-Based Prospective Memory Is Related to Oral Health in Late Adulthood.

BACKGROUND: Most evidence now indicates that cognitive function is related to poorer oral health in late adulthood, but that this relationship is not invariant across specific cognitive domains. Prospective memory (PM) is a core memory skill that refers to memory for future intentions and is known to be related to the formation of habits such as tooth flossing. However, the relationship between PM and oral health has been subject to only limited empirical study. OBJECTIVE: The two studies reported in this paper were designed to test whether PM is related to oral health in older adults of varying vulnerability status. METHODS: Study 1 sampled community-dwelling older adults (N = 172) living independently in the community; Study 2 sampled older adults living in a retirement village (N = 32). Participants in both studies were asked to complete a behavioural measure of PM, with their oral health indexed via self-report (Study 1) or an objective oral health exam (Study 2). RESULTS: In both studies, relationships emerged between event-based PM and oral health, with Study 2 showing that these relationships were specific to oral health measures of plaque and calculus. CONCLUSIONS: Older adults are particularly vulnerable to dental pathology, with important implications for their broader health and well-being. By showing that there is a relationship between oral health and a particular type of PM, this work will have potential implications for the development of more effective interventions focused on enhancing oral health outcomes in this group, such as those focused on strengthening habit formation.

Transoral Versus Endoscopic Examination in Predicting Outcomes of Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea.

OBJECTIVES/HYPOTHESIS: To examine the correlation between transoral and awake endoscopic examination and investigate their respective ability to predict outcomes of hypoglossal nerve stimulation (HGNS). STUDY DESIGN: Retrospective cohort study at a US medical center. METHODS: Subjects were adults with apnea-hypopnea index (AHI) >15 events/hr who underwent HGNS according to standard indications. Eligible subjects had diagnostic preoperative sleep studies, full-night efficacy postoperative studies, as well as postoperative video recordings of transoral examination and awake endoscopy. Recordings were independently scored by two blinded reviewers. Cohen's κ coefficient, Student t test, and χ2 analyses were performed. RESULTS: Fifty-seven patients met all inclusion criteria. On average, patients were Caucasian, middle aged, and overweight. The mean preoperative AHI was 36.7 events/hr, which improved significantly to 18.3 events/hr following HGNS (P < .01). Overall, the response rate (defined as AHI reduction >50% and AHI < 20 events/hr) was 49%. There was slight correlation between transoral tongue protrusion and endoscopic tongue base movement (κ = 0.10). On transoral examination, patients with minimal/moderate tongue motion achieved a greater mean AHI reduction than patients with full motion (26.0 ± 18.0 vs. 12.8 ± 24.1, P = .02). In contrast, on awake endoscopy, patients with minimal/moderate tongue motion achieved a lesser mean AHI reduction than patients with full motion (8.7 ± 19.9 vs. 22.1 ± 22.7, P = .04). CONCLUSIONS: Transoral tongue protrusion bears an inverse relationship to HGNS success and correlates poorly with endoscopic tongue base movement. Endoscopic tongue base motion appears reflective of response to HGNS, with greater motion corresponding to greater AHI reduction. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:675-679, 2021.

Countermeasure and opportunistic screening systems for oral cancer.

OBJECTIVES: Tokyo Dental College started oral cancer screening in cooperation with a local dental association in 1992. Reveal the usefulness of Countermeasure and Opportunistic Screening Systems for Oral Cancer. The actual results of countermeasure and opportunistic oral cancer screening systems are reported. MATERIALS AND METHODS: Countermeasure screening for the public was performed in each region, and opportunistic screening was performed in a general dental clinic of a cooperating physician. RESULTS: In countermeasure screening, 19,721 persons were checked from 1992 to 2018; the gender ratio was 1:3. The close examination rate was 4.45%. The detection rates of oral cancer and oral potentially malignant disorders were 0.13% and 1.85%, respectively. In opportunistic screening, 29,912 persons were checked from 2006 to 2018; the gender ratio was 2:3. The close examination rate was 2.33%. The detection rates of oral cancer and oral potentially malignant disorders were 0.08% and 2.15%, respectively. The close examination rate was significantly lower in opportunistic screening than in countermeasure screening. The oral cancer detection rates and the positive predictive value for cancer were equivalent. In addition, the detection rate of oral potentially malignant disorders was significantly higher in opportunistic screening than in countermeasure screening. CONCLUSION: Oral cancer detection rates were equivalent between countermeasure and opportunistic screenings, and opportunistic screening were more effective on number of participants and the close examination rate, and the detection rate of oral potentially malignant disorders.

