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Considerable health inequities occur among people who are incarcerated, with ripple effects into broader community health. The Indiana Peer Education Program uses the Extension for Community Health Outcomes (ECHO) model to train people who are incarcerated as peer health educators. This analysis sought to evaluate the effectiveness of this program and explore emergent themes not covered in survey instruments. Survey data for both peer educators and their students were assessed using multivariate regression. Qualitative data were used to triangulate survey findings and explore additional themes via thematic analysis. Students showed improvements in knowledge scores and postrelease behavior intentions; peer educators improved in knowledge, health attitudes, and self-efficacy. Qualitative data affirmed survey findings and pointed toward peer educators acquiring expertise in the content they teach, and how to teach it, and that positive results likely expand beyond participants to others in prison, their families, and the communities to which they return. Though preliminary, the results confirm an earlier analysis of the New Mexico Peer Education Program ECHO, adding to the evidence that training individuals who are incarcerated as peer educators on relevant public health topics increases health knowledge and behavior intentions and likely results in improvements in personal and public health outcomes.
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Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Grupo Paritario , Prisioneros , Humanos , Indiana , Masculino , Femenino , Educación en Salud/organización & administración , Adulto , Persona de Mediana Edad , AutoeficaciaRESUMEN
Purpose: The purpose of this study was to longitudinally evaluate follow-up treatment on primary teeth initially treated with silver diammine fluoride (SDF). Methods: This retrospective cohort evaluated private insurance (not Medicaid) claims data from 2018 to 2019 for children no older than 12 years with at least one primary tooth initially treated with SDF. Additional treatment per tooth was recorded over a follow-up of at least 24 months. Results: The mean and standard deviation (±SD) age of 46,884 patients was 5.7±2.3 and for SDF-treated teeth per patient was 2.6±2.1. Forty percent (95 percent confidence interval [95% CI] equals 39 to 40.7 percent) of teeth initially treated with SDF received additional treatment. The odds of SDF-treated teeth receiving future treatment significantly decreased with patient age by 22 percent per year (odds ratio equals 0.78; 95% CI equals 0.077 to 0.79; P<0.001). Pediatric dentists had only slightly lower odds than general dentists for providing additional treatment (0.91, P<0.001). Posterior teeth and teeth expected to exfoliate in two or more years had significantly higher odds of receiving additional treatment (2.47 and 1.27, respectively, P<0.001). Conclusions: Beginning at age four, patient age at placement of silver diammine fluoride was inversely proportional to future treatment provided. Posterior teeth and teeth expected to exfoliate in two or more years were more likely to receive additional treatment.
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Fluoruros Tópicos , Revisión de Utilización de Seguros , Compuestos de Plata , Diente Primario , Humanos , Niño , Fluoruros Tópicos/uso terapéutico , Estudios Retrospectivos , Femenino , Masculino , Preescolar , Estudios Longitudinales , Compuestos de Plata/uso terapéutico , Estudios de Seguimiento , Cariostáticos/uso terapéutico , Caries Dental/prevención & control , Atención Dental para Niños , Seguro Odontológico , Compuestos de Amonio CuaternarioRESUMEN
The objective of this study was to quantify the prevalence of and identify the factors associated with dental pain among elementary- and middle-school students in Mexico. An ecological study was carried out with data from the 2008 National School-based Student-Health Survey. Information on dental pain from schoolchildren (aged 5 to 16 years) was collected from public schools across the 32 states of Mexico. In the original study, a questionnaire was used to explore various factors that affect the oral and dental health status of schoolchildren. The outcome variable was the prevalence rate (for dental pain) reported at state level. Various contextual socioeconomic variables were included, in addition to dental caries. Analyses were performed using Stata software. 52.9% of interviewees were girls; 26.9% of male and female schoolchildren in Mexico experienced gum or dental pain during the period analyzed (95% Confidence Interval = 26.02, 27.77%); according to the Spearman correlation results, self-reported dental pain was unrelated (p > 0.05) to the socioeconomic and sociodemographic variables that make up the Gross Domestic Product (GDP) and the Human Development (HDI), as well as the marginalization and the Gini indices. However, the estimated percentages of self-reported dental pain and caries were positively correlated in the elementary- (r = 0.8958, p < 0.0001), middle-school (r = 0.8958, p < 0.0001) and total populations (r = 0.8542, p < 0.0001). Prevalence of self-reported dental pain was 28%, or about one in three, of the Mexican children and adolescents in the study sample. The state-level sociodemographic and socioeconomic risk indicators were not associated with the prevalence of dental pain. Self-reported caries was positively correlated with self-reported dental pain.
