Relationship between erosive tooth wear and beverage consumption among a group of schoolchildren in Mexico City.

OBJECTIVE: To assess the association between erosive tooth wear (ETW) and consumption of different kinds of beverages in a group of schoolchildren 11-14 years old in Mexico City. METHODS: Cross-sectional study in a sample of students (n = 512) in Mexico City. The Basic Erosive Wear Examination (BEWE) was used to quantify ETW. Beverage consumption (BC) was determined using a frequency questionnaire; beverages included pure water, natural fruit juices, milk, hot beverages, and soft drinks. Ordinal logistic regression model was used to evaluate the association between the presence of ETW and BC. RESULTS: In total, 45.7% of the schoolchildren showed an initial loss of surface texture (BEWE = 1) and 18.2% a distinct defect involving loss of dental tissue (BEWE ≥ 2) in at least one tooth. For each glass (350 ml) of milk/week, the odds of not having erosive wear (BEWE = 0) versus having an initial loss of surface texture (BEWE = 1) or of having an initial loss of surface texture versus the presence of a defect involving the loss of dental tissue (BEWE ≥ 2) decreased 4% (OR = 0.96, 95% CI 0.93-0.99, p = 0.008); for each portion of sweet carbonated beverage consumed (350 ml), the odds increased 3% (OR = 1.03, 95% CI 1.001-1.07, p = 0.046). CONCLUSION: The intake of milk and milk-based products could be a dietary means of helping prevent ETW, especially if their consumption could replace sweet carbonated drink consumption. CLINICAL RELEVANCE: Knowing the impact of beverage consumption on ETW helps to provide suitable recommendations for the prevention and control of ETW in order to promote tooth longevity.

Impact of caries and dental fluorosis on oral health-related quality of life: a cross-sectional study in schoolchildren receiving water naturally fluoridated at above-optimal levels.

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.

Understanding the Dynamics of Inflammatory Cytokines in Endodontic Diagnosis: A Systematic Review.

The primary aim of this literature review is to delineate the key inflammatory cytokines involved in the pathophysiology of pulp inflammation. By elucidating the roles of these cytokines, a deeper comprehension of the distinct stages of inflamed pulp can be attained, thereby facilitating more accurate diagnostic strategies in endodontics. The PRISMA statement and Cochrane handbook were used for the search strategy. The keywords were created based on the review question using the PICO framework. The relevant studies were meticulously assessed according to predefined inclusion and exclusion criteria for this systematic review. A rigorous quality checklist was implemented to evaluate each included study, ensuring scrutiny for both quality and risk-of-bias assessments. The initial pilot search conducted on PubMed, Scopus, Cochrane, and WoS databases yielded 9 pertinent articles. Within these articles, multiple cytokines were identified and discussed as potential candidates for use in endodontic diagnosis, notably including IL-8, IL-6, TNF-α, and IL-2. These cytokines have been highlighted due to their significant roles in the inflammatory processes associated with pulp pathology. The identification of specific inflammatory cytokines holds promise for enhancing endodontic diagnostic procedures and exploring diverse treatment modalities. However, the current body of research in this area remains limited. Further comprehensive studies are warranted to fully elucidate the potential of cytokines in refining diagnostic techniques in endodontics.

Malocclusion and TMJ disorders in teenagers from private and public schools in Mexico City.