Design and Progress of Oral Health Examinations in the Tohoku Medical Megabank Project.

In order to assess the long-term impact of the Great East Japan Earthquake on the oral health of disaster victims and to evaluate gene-environmental interactions in the development of major oral diseases and oral-systemic associations, the oral part of two large-scale genome cohort studies by the Tohoku Medical Megabank Organization (ToMMo), including the Community-based cohort (CommCohort) study and the Birth and Three-Generation cohort (BirThree) study, have been conducted. The study population comprised 32,185 subjects, including 16,886 participants in the CommCohort study and 15,299 participants in the BirThree cohort study, recruited from 2013 to 2017. The oral studies consist of a questionnaire regarding oral hygiene behavior, clinical examinations by dentists, and oral plaque and saliva sampling for microbiome analyses, which were carried out at seven community support centers in Miyagi prefecture. The median age of all participants was 55.0 years, and 66.1% of participants were women. Almost all participants reported that they brushed their teeth more than once a day. The median number of present teeth was 27.0, and the decayed, missing and filled tooth number was 16.0, with a significant difference according to age and sex. The median periodontal pocket and clinical attachment level was 2.48 mm and 4.00 mm, respectively. Periodontal parameters increased significantly according to age, except for the accumulation of dental calculus. The oral part of these extensive cross-sectional studies provides a unique and important platform for future studies on oral health and diseases that elicit through interactions with systemic diseases, lifestyles, life events and genetic backgrounds, and contributes to researches clarifying the long-term effects of disasters on oral health.

Short-Term Effects of a Deterioration of General Health on the Oral Health of Nursing-Home Residents.

PURPOSE: The purpose of this study was to identify how changes to general health might affect the oral health of nursing-home residents over a six-month period. MATERIALS AND METHODS: The study was conducted in nine nursing homes in Germany. Sociodemographic and general data were collected at baseline and after six months. Complete baseline and follow-up data were available for 114 participants. The Clinical Dementia Rating (CDR) and the Global Deterioration Scale (GDS) were used to identify the presence and, if applicable, severity of dementia among participants. The Apraxia Screen of TULIA (AST) was used to identify motor impairment. A comprehensive dental examination of each participant was also performed. The examination included the documentation of dental and denture status and the number of decayed, missing and filled teeth (DMF-T). In addition, dental and denture hygiene were quantitatively assessed using the Plaque Index (PI) and the Denture Hygiene Index (DHI), respectively. Global dental treatment needs were evaluated by use of the Oral Health Assessment Tool (OHAT). Univariate and multivariate linear regression models were compiled to analyse possible factors affecting the dependent target variables. RESULTS: During the study period, denture hygiene among the study population worsened by an average of 15%. The regression models detected that a more advanced age (in years) was associated with a less pronounced deterioration of denture hygiene as measured by use of the DHI (-0.806 per additional year of age; p = 0.030). Furthermore, an increase in the level of care needed (coefficient (C): -1.948; p = 0.002) and a more poorly graded assessment of general health compared with the value at baseline (C: 1.054; p = 0.026) were both associated with a deterioration of oral health as evaluated by use of the OHAT. In addition to these results, an increase in care needs was also associated with a deterioration of dental health as evaluated by use of the DMF-T (C: 0.966; p = 0.013). CONCLUSION: In the short term, a deterioration of general health, including an increase in care needs, seems to be the predominant factor associated with a more pronounced deterioration of oral health among nursing-home residents.

Association between dental consultation and oral health status among male Japanese employees.