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Autoinforme , Odontalgia , Humanos , México/epidemiología , Niño , Femenino , Masculino , Adolescente , Odontalgia/epidemiología , Prevalencia , Preescolar , Caries Dental/epidemiología , Factores SocioeconómicosRESUMEN
Recruiting and retaining Hispanic/Latinx (H/L) participants, specifically undocumented immigrants, is challenging in part because of the mistrust and fear in participating in research studies. Additionally, only a few longitudinal studies describe the recruit and retention strategies among Mexican and Central American immigrants aiming to expand the knowledge base about those underprivileged groups; this was the objective of the 6-year longitudinal VidaSana study. In the present methods report, we specifically omit the presentation of results from the empirical data findings of the VidaSana study: the present report describes the process and offers a subjective appraisal of multiple and complementary approaches in the recruitment and retention strategies for Hispanics living in the Midwest region of the United States, including very recently arrived immigrants. This study was able to effectively recruit and retain (81.7%) a cohort of Mexican and Central American immigrants within a period of 36 months. Our recruitment and retention performance were successful in the context of the hostile environment against immigration that dominated the national landscape at the time of our study. The present methods report of the VidaSana study provides an insightful understanding in recruiting and, in particular, retaining H/Ls and H/L recent immigrants into longitudinal studies.
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OBJECTIVES: This study examined how Mexican and Central American immigrants' social support was associated with three selected dental outcomes among recent immigrants, prior to the 2020 COVID-19 pandemic. METHODS: Using baseline wave data from the 2017-2022 VidaSana study about the health and social networks of Mexican and Central American immigrants living in Indiana, this study utilized logistic and ordinal logistic regression to predict lifetime fluoride use, lifetime dental restoration and flossing frequency, across levels of social support and differences between Mexican and Central American immigrants. RESULTS: Data from 547 respondents were included in the present analysis (68% women; mean age 34.4 years [SD 11.2]; Central American 42%; Mexican 58%). Results show a high level of social support was associated with increased probability of fluoride use, dental restoration and higher flossing frequency for Mexican immigrants. However, social support for Central American immigrants was associated with a decreased likelihood of fluoride use, more infrequent flossing, and had no significant association with dental restorations experience. What would be a negative association between Central American immigrants and dental restoration was accounted for by education level and never having been to a dentist. CONCLUSIONS: While higher social support was linked to beneficial outcomes for oral health in Mexican immigrants, the opposite was found in Central Americans. These findings highlighted the complexities of social relationships among new immigrants, and potential heterogeneity within the Hispanic population, particularly regarding social and behavioural measures as they pertain to oral health. Further research is needed to identify the underlying mechanisms producing both differences in social support and oral health outcomes.