OBJECTIVE: To identify, among Mexican teenagers from public and private schools, the frequency, severity of malocclusion and orthodontic treatment needs, and their possible association with temporomandibular joint disorders. MATERIAL AND METHODS: Fifteen-year-old students were recruited from public and private schools. Clinical findings were registered as follows: oral hygiene status with the Oral Hygiene Index-Simplified, malocclusion using the Dental Aesthetic Index (DAI), and TMJ disorders following WHO criteria. Negative binomial and logistic regression models were constructed for data analysis. RESULTS: A total of 249 fifteen-year old students were included in the study (118 female 47.4%). 68% had a DAI score ≤ 25 (minor or no occlusal anomalies), 18% scored 26-30 (mild anomalies), 7% scored 31-35 (evident anomalies), and 6% scored ≥ 36 (major malocclusion). The most frequent anomalies were dental crowding in 50%, maxillary dental irregularity in 44.6%, mandible irregularity in 41.2% and excessive maxillary overjet in 37.8%. Among the students, 26.1% had clicking/muscle or TMJ pain, of these 12.3% showed pain during palpation. OHI-S > 1 was found in 34% of the participants. The negative binomial model showed an association between DAI score and TMJ disorders (P=0.041). Also the logistic regression model showed an association between malocclusion (DAI>25) and TMJ disorders (OR=2.58, p=0.002). Malocclusion was associated also with poor oral hygiene (OR=1.65, p=0.007), and with attendance to public schools (OR=1.97, p=0.039). CONCLUSIONS: TMJ disorders and DAI scores were significantly associated. Screening/Diagnostic programs for orthodontic and TMJ-disorders are needed, to identify and offer treatment to teenagers with major malocclusion and TMJ/muscle pain.

[Dental fluorosis prevalence in Mexican localities of 27 states and the D.F.: six years after the publication of the Salt Fluoridation Mexican Official Regulation]. / Prevalencia de fluorosis dental en localidades mexicanas ubicadas en 27 estados y el D.F. a seis anos de la publicación de la Norma Oficial Mexicana para la fluoruración de la sal.

OBJECTIVE: To identify the prevalence and severity of dental fluorosis in communities located in 28 states of Mexico. MATERIALS AND METHODS: The National Dental Caries Survey 2001 (NDCS2001) data base was analyzed. The information of 26,893 students, ages 12 and 15 years old, of 27 states and the Federal District was examined. Dean's dental fluorosis index was applied by standardized examiners. The fluorosis prevalence and the Community Fluorosis Index (FCI) were calculated. RESULTS: The fluorosis prevalence was 27.9% (95% CI 24.4, 28.5). A statistical significance difference in the fluorosis prevalence was observed among the states studied (p < 0.0001). The lowest prevalence was detected in Morelos (3.2%) and the highest in Durango (88.8%). In 18 (64.3%) of the states included more than 90% of the participants showed very mild or lower levels of the dental fluorosis index. A low level of the FCI was found in the localities belonging to 19 (67.9%) of the states studied (FCI < 0.4). The lowest FCI was found in Colima, Yucatán and Morelos. The highest FCI were found in Durango, Zacatecas, Aguascalientes and San Luis Potosí (1 ≤ ICF). This information indicates that in these states dental fluorosis is a public health problem. CONCLUSIONS: Two-thirds of the states had localities with low prevalence of dental fluorosis; however, approximately, one-third of the states investigated the fluorosis levels showed the need of a reduction in fluoride exposure among the young population.

Relationships between dental fluorosis and fluoride concentrations in bottled water and groundwater in low-income children in Mexico.

Introduction: The aim of the current study was to investigate associations between dental fluorosis in children living in low socioeconomic areas in Mexico, and fluoride concentrations in tap water, fluoride concentrations and in bottled water, and body mass index (BMI). Methods: A cross-sectional study involving 585 schoolchildren aged 8-12 years was conducted in communities in a southern state of Mexico with >0.7 parts per million (ppm) fluoride in the groundwater. The Thylstrup and Fejerskov index (TFI) was used to evaluate dental fluorosis, and the World Health Organization growth standards were used to calculate age-adjusted and sex-adjusted BMI Z-scores. A BMI Z-score ≤ -1 SD was used as the cut-off point for thinness, and multiple logistic regression models for dental fluorosis (TFI ≥ 4) were constructed. Results: The mean fluoride concentration in tap water was 1.39 ppm (SD 0.66), and the mean fluoride concentration in bottled water was 0.32 ppm (SD 0.23). Eighty-four children (14.39%) had a BMI Z-score ≤ -1 SD. More than half (56.1%) of the children presented with dental fluorosis in TFI categories ≥ 4. Children living in areas with higher fluoride concentrations in the tap water [odds ratio (OR) 1.57, p = 0.002] and bottled water (OR 3.03, p < .001) were more likely to have dental fluorosis in the severe categories (TFI ≥ 4). BMI Z-score was associated with the probability of dental fluorosis (TFI ≥ 4; OR 2.11, p < 0.001), and the effect size was 29.3%. Discussion: A low BMI Z-score was associated with a higher prevalence of dental fluorosis in the severe category. Awareness of the fluoride concentrations in bottled water may help prevent dental fluorosis, particularly in children exposed to several high fluoride content sources. Children with a low BMI may be more vulnerable to dental fluorosis.

