Control of Dental Caries in Children and Adolescents Using Fluoride: An Overview of Community-Level Fluoridation Methods.

The maintenance of oral health is a crucial aspect of general well-being; however, a significant proportion of the worldwide population experiences a range of oral diseases. Dental caries is a highly prevalent non-communicable disease globally, especially in children and adolescents. Fluoride is involved in the control of dental caries, primarily by decreasing the critical pH for dental hard tissue dissolution and decreasing enamel solubility. Due to the substantial data supporting the efficacy of fluoride in controlling dental caries, many community-level fluoridation initiatives have been devised and executed as global public health preventive interventions. These initiatives encompass the fluoridation of water, salt, and milk. Water fluoridation is considered safe and effective when fluoride levels are maintained within the recommended range (0.6 to 1.1 mg/L). Salt fluoridation has a cariostatic potential similar to that of water fluoridation, and a fluoride concentration of 250 micrograms per gram in salt is not associated with an increased risk of developing dental fluorosis. However, there is currently an effort to reduce the consumption of table salt in order to mitigate the harmful effects of excessive salt consumption. It has been hypothesized that fluoride food supplementation, such as fluoridated milk, is associated with a decrease in caries experience in permanent teeth; however, the effect is not clear in primary teeth. Public-level fluoride interventions are more cost-effective than the operative care of caries lesions and limit the burden of care. The administration of fluorides should be conducted using safe methods, limiting ingestion, and adhering to the guidelines set by international and national health agencies in each country. This is particularly important when considering children with developing dentitions. Fluoride is an important tool in the control of dental caries, but it is crucial to combine it with good oral hygiene, a healthy diet, and regular visits to a dental professional to maintain long-term oral health.

Clinical and socio-demographic factors associated with dental extractions in a clinical sample.

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.

Tooth Loss and Associated Factors in Mexican Older Adults in Nursing Homes: A Multicenter Cross-Sectional Study.

The objective of this study was to determine the experience of tooth loss and associated factors in older adults and elderly residing in nursing homes. A cross-sectional study was conducted in Mexican older adults and elderly aged ≥60 years living in four nursing homes (two in Mexico City, Mexico: one in Cuernavaca, Morelos, and one in Oaxaca, Oaxaca). The data were collected at the facility (home nursing) by two dentists in 2019. To determine the number of tooth loss and DMFT, a clinical oral examination was performed. In addition, a questionnaire was applied to determine diverse independent variables (demographic, socioeconomic, and behavioral). The analysis was performed using nonparametric tests and negative binomial regression (p < 0.05). 257 subjects were included. The mean age was 81.25 ± 9.02 years, and 60.7% were women. The mean number of lost teeth was 18.78 ± 9.05 (women = 19.43 ± 8.59 and men = 17.77 ± 9.68; p > 0.05). In the multivariate negative binomial regression model, it was found that, for each one-year increase in age, the mean tooth loss increased 0.92% (p < 0.05). In current smokers (p < 0.01) and in those who brush their teeth < 2 times a day (p < 0.01), the average of tooth loss increased 22.04% and 61.46%, respectively. The experience of tooth loss in Mexican older adults and elderly was high. Demographic (age) and habit of behavior (tobacco use and less frequent tooth brushing) were associated with increased tooth loss. It is important to promote oral health programs for institutionalized older adults.

Clinical and socio-demographic factors associated with dental extractions in a clinical sample

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.

Association of Edentulism with Various Chronic Diseases in Mexican Elders 60+ Years: Results of a Population-Based Survey.

OBJECTIVE: To determine the association of edentulism with different chronic diseases and mental disorders in Mexicans aged 60 years and over. MATERIAL AND METHODS: A cross-sectional study was carried out using data from the World Health Survey for Mexico, in a probabilistic, multi-stage cluster sampling framework. Data for self-report of chronic diseases (diabetes, arthritis, angina pectoris and asthma), mental disorders (depression and schizophrenia) and edentulism were analyzed. Edentulism data were available for 20 of the 32 States of Mexico. Statistical analysis was performed in Stata 14.0 using the svy module for complex sampling (Complex nature under which individuals are sampled). RESULTS: In total 4213 subjects were included, representing a population of 7,576,057 individuals. Mean age was 70.13 ± 7.82 years (range 60 to 98); 56.2% were women. Chronic diseases' prevalence and mental disorders prevalence were as follows: diabetes 15.0% (N = 1,132,693); arthritis 13.2% (N = 1,001,667); depression 5.5% (N = 414,912); angina pectoris 4.5% (344,315); asthma 3.6% (N = 269,287); and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which pertained to 1,993,463 people aged 60 years and over. Angina in women aged 60 to 69 years (p < 0.05) and depression in men aged 70 years and over (p < 0.0001) were associated with higher prevalence of edentulism. CONCLUSIONS: There was generally sparse association between edentulism on chronic diseases and mental disorders included in the study, except for women aged 60 to 69 years for angina, and in men aged 70 and over, for depression. Although our findings are misaligned with previous reports, longitudinal studies are required to test causal and temporal relationships between edentulism with chronic diseases and mental disorders.

Self-Reported Dental Caries by Mexican Elementary and Middle-School Schoolchildren in the Context of Socioeconomic Indicators: A National Ecological Study.