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Emigrantes e Inmigrantes , Fluoruros , Adulto , Femenino , Humanos , Masculino , América Central , Estudios Transversales , Fluoruros/uso terapéutico , Americanos Mexicanos , México/epidemiología , Pandemias , Apoyo Social , Adulto Joven , Persona de Mediana Edad , Pueblos de CentroaméricaRESUMEN
Improving understanding of behaviors that increase or reduce cancer risk for different Hispanic groups is a public health priority; such knowledge is sparse in new gateway immigration locations such as Indiana. The aims of this study were to: 1) describe cancer beliefs and cancer preventive/risk reduction behaviors (physical activity, tobacco, and alcohol use) among Hispanic adults; 2) examine differences in cancer beliefs and preventive behaviors by country/territory of birth, socioeconomic status, and area of residence (urban vs. rural); and 3) determine predictors of engagement in cancer prevention and risk reduction behaviors in this population. A cross-sectional online survey targeted adult Indiana residents who identified as Latino, Hispanic, or Spanish recruited using Facebook-targeted advertising. Complete survey data from 1520 respondents were analyzed using descriptive, unadjusted, and adjusted models. The majority of respondents believed they were unlikely to get cancer but held many other fatalistic beliefs about cancer. Only 35.6% of respondents had received the HPV vaccine, 37.6% reported they were currently smoking cigarettes, and 64% reported occasional or frequent drinking of alcohol. Respondents spent an average of 3.55 days per week engaged in moderate exercise. Differences were observed by country/territory of birth, income, and education but not by rural residence status. Predictors of cancer risk/risk reduction behaviors were identified. The Hispanic population in Indiana is diverse and effective interventions for cancer prevention should be culturally targeted based on country/territory of birth and individually tailored based on cancer-related beliefs.
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The objective of the present study was to identify the reasons for dental extractions in patients seeking dental care in a university dental clinic in Mexico. This is a cross-sectional study that assessed 284 consecutive patients at the School of Dentistry, Autonomous University of the State of Mexico between August 2017 and November 2018. In total, 505 extractions were performed. The dependent variable was the reason for extraction: 0) dental caries and ensuing sequels (reference category); 1) periodontal disease and ensuing sequels; and 2) other reasons. Sociodemographic, socioeconomic, and clinical variables were included as independent variables. The analysis was done with multinomial logistic regression (Stata 14.0). Out of all extractions, 63.6% (n=321) were due to dental caries and ensuing sequels; 22.0% (n=111) were due to periodontal disease and ensuing sequels; 5.3% (n=27) endodontic failure; 5.1% (n=26) prosthetic indications; 1.6% (n=8) orthodontic indications; and the rest (2.4%) were due to other reasons. In the multivariate model extractions due to periodontal disease vs dental caries were associated with occasionally smoking tobacco (Odds Ratio, OR=3.90) or daily tobacco use (OR=3.19); the tooth to be extracted having been previously restored (OR=2.35); extracted anterior as opposed to posterior teeth (OR =2.63); and patients with multiple extractions (OR=2.68). In the case of extractions due to "other reasons", no variable was significant. Dental caries and periodontal disease were the main reasons for dental extraction in this sample. Several variables, mostly clinical, were associated with extractions for periodontal reasons.
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Caries Dental , Enfermedades Periodontales , Humanos , Caries Dental/epidemiología , Caries Dental/complicaciones , Extracción Dental , Estudios Transversales , Enfermedades Periodontales/epidemiología , Enfermedades Periodontales/complicaciones , DemografíaRESUMEN
Objective: The study examines the association of gender, parenthood, and marriage with reports of perceived pandemic precarity among Mexican and Central American immigrants during the COVID-19 pandemic (Fall 2020) to understand predictors of vulnerability in periods of crisis. Background: Latinos/as, immigrants, parents, and women have faced significant challenges during the COVID-19 pandemic. Family structure, along with social expectations for gender (i.e., self-sacrificing femininity for women and hegemonic masculinity for men), parenthood, and marriage may explain perceptions of pandemic precarity - defined as the material deprivation and economic anxiety resulting from the COVID-19 pandemic. Method: This study used data from the Hispanic COVID-19 Rapid Response Study (n=400), a follow-up of the VidaSana Study of Mexican and Central American immigrants, to examine how family structure is associated with pandemic precarity (i.e., food, housing, and economic insecurity). Using linear regression models, average marginal effects (AMEs), and tests for group differences we investigate the independent and interactive effects of gender, parenthood, and marriage on pandemic precarity. Results: Men and parents reported the highest pandemic precarity. Fathers reported higher pandemic precarity than mothers. For men, marriage is associated with greater precarity, and for women, marriage is associated with less precarity, yet marriage increased precarity for those without children. Conclusion: We discuss the importance and implications of examining gender along with family structure to understand how immigrant families were faring in response to the pandemic.