Assessment of the Penetration of an Endodontic Sealer into Dentinal Tubules with Three Different Compaction Techniques Using Confocal Laser Scanning Microscopy.

Adequate root canal sealing is essential for the success of endodontic treatment. There are numerous techniques available; identifying simple and efficient techniques is important to provide good patient care. The purpose of the study was to compare the maximum penetration depth and the percentage of sealant penetration of an endodontic sealer into dentine tubules using cold lateral condensation, continuous wave, and hybrid techniques, and to contrast the effectiveness of two different tapered gutta-percha master cones (0.02 and 0.04). A sample of sixty single root teeth was used. Six experimental groups were formed from the three filling techniques and the two tapered master cones. Images were acquired using a confocal laser scanning microscope. In the apical root third, the penetration percentage was higher in the hybrid compared with the continuous wave technique. The results indicated a higher penetration depth of hybrid compared with cold lateral condensation in the middle and coronal thirds, and in the apical third, a higher penetration was identified in the hybrid group compared with the continuous wave group. No significant differences in penetration were found comparing 0.02 with 0.04 taper gutta-percha groups. The coronal cross-sections presented a higher penetration than the apical third sections. In conclusion, the hybrid technique a had higher maximum sealer penetration than the continuous wave in the apical third, and the coronal third hybrid and continuous wave had a higher penetration than cold lateral condensation.

Using the Expanded Andersen Model to Determine Factors Associated with Mexican Adolescents' Utilization of Dental Services.

Many factors contribute as facilitators of or barriers to adolescents' use of dental services. Guided by the expanded Andersen model for dental service utilization, the aim of this study was to identify factors associated with the use of dental services among adolescents ages 12-16 in south Mexico City (n = 247). Adolescents answered a questionnaire on predisposing factors (age and gender), enabling factors (socioeconomic status, oral health support, parental years of education, and previous dental treatments), and psychosocial and behavioral factors (attitudes towards oral health; knowledge of gingivitis; alcohol, drug, and tobacco use; and depressive symptoms), and they underwent a visual clinical exam to determine their need factors (caries and gingivitis). The adolescents reported whether or not they had attended a dental visit in the last year for any reason. Multiple logistic regression was used to evaluate these factors. Having oral health support increased the odds of a dental visit by 2.69 (95% CI = 1.24-5.84). Previous dental treatment increased the odds of a dental visit by 2.25 (95% CI = 1.12-4.52). The presence of depressive symptoms reduced the odds of a dental visit by 4% (OR = 0.96, 95% CI = 0.94-0.99). Enabling and psychosocial factors of oral health support and previous dental treatment were positively associated with the utilization of dental services, while depressive symptoms were negatively associated.

Validation of the CPQ8-10ESP in Mexican school children in urban areas.

