Oral health of children from rural excluded villages (Trancas and Calchaqui valleys. Tucumán, Argentina).

UNLABELLED: The general hypothesis of the study was to evaluate strategically important rural areas to confirm their characteristics of "excluded population" and identify the priorities to allocate human and financial resources of the international co-operation project. The aim of this study was to establish the degree of development of villages in the Trancas and Calchaqui valleys, and the oral health of children living in areas involved in an integral study on excluded villages in the northwest of Argentina. These villages are considered a priority in the UNIR Project; they are thus strategically important as a link with countries of the MERCOSUR. Data on living conditions were obtained through direct inquiries (Project UNIR, W. K. Kellogg Foundation/University of Tucumán) and from data supplied by the Ministry of Economy, by the Ministry of Culture and Education and by the SIEMPRO project of the Secretariat of Social Development of the Ministry of Health. The Human Development Index (HDI) was calculated as World Bank criteria (1995), The studies on dental conditions were carried out in all the children between 12 and 14 years old, that is a total of 58 in the Trancas Valley and 212 in the Calchaqui Valley. RESULTS: (1) The HDI was 0.731 for the province, 0.56 for the Trancas Valley and 0.51 for Calchaqui valley. (2) The results are above the values for the country in the first case, and below the average country values for the valleys. (3) The percentage of BNN families reached 92%. The results for oral health show: (4) the DMFT were 6.34 +/- 0.07 in the Trancas Valley and 7.47 +/- 0.276 in the Calchaquí valley. (5) Carious teeth (CT) were the most important component of this index. (6) The absence of a specific and preventive assistance. CONCLUSIONS: (a) Children between 12 and 14 living in the Valleys of Trancas and Calchaqui (Tucumán, Argentina) are affected by severe levels of caries, with values above the national and province means. (b) The human development index is below that of the corresponding national and province levels. (c) Inhabitants of these valleys can be identified as socially and biologically highly vulnerable. (d) The indicators of cariogenic risk reveal the importance of introducing oral preventive care components to the health plan for the area focused on the excluded population.

Relation between demographic and epidemiological characteristics and permanency under a dental health care program for HIV infected patients.

The association between factors involved in health care and the health status of the people has been proven. The use of health care services, particularly in the case of patients who suffer from chronic pathologies, has been the object of many studies aimed at establishing factors which contribute to guarantee permanence in treatment and implementation of health care controls. The purpose of the present study was to identify the response of HIV infected or AIDS patients to the oral health care program and establish the association between permanence in treatment and the presence of risk factors, epidemiological or demographic conditions of the users. Ninety patients selected at random from the 300 who attended the Clinic for High Risk Patient Care, School of Dentistry, University of Buenos Aires (CLAPAR, Spanish acronym) during 1994-1995 were included in this study. The patients were assigned to one of seven groups, according to their permanence in treatment and commitment to the program during the phase of maintenance in health. Each of these categories was characterized in terms of age, sex, educational level, place of residence (CIRFS, 1990), type of job, type of health coverage and place where healthcare was received, risk behavior and date of positive serological diagnosis. The frequency of each variable was established. Contingency tables were employed to establish the statistical significance of the association between the different variables and the patient categories. The data revealed that 24.2% of the patients performed occasional or emergency consultation, 57.1% achieved discharge with or without the assistance of the social worker or are still in treatment and 18.7% abandoned the program. Significant association were found between the response to odontological treatment and the following variables: place of residence, date of positive serological diagnosis, and risk behavior. We may conclude that certain demographic, epidemiological or life-related factors would be linked to the response to odontological treatment.

Effect of self-brushing with acidulated phosphate fluoride (pH 5.6) on dental caries in children.

The aim of this work was to study the effect of a preventive program on the dental plaque and on the caries incidence in school children. The program comprised weekly supervised self brushing with acidulated phosphate fluoride (APF) gel (pH 5.6; concentration: 4520 ppm of ion F-). The program involved 240 children of 1st., 3rd and 5th grade of a primary school in the City of Buenos Aires (Argentina). The population was divided in 2 groups: A (experimental) and B (control). Ninety children from both groups (45 experimental and 45 control) were submitted to baseline clinical examination (DMFT and plaque index) and microbiological analysis (total streptococci, St mutans and St. mutans and St. mutans percentage). Group A was then submitted to a preventive program which included self brushing with APF gel (4520 ppm of ion F-). The 90-children sample was monitored after 1 and 2 years of program. Results were statistically processed and they revealed the following: a--DMFT was significantly greater in the control group than in the experimental group after 1 and 2 years of program; b--an 81.43% reduction in caries increment rate at the end of the 2-years program in the experimental group as compared to the control group; c--a rise in the number of colonies of total streptococci and of St. Mutans; d--a reduction in the % of St. mutans in the total streptococci flora in the plaque of children in the experimental group; e--the presence of St. mutans colonies featuring a rough surface; f--the effectiveness of the program in the modifying the profile of the diagnosed dental pathology.