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The objective of this systematic review was to evaluate the current evidence of case reports where the treatment for permanent teeth with a diagnosis of irreversible pulpitis was a full pulpotomy. This study was carried out by two reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic electronic search was carried out in the PubMed, Google Scholar, and Scopus databases until the year 2022 to find articles in English where the treatment for irreversible pulpitis in permanent teeth was a full pulpotomy. Literature reviews, in vitro or animal studies, abstracts, and unpublished data were excluded. The intervention, control, and outcome parameters were selected following the "Population, Interventions, Control, and Outcome" (PICO) guidelines. A total of 636 articles were found, and 14 articles were selected to be included in this review. The selected articles describe cases of full pulpotomies in mature permanent teeth with a diagnosis of irreversible pulpitis with a total of 34 (100%) successful cases, where 18 were men and 16 were women, with an average age of 19.20 ± 10.59 years and an average follow-up of 35.82 ± 26.39 months, with 12 months being the minimum follow-up time. The material used most frequently for obturation of the full pulpotomy was mineral trioxide aggregate in 16 cases (47.06%). Within the limitations of this review, full pulpotomy presents a high success rate regardless of the tooth, age, or sex as a treatment for teeth diagnosed with irreversible pulpitis.
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BACKGROUND: Caries is one of the most prevalent diseases affecting children. Topical fluoride is used to decrease the incidence of caries. The purpose of this study was to investigate the impact of fluoride varnish and gel applications on future restorative dental treatment claims. METHODS: The data were obtained in conjunction with a dental data warehouse through a partnership agreement. A retrospective analysis of dental claims made from 2010 through 2018 was completed. Data were extracted for patients aged 1 through 8 years with topical fluoride application and its subsequent impact on restorative dental claims. RESULTS: Data for 672,889 patients were included in the analysis. Patients who received topical fluoride had significantly lower numbers (P < .001) of restorative procedures and extractions per year and significantly increased time (P < .001) to their first restorative procedure or extraction after the index visit than patients who did not receive topical fluoride. CONCLUSIONS: The application of fluoride varnishes and gels increased the time to future restorative and extraction dental claims and decreased the number of future restorative and extraction dental claims. PRACTICAL IMPLICATIONS: This study is important because it found that the use of topical fluoride decreased the number of future restorative and extraction dental claims.
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Caries Dental , Fluoruros Tópicos , Niño , Humanos , Fluoruros Tópicos/uso terapéutico , Cariostáticos/uso terapéutico , Estudios Retrospectivos , Caries Dental/prevención & control , Fluoruros , GelesRESUMEN
BACKGROUND: Advancements in dental materials and changing parental preferences are modifying the frequency of use of restorative materials. This insurance claims analysis examined the trends in the use of amalgam and resin composite in the United States. METHODS: Commercial dental insurance claims were analyzed to compare 505,994 restorations, corresponding with procedure codes for 1-, 2-, and 3-surface amalgam or resin restorations. Paid claims collected nationwide from January 2010 through March 2020 were analyzed. Data for children aged 3 through 12 years were used, resulting in 219,632 unique patient identification numbers. Generalized estimating equation models applied to logistic regression were used. All tests were conducted using a 2-sided 5% significance level. RESULTS: In general, girls were less likely to receive amalgam than boys. A $20,000 increase in median household income was associated with a 16% decrease in the odds of amalgam being placed. Pediatric dentists (performing 15.1% of all restorations) were not as likely as general dentists (18.4%) to use amalgam. Having more surfaces in a restoration was associated with higher probability of amalgam placement. The percentage of amalgam restorations was higher for 2010 (26.9%) than for 2011 through 2020, and this pattern recurred in several of the years analyzed. Generally, patient age at time of amalgam restoration increased over time. CONCLUSION: The use of amalgam is trending down; the sharpest decline was noted in 2014. Pediatric dentists were less likely to use amalgam than general dentists. Girls and patients with higher socioeconomic status were less likely to have amalgam. PRACTICAL IMPLICATIONS: The findings of this study can inform and support clinical decisions and the formation of public policies.