UNLABELLED: The current indicators used to gather information on oral health in children are basically clinical indexes that register mainly dental caries, periodontal disease, and malocclusion. These indexes should be complemented with emotional and social aspects related to the individual experience and perception of oral health status. In order to obtain this information, valid instruments capable of evaluating the impact of oral health as it relates to the quality of life (OHRQoL) are required. The objective of the Child Perceptions Questionnaire (CPQ8-10) is to assess OHRQoL in children aged eight to ten years. CPQ8-10 consists of 25 questions divided into four domains: oral symptoms, functional limitation, emotional well-being, and social well-being. OBJECTIVE: The aim of this study was to validate the translated Spanish version of the Child Perceptions Questionnaire (CPQ8-10ESP) in use with Mexican urban children. MATERIAL AND METHODS: Three hundred fifteen students in Mexico City aged eight- to ten-years-old participated in this study. The CPQ8-10ESP questionnaire was self-administered in the classroom. Clinical data about caries and malocclusion were obtained. To assess test-retest reliability, the questionnaire was reapplied to a subgroup of children. RESULTS: Cronbach's alpha reliability coefficient was 0.89 for the total CPQ8-10ESP scale. The intraclass correlation coefficient was 0.67; a statistically significant difference was found in the CPQ8-10ESP mean score between children with caries and malocclusion; a significant correlation between general well-being ratings with all domains was found (p<0.001). General perception of oral health was associated with both oral symptoms (p=0.049) and emotional well-being (p=0.022) domains, as well as with the total scale (p=0.015). CONCLUSIONS: The CPQ8-10ESP version showed good validity and reliability for use with Mexican schoolchildren from urban areas.

Diagnosis of Dental Fluorosis Using Micro-Raman Spectroscopy Applying a Principal Component-Linear Discriminant Analysis.

Dental fluorosis is an irreversible condition caused by excessive fluoride consumption during tooth formation and is considered a public health problem in several world regions. The objective of this study was to evaluate the capability of micro-Raman spectroscopy to classify teeth of different fluorosis severities, applying principal component analysis and linear discriminant analysis (PCA-LDA), and estimate the model cross-validation accuracy. Forty teeth of different fluorosis severities and a control group were analyzed. Ten spectra were captured from each tooth and a total of 400 micro-Raman spectra were acquired in the wavenumber range of 250 to 1200 cm-1, including the bands corresponding to stretching and bending internal vibrational modes ν1, ν2, ν3, and ν4 (PO43-). From the analysis of the micro-Raman spectra an increase in B-type carbonate ion substitution into the phosphate site of the hydroxyapatite as fluorosis severity increases was identified. The PCA-LDA model showed a sensitivity and specificity higher than 94% and 93% for the different fluorosis severity groups, respectively. The cross-validation accuracy was higher than 90%. Micro-Raman spectroscopy combined with PCA-LDA provides an adequate tool for the diagnosis of fluorosis severity. This is a non-invasive and non-destructive technique with promising applications in clinical and epidemiological fields.

Body Mass Index and Dental Caries, a Five-Year Follow-Up Study in Mexican Children.

There are conflicting reports on a possible association between body mass index (BMI) and caries. Given the ongoing worldwide increase in obesity, we undertook a 5-year follow-up study on 201 Mexican schoolchildren to analyse their BMI and dental caries experience. The children's weight and height were recorded, and their BMI was calculated using the WHO tables. Decayed, missing, and filled surfaces in both dentitions (dmf/DMFS) were assessed annually according to WHO criteria by two calibrated researchers (Kappa value 0.92 p < 0.001). The means, standard deviation, an ANOVA, and Student's t-test were calculated to analyse the relationship between the variables. At baseline, the children had an average of 6.5 ± 0.5 years, a BMI of 17.2 ± 3.1 (CI95% 16.8-17.6). Their weight's classifications were 61% normal, 19% obese, 17% overweight, and 3% showed thinness. At the end of the study, their BMI were 20.6 ± 4.4 (CI95% 19.8-21.5), 53% normal, 15% obese, 30% overweight, and 2% thin. The children's dmfs decreased from 5.8 ± 9.2 to 1.8 ± 3.4 and the DMFS increased from 0.07 ± 05 to 1.4 ± 2.3. In this population based on a 5-year follow-up, caries prevalence and incidence were not significantly associated with the BMI. However, schoolchildren with malnutrition had the highest caries indexes.

[Validation of an instrument for measuring the effects of oral health on the quality of life of older adults in Mexico]. / Validación de un instrumento para medir el efecto de la salud bucal en la calidad de vida de 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% 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.

Evaluating the changes in molar incisor hypomineralization prevalence: A comparison of two cross-sectional studies in two elementary schools in Mexico City between 2008 and 2017.