OBJECTIVE: To investigate the association between dental consultation and oral health status among male Japanese employees. METHODS: The participants were 3351 male employees who received a workplace oral health examination conducted at the ages of 35, 40, 45, 50, 55, and 59 years before retirement in conjunction with an annual health checkup. Data on dental expenditures were collected from health insurance claims. The number of dental visits and dental care expenses, alone or in combination, were used as indices of the dental consultation status for the analyses. The effects of dental consultation status on oral health status (number of total teeth, number of decayed teeth, and periodontal status) were analyzed using multivariate multinomial logistic regression analyses adjusted for confounders. RESULTS: Multivariate analyses revealed that the odds ratio (OR) for 20-27 teeth (losing 1-8 teeth) was significantly higher (OR 1.4, 95% confidence interval (CI) 1.1-1.7) in those who had a high number of dental visits and high dental care expenses than in those who did not have a dental visit. By contrast, the ORs for ≤19 teeth (losing ≥9 teeth), having ≥3 decayed teeth, or having a periodontal pocket ≥6 mm were significantly lower (OR 0.2, 95% CI 0.1-0.6; OR 0.5, 95% CI 0.3-0.6; OR 0.7, 95% CI 0.5-1.0, respectively) in those who had fewer dental visits and lower dental care expenses. CONCLUSIONS: These results imply that the dental consultation status is associated with oral health status among male employees.

Factors affecting oral examinations and dental treatments among older adults in Israel.

BACKGROUND: Routine dental examinations are important for early diagnosis and treatment of dental problems among older adults in order to improve their quality of life and avoid costly future treatments. In Israel, a significant percentage of adults do not seek dental care. METHODS: The study is based on a 2017 telephone survey conducted among people aged 50-75 from different population groups in Israel to examine their health beliefs and attitudes toward dental treatments. RESULTS: The results show that among older adults the decision to undergo routine dental checkups is affected by socio-demographic status and health beliefs regarding dental health. Lower age, higher income levels, and Jewish religion predicted higher chances of frequent checkups. In addition, those who saw the benefits of routine checkups, believed that dentists were readily available, and had higher levels of health motivation were more likely to seek out routine dental care. CONCLUSIONS: According to the recent dental reform in Israel, people aged 75 and over are eligible for subsidized dental treatments. To enhance the frequency of dental checkups among older adults, it is recommended to provide this subsidized coverage for adults under age 75. In addition, planning dental health services for individuals in this age group should be based upon their accepted beliefs and values. Moreover, systematic health education through the media and health maintenance organizations should specifically target this population group to encourage them to undergo dental checkups more frequently.

Determinants for craniofacial pains in children 6-8 years of age: the PANIC study.

OBJECTIVE: Determinants for orofacial pain, headache, morning headache and painful signs of temporomandibular disorders (TMD) were investigated in prepubertal children. MATERIAL AND METHODS: The participants were a population sample of 439 children aged 6-8 years. Craniofacial pains, eating meals and snacks, sleep bruxism, sleep quality, sleep-disordered breathing (SDB), psychological well-being, parental education and household income were assessed by questionnaires filled out by the parents. Sleep duration was assessed using a combined heart rate and movement sensor and clinical signs of TMD and dental occlusion by a dentist. The determinants of pain conditions were analyzed using logistic regression. RESULTS: Of all 439 children, 26% had experienced orofacial pain and 31% headache during the past 3 months, 17% had suffered morning headache weekly and 13% had painful signs of TMD in a clinical examination. Restless sleep was associated with increased risk of orofacial pain, the painful signs of TMD and restless sleep with increased risk of headache and restless sleep, sleep bruxism and skipping meals with increased risk of morning headache after adjustment for other independent determinants of these pain conditions. Headache was associated with increased risk for painful signs of TMD. CONCLUSIONS: Craniofacial pains are common among prepubertal children. Prepubertal children with sleep bruxism, restless sleep and skipping meals have increased likelihood of craniofacial pains.

Telemedicine Consultations in Oral and Maxillofacial Surgery: A Follow-Up Study.