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Restauración Dental Permanente , Seguro , Masculino , Niño , Femenino , Humanos , Restauración Dental Permanente/métodos , Odontología Pediátrica , Materiales Dentales , Resinas Compuestas , Amalgama DentalRESUMEN
Tobacco use is associated with diseases worldwide, including cancer. This is one of the major public health problems globally, causing more than 19 million new cases in 2020. Lip and oral cavity cancer (LOCC) is neoplastic growth in the tongue, gums, and lips. The objective of this ecological study was to quantify the strength of the association between incidence and mortality of LOCC, with tobacco use and with the Human Development Index (HDI). Incidence and mortality data on LOCC were obtained for 172 countries in 2020, from the Global Cancer Observatory (GLOBOCAN). The prevalence of tobacco smoking and chewing was obtained from reports conducted in 2019. The inequality in human development was estimated using the HDI from the United Nations Development Program, Human Development Report (2019). Statistically significant correlations were observed between the incidence of LOCC and tobacco smoking and chewing prevalence, except for negative correlations between the prevalence of tobacco smoking LOCC mortality in women, just as in the case of the HDI. No statistically significant differences were found between the prevalence of tobacco chewing only and the incidence of LOCC overall and by sex. A higher LOCC incidence overall and by sex was associated with higher HDI. In conclusion, the present study found positive correlations for various HDI socioeconomic indicators and tobacco use with the incidence and mortality of LOCC, but also a few inverse correlations.
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PURPOSE: The purpose of this study was to quantify the impact of the COVID-19 pandemic on private dental insurance claims for pediatric dental care. METHODS: Commercial dental insurance claims for patients in the United States ages 18 and younger were obtained and analyzed. The claims dates ranged from January 1, 2019, to August 31, 2020. Total claims paid, average paid amount per visit, and the number of visits were compared between provider specialties and patient age groups from 2019 to 2020. RESULTS: Total paid claims and total number of visits per week were significantly lower in 2020 compared to 2019 from mid-March to mid-May (P<0.001). There were generally no differences from mid-May through August (P>0.15), except for significantly lower total paid claims and visits per week for "other" specialists in 2020 (P<0.005). The average paid amount per visit was significantly higher during the COVID shutdown period for 0-5 year-olds (P<0.001) but significantly lower for all other ages. CONCLUSIONS: Dental care was greatly reduced during the COVID shutdown period and was slower to recover for "other" specialties. Younger patients ages zero to five years had more expensive dental visits during the shutdown period.
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COVID-19 , Humanos , Niño , Adolescente , Recién Nacido , Lactante , Preescolar , COVID-19/epidemiología , Revisión de Utilización de Seguros , Pandemias , Salarios y Beneficios , Atención OdontológicaRESUMEN
OBJECTIVES: We showed in a previous analysis the patterns of disruption for private dental insurance claims in the United States caused by the SARS-CoV-2 pandemic in 2020. The present report examines trends during 2020 and 2021, that is, contrasting perspectives during 2019 with the acute phase of the pandemic in 2020, and 2021. METHODS: Private dental insurance paid claims from a data warehouse were obtained, encompassing a 5% random sample of records between January 2019 and December 2021 for child and adult insureds who filed a claim in 2019, 2020, and 2021. We classified claims into one of four categories based on the likelihood of being associated with urgent/emergency care. RESULTS: The precipitous reduction in dental care claims in March-June 2020 recovered to almost pre-pandemic levels by the fall of 2020. However, a downward decline in private dental insurance claims started in the late fall of 2020 and continued through 2021. Differential impacts in dental care categories-in terms of urgency of care-were evident 2021, closely resembling previous trends in 2020. CONCLUSIONS: Dental care claims from the first year of the 2020 SARS-CoV-2 pandemic were contrasted with perspectives in 2021. A downward trend in demand/availability changes in dental care insurance claims set in for 2021, perhaps linked to perceptions of the overall economic situation. Such downward trend has continued overall, even after considering seasonal changes and the acceleration of the pandemic during the Delta, Omicron, and other variants.