BACKGROUND: Little information is available on the trends over time of the prevalence of molar incisor hypomineralization (MIH). This condition may be preventing dental caries decline. AIM: (a) To compare the prevalence of MIH, in Mexico City schoolchildren, evaluated in 2008 with a group evaluated in 2017, (b) to identify the association of MIH with dental caries, and (c) to assess the mother's perception of her child's oral health status. DESIGN: Two cross-sectional studies performed in 2008 and in 2017 were compared. The oral examiner and the selected schools were the same in both surveys. RESULTS: A total of 549 schoolchildren were evaluated. The prevalence of MIH in the first survey was 20.3%, and 31.9 % in the second survey, (p = .002). Children with MIH were more likely to have dental caries. The odds ratio was 2.24 (p = .036) and 4.18 (p ˂ .001) in the first and second surveys, respectively. Mothers of children with MIH perceived worse oral health status of their children than the mothers whose children did not have MIH (odds ratio = 4.47, p ˂ .001). CONCLUSION: The findings portray a clear increase in prevalence of MIH and highlight the need for increased awareness about this condition among dentists and the general population.

Fissure Depth and Caries Incidence in First Permanent Molars: A Five-Year Follow-Up Study in Schoolchildren.

This study aimed to evaluate the association between the fissure depth (tooth morphology) of permanent molars and dental caries incidence with a five-year follow-up period. In total, 110 Mexican schoolchildren aged seven years were recruited at baseline, of which 88 children completed the follow-up assessments. The fissure depths of the first permanent lower molars were recorded, and dental caries [decayed, missing, and filled deciduous surfaces (dmfs) and decayed, missing, and filled permanent surfaces (DMFS)] was evaluated annually. A generalized estimating equation model was constructed for evaluating the association between dental caries and fissure depth. The initial and final DMFS scores were 0.02 (±0.2) and 1.55 (±2.49), respectively. The generalized estimating equation model showed that children with deep molar fissures were more likely to develop caries lesions, (Odds Ratio OR = 3.15, p = 0.028) compared to children with shallow fissures. Moreover, dental caries in primary teeth (OR = 1.07, p = 0.005) was associated with the development of carious lesions in the permanent dentition. Fissure depth was a useful predictor of dental caries, according to this five-year follow-up study. The detection of deep occlusal fissures in the lower first permanent molars could contribute to the identification of children at high risk of dental caries. Tooth morphology may be used to identify children at a higher caries risk, particularly in settings with limited resources.

Prevalence and Severity of Molar-Incisor Hypomineralization, Maternal Education, and Dental Caries: A Cross-Sectional Study of Mexican Schoolchildren with Low Socioeconomic Status.

OBJECTIVES: The aims of this study were to identify the prevalence of molar-incisor hypomineralization (MIH) in a group of low-income schoolchildren and to evaluate the role of maternal education on MIH and dental caries in these children. MATERIALS AND METHODS: This cross-sectional study enrolled 686 schoolchildren. To evaluate dental caries, the International Caries Dental Assessment System II (ICDAS) criteria were utilized. MIH was assessed by using the European Academy of Paediatric Dentistry criteria. Mixed-effects models were applied for the data analysis. RESULTS: The prevalence of MIH was 35.4% (244). Most children exhibited moderate MIH (163, 67.1%), followed by mild MIH (45, 18.5%) and severe MIH (35, 14.4%). Caries presence in the first permanent molars, evaluated using ICDAS score, indicated that the mean number of noncavitated and cavitated lesions (ICDAS ≥2) was 0.90 (±0.30); the mean number of lesions with ICDAS ≥3 was 0.36 (±0.48). Odds ratio (OR) analysis of MIH severity revealed that the children of mothers with low education were more likely to exhibit MIH (OR 2.13; 95% confidence interval [CI]: 1.25-3.85). Modeling of dental caries (ICDAS ≥3) revealed that low maternal education (OR 2.27; 95% CI: 1.25-4.16) and the presence of MIH (OR 4.37; 95% CI: 3.05-6.25) were associated with dental caries. CONCLUSIONS: There were associations between low maternal education and both MIH and dental caries. The presence of both initial and cavitated caries lesions was associated with MIH. Dentists should offer adequate advice to mothers with children with MIH, based on their educational background.