PURPOSE: The purpose of this study was to follow up on the previous study in evaluating the efficiency and reliability of telemedicine consultations for preoperative assessment of patients. MATERIALS AND METHODS: A retrospective study of 335 patients over a 6-year period was performed to evaluate success rates of telemedicine consultations in adequately assessing patients for surgical treatment under anesthesia. Success or failure of the telemedicine consultation was measured by the ability to triage patients appropriately for the hospital operating room versus the clinic, to provide an accurate diagnosis and treatment plan, and to provide a sufficient medical and physical assessment for planned anesthesia. Data gathered from the average distance traveled and data from a previous telemedicine study performed by the National Institute of Justice were used to estimate the cost savings of using telemedicine consultations over the 6-year period. RESULTS: Practitioners performing the consultation were successful 92.2% of the time in using the data collected to make a diagnosis and treatment plan. Patients were triaged correctly 99.6% of the time for the clinic or hospital operating room. Most patients (98.0%) were given sufficient medical and physical assessment and were able to undergo surgery with anesthesia as planned at the clinic appointment immediately after telemedicine consultation. Most patients (95.9%) were given an accurate diagnosis and treatment plan. The estimated amount saved by providing consultation by telemedicine and eliminating in-office consultation was substantial at $134,640. CONCLUSION: This study confirms the findings from previous studies that telemedicine consultations are as reliable as those performed by traditional methods.

[DENTIST AND EARLY DETECTION OF ORAL CARCINOMA]. / STOMATOLOG I RANO OTKRIVANJE ORALNOG KARCINOMA.

Oral cancer is one of the ten cancers with the worst prognosis. Higher mortality rate is due to the fact that the majority of cases are diagnosed at an advanced stage. Early stage of the disease causes no discomfort and symptoms start to present in later stages. Oral cancer can be detected in its earliest stage by simple examination of oral mucosa. Oral mucosa can be easily examined during routine dental examination. The examination itself is noninvasive, takes no more than one minute, does not require any special equipment, and poses no discomfort to the patient. Apart from better knowledge about the physiological and pathological characteristics of oral mucosa, dentist is in an ideal position to perform oral mucosa examinations every day, since he/she regularly sees the patient oral cavity. In Croatia, between 300 and 400 new cases of oral carcinoma per year are diagnosed at the sites that are visible during routine dental examination. Since oral cancer in its early stage does not cause any symptoms, dentists should be sensitized/motivated to perform mucosal as well as dental examinations in all patients irrespective of the patient's lack of complaint.

Trends in dental service provision in Australia: 1983-1984 to 2009-2010.

OBJECTIVE: To investigate time trends in dental service provision. METHODS: A random sample of Australian dentists was surveyed by mailed questionnaires in 1983-1984, 1993-1994, 2003-2004, and 2009-2010 (response rates 67-76%). The service rate per visit was collected from a log of services. RESULTS: The rate of service provision per visit [rate ratio (RR)] increased from 1983-1984 to 2009-2010 for the service areas of diagnostic (RR=1.8; 1.6-1.9), preventive (RR=1.9; 1.6-2.1), endodontic (RR=2.1; 1.7-2.6), and crown and bridge (RR=2.9; 2.3-3.8), whereas prosthodontic services decreased (RR=0.7; 0.6-0.9). CONCLUSIONS: The profile of services provided by dentists changed over the study period to include less emphasis on replacement of teeth and more on diagnosis, prevention, and retention of natural dentitions.

Saliva and biofilm-based diagnostics: a critical review of the literature concerning sialochemistry.

UNLABELLED: There is some evidence to support the use of salivary diagnostics in dentistry. BACKGROUND AND PURPOSE: The use of saliva as a diagnostic fluid has the potential to shape the role of oral health care professionals in the health care system. While more than a handful of chairside diagnostic tests are available for use by private practitioners, the evidence supporting their use continues to emerge. METHODS: An electronic search of the literature indexed on the PubMed electronic database was conducted to identify human clinical trials utilizing commercially available salivary diagnostics. Papers meeting the inclusion criteria, and any applicable references were critically appraised following SORT guidelines. CONCLUSIONS: While the literature concerning salivary analysis is continuously growing, the limited literature that is available doesn't focus on patient oriented health outcomes. This 'infant' literature is focused on validating metrics and identifying biomarkers with diagnostic potential. As such, the evidence level of the literature is graded as level 3. Despite the lower grade, the research in this area shows consistent results, coherent conclusions, and research identifying new biomarkers will provide additional dimensions to salivary diagnostics.