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COVID-19 , Niño , Adulto , Humanos , Estados Unidos/epidemiología , COVID-19/epidemiología , Seguro Odontológico , Pandemias , SARS-CoV-2RESUMEN
BACKGROUND: Cancer is the leading cause of death for Hispanics in the USA. Screening and prevention reduce cancer morbidity and mortality. METHODS: This study administered a cross-sectional web-based survey to self-identified Hispanic residents in the state of Indiana to assess their cancer-related knowledge, beliefs, and behaviors, as well as to identify what factors might be associated with cancer screening and prevention. Chi-square and Fisher's exact test were used to compare associations and logistic regression used to develop both univariate and multivariate regression models. RESULTS: A total of 1520 surveys were completed, median age of respondents was 53, 52% identified as men, 50.9% completed the survey in Spanish, and 60.4% identified the USA as their country of birth. Most were not able to accurately identify ages to begin screening for breast, colorectal, or lung cancer, and there were significant differences in cancer knowledge by education level. US-born individuals with higher income and education more often believed they were likely to develop cancer and worry about getting cancer. Sixty eight percent of respondents were up-to-date with colorectal, 44% with breast, and 61% with cervical cancer screening. Multivariate models showed that higher education, lack of fatalism, older age, lower household income, and unmarried status were associated with cervical cancer screening adherence. CONCLUSIONS: Among a Hispanic population in the state of Indiana, factors associated with cervical cancer screening adherence were similar to the general population, with the exceptions of income and marital status. Younger Hispanic individuals were more likely to be adherent with breast and colorectal cancer screening, and given the higher incidence of cancer among older individuals, these results should guide future research and targeted outreach.
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Neoplasias Colorrectales , Neoplasias del Cuello Uterino , Masculino , Femenino , Humanos , Indiana/epidemiología , Neoplasias del Cuello Uterino/diagnóstico , Detección Precoz del Cáncer , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Hispánicos o Latinos , Tamizaje MasivoRESUMEN
OBJECTIVE: To describe trends in cases and prevalence at birth rates of cleft lip and/or palate (CL/P) in Mexico between 2003 and 2019. DESIGN: Ecological study. SETTING: Multiple data sources systematically collected into a national epidemiological surveillance data warehouse. PARTICIPANTS: National Live Birth Information System. MAIN OUTCOME MEASURE(S): Both cases and prevalence at birth rates of CL/P in Mexico within a 17-year period were used as dependent variables. RESULTS: At the national level there were 23â 184 new cases of CL/P (average of 1364 per year) in the 32 states of Mexico, with an average prevalence at birth rate of 0.53 per 1000 live births. The states with the highest prevalence at birth rates of CL/P during the period were Hidalgo (1.59) and Jalisco (1.32), while the states with the lowest rates were Nayarit (0.22) and Durango (0.29). A slight decrease in both cases (z = -2.41, P = .016) and prevalence at birth rates (z = -2.58, P = .010) of CL/P was observed at the national level. States such as Durango, Puebla, Chiapas, Guerrero, Oaxaca, Mexico City, State of Mexico, Coahuila and Jalisco showed a clear downward trend (P < .05) in their prevalence at birth of CL/P between 2003 and 2019, while in Hidalgo its trend was upward (P = .05). Significant differences by sex and region were observed (P < .05). CONCLUSION: Some states consistently had the highest or lowest prevalence of CL/P. Decreasing trends in the overall prevalence at birth rates were observed. More detailed, epidemiological studies are necessary to adequately characterize CL/P in the Mexican population.