A Comparison of Ki67, Syndecan-1 (CD138), and Molecular RANK, RANKL, and OPG Triad Expression in Odontogenic Keratocyts, Unicystic Ameloblastoma, and Dentigerous Cysts.

BACKGROUND AND OBJECTIVE: Reduced expression of syndecan-1 (CD138), increased proliferation index, and modifications in the expression of the molecular RANK/RANKL/OPG triad are related to an intensified potential of aggressiveness and invasion of diverse tumors and cysts. The aim was to compare the expression of Ki-67, CD138, and the molecular triad RANK, RANKL, and OPG in odontogenic keratocysts (OKC), unicystic ameloblastomas (UA), and dentigerous cysts (DC). METHODS: Immunohistochemistry for Ki-67, CD138, RANK, RANKL, and OPG was performed in 58 odontogenic cystic lesions (22 OKC, 17 DC, and 19 UA). RESULTS: A higher expression of Ki-67 was identified in OKC as compared to UA (p < 0.0001). UA exhibited a greater loss of CD138 expression versus OKCs (p > 0.0034). RANKL was expressed higher in the epithelium (p = 0.0002) and in the stroma (p = 0.0004) of UA. DC had a lower expression of these markers. CONCLUSION: Higher RANKL expression together with the reduction on CD138 expression in UA could be linked to a greater invasive and destructive potential, while the increased proliferation rate observed in OKC could be related to its continuous intrabony growth. The expansion of DC does not seem to be related to such factors, justifying the different therapeutic approaches proposed for each of these entities.

[Periodontal disease in type 2 diabetes patients with and without chronic renal failure]. / Enfermedad periodontal en pacientes diabéticos con y sin insuficiencia renal crónica.

OBJECTIVE: To estimate and compare periodontal disease prevalence (PD) in two groups of patients with type 2 diabetes (T2D), with and without end stage renal disease (ESRD) and dialysis. MATERIAL AND METHODS: Using a cross sectional design, two groups of patients with type 2 diabetes were examined in two general hospitals belonging to Instituto Mexicano del Seguro Social in San Luis Potosí. Group A were patients with ESRD and dialysis; Group B, patients with serum creatinine < 2.0 mg/dL. The WHO Community Periodontal Index (CPI) was used to assess PD. 233 patients were examined among which 172 had functional tooth, suitable for PD evaluation. RESULTS: 71 patients integrated group A; their mean age was 56.2 +/- 11.8 years. 101 patients integrated group B, their mean age was 56.7 +/- 11.9 years (p = 0.768). Elapsed time from T2D diagnosis was 221 +/- 86 months for group A, and 126 +/- 101 months for group B (p < 0.001). Poor oral hygiene was found in 39.8 % of group A patients, and 34.6 % of group B patients (p = 0.133). PD prevalence, with CPI scores 3 and 4, was 63.4 % for group A, and 72.3 % for group B (p = 0.216). Multiple linear regression analysis found PD severity associated to ageing (p < 0.001), poor oral hygiene (p < 0.001) and for group A a shorter time from T2D diagnosis to ESRD (p = 0.0315). ESRD hemodialysis patient's PD was more severe than that of peritoneal dialysis patients (p < 0.03). CONCLUSIONS: both groups had high prevalence of PD and poor oral hygiene. Patients treated with haemodialysis had more severe PD than peritoneal dialysis patients. A shorter time from DM diagnosis to ESRD was found associated to more severe PD.

Enzymatic Activity of Glutathione S-Transferase and Dental Fluorosis Among Children Receiving Two Different Levels of Naturally Fluoridated Water.