Analysis of a payments database reveals trends in dental treatment provision.

Use of fluoride has led to dramatic improvements in oral health; however, the impact of these improvements on the volume and mix of treatment provided in dental systems is largely unknown. The use of administrative data to analyze trends in treatment provision gives 'real-life' insight into the impact of changing levels of oral health on oral health services. The first aim of this study was to determine the extent to which useful data on temporal treatment patterns could be extracted from a public insurance database. The second aim, contingent on the first, was to investigate whether increased tooth retention and decreases in caries were reflected in the volume and types of treatment provided to adults within a public social insurance scheme between 1997 and 2008. Data were retrieved from the Dental Treatment Benefit Scheme databases, and new datasets were generated to analyze the distribution of treatments and mean treatments provided to 1,271,937 adults over the 12-year period. Provision of restorations, extractions, and dentures decreased, and the ratio of preventive/diagnostic to invasive treatments per dentist increased, which supports reported improvements in oral health. In conclusion, this paper illustrates the decline in invasive treatments, and increase in preventive treatments that accompanied improvements in oral health.

Detection and characterization of usability problems in structured data entry interfaces in dentistry.

BACKGROUND: Poor usability is one of the major barriers for optimally using electronic health records (EHRs). Dentists are increasingly adopting EHRs, and are using structured data entry interfaces to enter data such that the data can be easily retrieved and exchanged. Until recently, dentists have lacked a standardized terminology to consistently represent oral health diagnoses. OBJECTIVES: In this study we evaluated the usability of a widely used EHR interface that allow the entry of diagnostic terms, using multi-faceted methods to identify problems and work with the vendor to correct them using an iterative design method. METHODS: Fieldwork was undertaken at two clinical sites, and dental providers as subjects participated in user testing (n=32), interviews (n=36) and observations (n=24). RESULTS: User testing revealed that only 22-41% of users were able to successfully complete a simple task of entering one diagnosis, while no user was able to complete a more complex task. We identified and characterized 24 high-level usability problems reducing efficiency and causing user errors. Interface-related problems included unexpected approaches for displaying diagnosis, lack of visibility, and inconsistent use of UI widgets. Terminology related issues included missing and mis-categorized concepts. Work domain issues involved both absent and superfluous functions. In collaboration with the vendor, each usability problem was prioritized and a timeline set to resolve the concerns. DISCUSSION: Mixed methods evaluations identified a number of critical usability issues relating to the user interface, underlying terminology of the work domain. The usability challenges were found to prevent most users from successfully completing the tasks. Our further work we will determine if changes to the interface, terminology and work domain do result in improved usability.

Relação entre o senso de coerência e alterações bucais de adolescentes / Relationship between sense of coherence and oral health status in adolescents

O presente estudo transversal foi realizado com o objetivo de investigar a relação entre o Senso de Coerência (SOC) das mães e dos adolescentes e as alterações bucais (cárie, sangramento gengival e placa visível) de adolescentes. A amostra foi composta por 366 adolescentes entre 13 e 15 anos, matriculados no ensino findamental em escolas de Itabira, Minas Gerais e suas respectivas mães. Os dados foram coletados através de questionários e exame clínico para diagnóstico de cárie dentária, placa visível e sangramento gengival após a calibração do examinador (Kappa intra-examinador 0,81, 0,76 e 0,80 e inter-examinador 0,80, 0,88 e 0,88)...

Characterization of tooth structure and the dentin-enamel zone based on the Stokes-Mueller calculation.

This is the first study of dentin-enamel zone (DEZ) identification with tooth structure characterization based on the optical Stokes-Mueller measurement. Stokes vectors of a cross-sectional tooth slice were measured using various polarization inputs. The direction of the DEZ is different in enamel and dentin structures; therefore, the Stokes profiles can specifically characterize the structures based on the DEZ. This optical method, using polarimetry, provides a useful tool for characterizing tooth.