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Labio Leporino , Fisura del Paladar , Recién Nacido , Humanos , Labio Leporino/epidemiología , Fisura del Paladar/epidemiología , Prevalencia , México/epidemiologíaRESUMEN
BACKGROUND: Prefabricated metal crowns (PMCs) have been widely used in pediatric dentistry due to their great success in various clinical situations. However, it is important to know the local effects, such as changes in pH in the oral environment. OBJECTIVE: To evaluate the pH variations before and after placement of PMCs. METHODS: A quasi-experimental study (before and after) was performed with 32 pediatric patients who needed rehabilitation with PMCs at a pediatric dentistry clinic in a public university. Measurements were made using a pH potentiometer before PMC placement, one week after, and one month after placement. ANOVA and Pearson correlation were performed in SPSS. RESULTS: The average age of the participants was 5.9 ± 1.6 years, and 53.1% were female. The average pH before, one week after, and one month after crown placement was 7.46 ± 0.37, 7.00 ± 0.32, and 7.1 ± 0.19, respectively. Significant differences (p< 0.05) were observed between the three pH measurements. We found differences when comparing the basal pH values to those at one week (p= 0.001) and one month (p= 0.002). CONCLUSION: Although there were statistically significant differences in the pH change values before and after the placement of crowns, these differences may not have a clinical impact.
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Coronas , Diente Primario , Humanos , Niño , Femenino , Preescolar , Masculino , Metales , Concentración de Iones de HidrógenoRESUMEN
Abstract The objective of the present study was to identify the reasons for dental extractions in patients seeking dental care in a university dental clinic in Mexico. This is a cross-sectional study that assessed 284 consecutive patients at the School of Dentistry, Autonomous University of the State of Mexico between August 2017 and November 2018. In total, 505 extractions were performed. The dependent variable was the reason for extraction: 0) dental caries and ensuing sequels (reference category); 1) periodontal disease and ensuing sequels; and 2) other reasons. Sociodemographic, socioeconomic, and clinical variables were included as independent variables. The analysis was done with multinomial logistic regression (Stata 14.0). Out of all extractions, 63.6% (n=321) were due to dental caries and ensuing sequels; 22.0% (n=111) were due to periodontal disease and ensuing sequels; 5.3% (n=27) endodontic failure; 5.1% (n=26) prosthetic indications; 1.6% (n=8) orthodontic indications; and the rest (2.4%) were due to other reasons. In the multivariate model extractions due to periodontal disease vs dental caries were associated with occasionally smoking tobacco (Odds Ratio, OR=3.90) or daily tobacco use (OR=3.19); the tooth to be extracted having been previously restored (OR=2.35); extracted anterior as opposed to posterior teeth (OR =2.63); and patients with multiple extractions (OR=2.68). In the case of extractions due to "other reasons", no variable was significant. Dental caries and periodontal disease were the main reasons for dental extraction in this sample. Several variables, mostly clinical, were associated with extractions for periodontal reasons.
Resumo O objetivo do presente estudo foi identificar os motivos das extrações dentárias em pacientes que procuram atendimento odontológico em uma clínica odontológica universitária no México. Este é um estudo transversal que avaliou 284 pacientes consecutivos na Faculdade de Odontologia da Universidad Autónoma del Estado de México entre agosto de 2017 e novembro de 2018. No total, foram realizadas 505 extrações. A variável dependente foi o motivo da extração: 0) cárie dentária e sequelas subsequentes (categoria de referência); 1) doença periodontal e sequelas subsequentes; e 2) outros motivos. Variáveis sociodemográficas, socioeconômicas e clínicas foram incluídas como variáveis independentes. A análise foi feita com regressão logística multinomial (Stata 14.0). De todas as extrações, 63,6% (n=321) foram devidas a cárie dentária e sequelas subsequentes; 22,0% (n=111) foram devidas a doença periodontal e sequelas subsequentes; 5,3% (n=27) a insucesso endodôntico; 5,1% (n=26) a indicações protéticas; 1,6% (n=8) a indicações ortodônticas; e o restante (2,4%) foi devido a outros motivos. No modelo multivariado, as extrações por doença periodontal vs. cárie dentária foram associadas ao tabagismo ocasional (Odds Ratio, OR=3,90) ou ao uso diário de tabaco (OR=3,19); ao fato de o dente a ser extraído ter sido restaurado anteriormente (OR=2,35); à extração de dentes anteriores em vez de posteriores (OR=2,63); e a pacientes com extrações múltiplas (OR=2,68). No caso de extrações devido a "outros motivos", nenhuma variável foi significativa. A cárie dentária e a doença periodontal foram os principais motivos de extração dentária nessa amostra. Diversas variáveis, principalmente clínicas, foram associadas às extrações por motivos periodontais.