This study was conducted to measure the activity of the enzyme glutathione S-transferase (GST) in saliva and to compare the activity of this enzyme in children with and without dental fluorosis in communities with different concentrations of naturally fluoridated water. A total of 141 schoolchildren participated in this cross-sectional study. Children were selected from two communities: one with a low (0.4 ppm) and the other with a high (1.8 ppm) water fluoride concentration. Dental fluorosis was evaluated by applying the Thylstrup and Fejerskov Index (TFI) criteria. Stimulated saliva was obtained, and fluoride concentration and GST activity were measured. The GST activity was compared among children with different levels of dental fluorosis using multinomial logistic regression models and odds ratios (OR). The mean age of the children was 10.6 (±1.03) years. Approximately half of the children showed dental fluorosis (52.5 %). The average GST activity was 0.5678 (±0.1959) nmol/min/µg. A higher concentration of fluoride in the saliva was detected in children with a higher GST activity (p = 0.039). A multinomial logistic regression model used to evaluate the GST activity and the dental fluorosis score identified a strong association between TFI = 2-3 (OR = 15.44, p = 0.007) and TFI ≥ 4 (OR = 55.40, p = 0.026) and the GST activity level, compared with children showing TFI = 0-1, adjusted for age and sex. Schoolchildren with higher levels of dental fluorosis and a higher fluoride concentration in the saliva showed greater GST activity. The increased GST activity most likely was the result of the body's need to inactivate free radicals produced by exposure to fluoride.

Impact of Dental Fluorosis, Socioeconomic Status and Self-Perception in Adolescents Exposed to a High Level of Fluoride in Water.

Objective: To identify adolescents' self-perception of dental fluorosis from two areas with different socioeconomic levels. Methods: A cross-sectional, descriptive study was conducted with 15-year-old youths by applying a questionnaire designed and validated to assess self-perceptions of dental fluorosis in two areas with different socioeconomic statuses (SESs). Fluorosis was clinically evaluated by applying the Thylstrup and Fejerkov (TF) index on the upper front teeth. Results: A total of 308 adolescents were included in the study. The medium-SES population, which was exposed to 2.5 ppm of fluoride in water, and the low-SES population, which was exposed to 5.1 ppm, presented the following levels of dental fluorosis: TF 2-3 (50%), TF 4-5 (45.6%) and TF 6-7 (4.4%) for medium SES and TF 2-3 (12.3%), TF 4-5 (67.1%) and TF 67 (20.6%) for low SES. A significant association was found between self-perception and dental fluorosis in those with medium and low SESs (p < 0.05). The multiple regression model found differences between TF levels and self-perception, with a 6-7 TF level for concerns about color (OR = 1.6), smile (OR = 1.2) and appearance (OR = 3.36). Conclusions: Self-perceptions of dental fluorosis affect adolescents such that adolescents with a medium SES have more negative perceptions than those with a low SES. Such perceptions increase as the TF index increases.

Prevalence of erosive tooth wear and associated factors in a group of Mexican adolescents.

BACKGROUND: Erosive tooth wear is the irreversible loss of dental hard tissue as a result of chemical processes. When the surface of a tooth is attacked by acids, the resulting loss of structural integrity leaves a softened layer on the tooth's surface, which renders it vulnerable to abrasive forces. The authors' objective was to estimate the prevalence of erosive tooth wear and to identify associated factors in a sample of 14- to 19-year-old adolescents in Mexico. METHODS: The authors performed a cross-sectional study on a convenience sample (N = 417) of adolescents in a school in Mexico City, Mexico. The authors used a questionnaire and an oral examination performed according to the Lussi index. RESULTS: The prevalence of erosive tooth wear was 31.7% (10.8% with exposed dentin). The final logistic regression model included age (P < .01; odds ratio [OR], 1.64; 95% confidence interval [CI], 1.26-2.13), high intake of sweet carbonated drinks (P = .03; OR, 1.81; 95% CI, 1.06-3.07), and xerostomia (P = .04; OR, 2.31; 95% CI, 1.05-5.09). CONCLUSIONS: Erosive tooth wear, mainly on the mandibular first molars, was associated with age, high intake of sweet carbonated drinks, and xerostomia. PRACTICAL IMPLICATIONS: Knowledge regarding erosive tooth wear in adolescents with relatively few years of exposure to causal factors will increase the focus on effective preventive measures, the identification of people at high risk, and early treatment.