Modelo para la toma de decisiones en atención odontologica: descripción y puesta a prueba de un modelo de intervención a nivel local / Modelo para a tomada de decissões na assistênciaodontológica: descrição e teste de um modelo deintervenção local / Model for decision making in dental care: description and testing of an intervention model at local level

Objetivo: Describir un modelo para analizar la atención odontológica de un área geográfica local para facilitar toma de decisiones en la atención basadas en la evidencia científica. Metodología: La metodología incorpora (a) el diseño del modelo (MI) y (b) su aplicación probatoria en un municipio (capital de provincia). (a) El modelo propuesto, construido desde un enfoque estratégico, incluye tres estadíos (MM). El MM1 (identificatorio) consiste en la identificación de los problemas mediante recopilación de datos primarios y secundarios. El MM2 (analítico) plantea el análisis cuanti-cualitativo de los datos relevados. El MM3 (propositivo) a partir de la información analizada y priorizada, formula recomendaciones en dimensiones social, jurídico administrativa, epidemiológica, perceptual e investigativa. (b) La aplicación probatoria del modelo incluyó la identificación, análisis y priorización de los ejes problemáticos surgidos de los datos censales, de estadísticas de servicios de salud y de los programas vigentes. Los datos fueron procesados mediante una matriz explicativa y la fórmula de Hanlon. Un análisis FODA (interno y externo) permitió realizar recomendaciones y su potencial traslación a decisiones educativo-sanitarias. Resultados: (1) La puesta a prueba del modelo en una base territorial local (municipio) permitió la identificación rápida de problemas de la atención odontológica y la integración de la información recogida. (2) El modelo facilitó la traduccióndel estado de salud buco-dental en actividades educativo-sanitarias de alcance local, con eventual impacto sobre la salud de la población cubierta. Conclusiones: El MI puede ser aplicado en tiempo corto y obtener información oportuna para la toma de decisiones en un área local.

Objective: To describe a model to analyze dental care in a local geographical location inorder to facilitate decision making related to care, based on scientific evidence.Methodology: The methodology includes (a) model design (MI) and (b) its testingapplication in a municipality (capital of the province). (a) The suggested model, builtfrom a strategic approach, includes three stages (MM). MM1 (identifying) consists in theidentification of problems through the collection of primary and secondary data. MM2(analytic) related to the quantitative and qualitative analysis of the collected data. From theanalyzed and prioritized information, the MM3 (propositive) makes recommendations inthe social, legal-administrative, epidemiologic, perceptual and investigative areas. (b) Thetesting application of the model included the identification, analysis and prioritization ofthe problematic focuses arising from census data, statistics from health services and currentprograms. Data were processed with an explicative matrix and Hanton´s formula. A SWOTanalysis (internal and external) made it possible to make suggestions and their potentialtransfer to health and education decisions.Results: (1) Testing the model in a local territory base (municipality) allowed the quickidentification of problems in dental care and the integration of the collected information. (2)The model facilitated the translation of dental status into local reach health and educationalactivities, with possible impact on the health of the covered population. Conclusions: TheMI can be applied in a short time and used to get timely information for decision makingin a local area.

[Dental caries]. / Caries dental.

Recent studies on the etiology and prevention of dental caries are synthetized. Caries is an infectious disease produced by the bacterial plaque where microorganisms act upon hydrocarbon substrate producing acids (lactic, pyruvic, acetic, etc.). These acids decalcify the enamel surface producing the carious cavity. The three types of caries are mentioned: 1. The sucrose-dependent caries on the free surfaces of the tooth with the Streptococcus mutans predominance. 2. The pits and fissures caries with Lactobacillus acidophilus predominance. 3. The root caries with Acinomyces viscosus predominance. Caries prevention points out to three aspects. 1. Increasing tooth resistance through the use of ingested fluoride and/or topical fluorides and pits and fissure sealants. 2. A profuse and promising research work on control of microbial plaque is being done. Meanwhile, the correct and periodically controlled toothbrushing is still the most efficient preventive measure. 3. Diet control. Being carbohydrates a deep rooted habit of our modern culture, its control has to be carefully evaluated. A judicious and reduced strategic consumption of carbohydrates and the use of substitutes are useful ways of achieving the preventive aims.

[Evaluation of non-conventional teaching methods]. / Evaluación de métodos de enseñanza no convencionales.

The article compares the learning performances of dentistry students in participative theory classes and using self-teaching modules. The subjects were a group of third-year students in the School of Dentistry of the University of Buenos Aires, who were divided into two subgroups, one that attended the participative theory class and the other that used the self-teaching modules. The information imparted was exactly the same in both cases. A written test was administered and graded by the instructors. The process was repeated with another group of students using other subject matter. The findings of this study showed that there was no significant difference between the two methods in terms of student performance. The self-teaching modules improved the learning results of the group of students with the lower performance rating, which indicates that this teaching method is particularly effective for students conventionally rated as poor performers.