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BACKGROUND AND OBJECTIVE: The perception of quality of life about health status is subjective; assessment of the impact includes well-being while eating, speaking, smiling, interacting with others, and feeling good about the esthetic appearance of teeth and mouth. The objective of the present study was to cross-culturally adapt and determine the validity and reliability of the Mexican version of the Iowa Fluoride Study Oral Health for adolescents. MATERIAL AND METHODS: A cross-sectional study was carried out in a sample of 240 Mexican adolescents aged 15 to 19 years. The questionnaire was translated, back-translated, and administered through the Google Forms platform. The cultural adaptation consisted of the evaluation of the grammatical, conceptual, and linguistic equivalences. The evaluation of the utility and acceptability was carried out through an analysis of semantic equivalence. The utility of the questionnaire was also evaluated by analyzing its grammatical readability. Reliability tests, Kaiser-Meyer-Olkin (KMO), factor analysis, and Pearson's correlation were performed. RESULTS: The mean age of all participants was 16.4±1.4; 65.3% (n=158) were female. Face validity was considered adequate. The wording of the objective and instructions of the questionnaire were improved. The confidentiality assurances were highlighted. The questions were clear, understandable, and pertinent, and they showed adequate syntax. The INFLESZ index corresponds to a "fairly easy" level of readability. In the quantitative validation, the correlation of items was greater than 0.4. The KMO was 0.930 (p=0.001), and Bartlett sphericity was 2466.5 (p=0.001). Through the exploratory factorial analysis, we evaluated the emotional well-being (12 items), social welfare (five items), and oral symptoms (OS) (three items) dimensions. Internal consistency was high (Cronbach's α=0.942). CONCLUSION: The culturally translated and adapted questionnaire is valid and reliable for use in research on Mexican adolescents.
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Objective Dental caries in Mexico continues to be a public health problem, indicated by it is high prevalence and incidence in children. This disease is associated with pain in preschool and school children, with large-scale consequences for the individual, society, and health systems. The objective of the present study was to determine the experience (mean of caries indices), prevalence, and severity of caries in children 2-12 years of age who sought dental care at a dental school in Mexico. Material and methods A cross-sectional study was carried out on 826 clinical records of patients ages 2-12 years. The dependent variable was caries, in terms of experience (mean primary teeth (dmft) and permanent teeth (DMFT) indices), prevalence (dmft and DMFT greater than 0), and severity (cutoffs of caries indices at various levels). The independent variables were age and sex. The data were analyzed in Stata 14 (StataCorp LLC, College Station, Texas). Results The average age was 7.2±2.3; 52.4% were boys. In the primary dentition, the caries experience (mean dmft) was 3.01±3.30, the prevalence of caries was 65.8%, and the severity dmft>3=37.3% and dmft>6=15.6%. In the permanent dentition, the caries experience (mean DMFT) was 0.99±1.88, the prevalence of caries was 31.5%, and the severity DMFT>3=12.5% ââand DMFT>6=1.6%. The percentage of caries-free children in both dentitions was 26.1% (n=216/826). The experience, prevalence, and severity of caries were statistically different by age (p<0.001). Only in the severity of dmft>3 were differences observed across sex (p<0.05). Among children with mixed dentition, primary teeth were more affected than permanent teeth (2.46±2.87 vs 0.88±1.61; p<0.0001). Conclusions About seven out of 10 children were affected by cavities in either or both dentitions. It was observed that age was positively associated with dental caries, equally affecting girls and boys. In this sample, the primary dentition was impacted more than the permanent dentition. Despite being preventable, dental caries continues to be a health problem in children.