The objective of the present research was to quantify the association between dental caries self-report and socioeconomic indicators in Mexican children. An ecological study included a self-report of dental caries in schoolchildren enrolled in public elementary and middle schools derived from the National School Health Survey. A total of 73,560 schoolchildren (representing 19,745,366 students) aged 5 to 16 years were included. Socioeconomic variables included were scales depicting physical characteristics of housing, purchasing power, etc. used in national surveys in Mexico to measure deprivation, poverty, and income inequality in official data. Data were analyzed in Stata using Spearman's correlation test. For the most part, no association (p > 0.05) was found between caries self-report, socioeconomic variables, or the Gini index. However, caries self-report in elementary schoolchildren and total (elementary + middle-school) schoolchildren groups was positively correlated (p < 0.05) with two poverty variables: extreme poverty by income (value of personal food purchases per month) and poverty by income (value of personal food and non-food purchases per month). National data for dental caries self-report were associated-at the ecological level-with a few socioeconomic indicators but not with most of the usual and customary indicators used in national surveys in Mexico.

Self-reported oral hygiene practices with emphasis on frequency of tooth brushing: A cross-sectional study of Mexican older adults aged 60 years or above.

The objective of the study was to characterize self-reported oral hygiene practices among Mexican older adults aged ≥60 years, and to measure the association between frequency of tooth brushing and a set of sociodemographic, socioeconomic, and dental variables.We conducted a cross-sectional study of 139 older adults aged ≥60 years in Pachuca, Mexico. A questionnaire and a clinical dental examination were administered to identify specific variables. We determined frequency of tooth brushing (or cleaning of dentures or prostheses) and use of toothpaste, mouthwash, and dental floss among respondents. Non-parametric testing was performed for statistical analysis and a multivariate logistic regression model was generated with Stata 11 software to determine frequency of tooth brushing.In our study sample, 53.2% of participants reported brushing their teeth at least once a day, 50.4% always using toothpaste, 16.5% using mouthwash and 3.6% using floss for their oral hygiene. In general, younger and female respondents used oral hygiene aids more than the others. Our multivariate model yielded an association (P < .05) between tooth brushing at least once daily and the following variables: having functional dentition (OR = 12.60), lacking health insurance (OR = 3.72), being retired/pensioned (OR = 4.50), and suffering from a chronic disease (OR = 0.43).The older adults in our sample exhibited deficient oral hygiene behaviors. The results suggest certain socioeconomic inequalities in oral health. The findings of this study should be considered when designing dental care instructions for older adults.

Correlation between the caries status of the first permanent molars and the overall DMFT Index: A cross-sectional study.

To analyze whether a correlation exists between the caries status (Decayed, Missing and Filled Teeth, DMFT Index) of the first permanent molars (FPMs) and that of the full permanent dentition of Mexican adolescents, and to propose its use in large epidemiological studies of dental caries.We conducted a cross-sectional study of 1538 adolescents from 12 to 15 years old. Based on a clinical oral examination, we determined the DMFT Indices of their FPMs (FPM-DMFT) and of their full permanent dentition (comprehensive DMFT Index). We explored each FPM to determine whether it was with or without caries, filled, missing or sealed. For our statistical analysis, we used Fisher exact test and Spearman correlation in Stata software.After examining a total of 6157 FPMs, we found that 56.8% of our sample of adolescents had no caries in their 4 FPMs whereas 4.9% experienced caries in all 4. No significant differences emerged by sex (P > .05); however, by age, the older adolescents experienced greater FPM-DMFT (P < .05). Analysis yielded a correlation of r = 0.8693 between the FPM-DMFT and comprehensive DMFT scores (P < .0001) of participants. The underestimation of caries prevalence (DMFT > 0) was 5.4% (48.6% vs 43.2%), while the DMFT Index was underestimated at 0.34 (1.15 vs 0.81).The strong correlation between the FPM-DMFT and comprehensive DMFT Indices suggests that overall caries status can be inferred on the basis of FPM caries status. This evidence is useful when conducting large epidemiological studies such as national surveys.

Clinical and non-clinical variables associated with preventive and curative dental service utilisation: a cross-sectional study among adolescents and young adults in Central Mexico.

OBJECTIVE: The present study aimed to identify preventive and curative dental health service utilisation (DHSU) in the context of associated clinical and non-clinical factors among adolescents and young adults in Mexico. DESIGN: Cross-sectional study. SETTING: Applicants to a public university in Mexico. PARTICIPANTS: Participants were 638 adolescents and young adults aged 16-25 randomly selected from university applicants. INTERVENTIONS: Data were collected using a self-administered questionnaire filled out by the students. For assessment of dental caries experience, we used the index of decayed, missing and filled teeth. PRIMARY OUTCOME: The dependent variable was DHSU in the previous 12 months, coded as 0=non-use, 1=use of curative services and 2=use of preventive services. RESULTS: The mean age was 18.76±1.76 years, and 49.2% were women. The prevalence of DHSU was 40.9% (95% CI 37.1 to 44.8) for curative services and 22.9% (95% CI 19.7 to 26.3) for preventive services. The variables associated with curative services were age, sex, mother's education, dental pain in the previous 12 months, caries experience, use of self-care devices and oral health knowledge. For preventive services, the variables associated were mother's education, dental pain in the previous 12 months, caries experience, use of self-care devices and self-perception of oral health. CONCLUSIONS: While differences emerged by type of service, a number of variables (sociodemographic and socioeconomic characteristics as well as dental factors) remained in the final model. Greater oral health needs and socioeconomic inequalities remained as predictors of both types of DHSU. Given the differences revealed by our study, oral health policies should refer those seeking dental care for oral diseases to preventive services, and promote the use of such services among the poorer and less educated population groups.

Study protocol of the cost-effectiveness comparison of two preventive methods in the incidence of caries: A randomized, controlled clinical trial.

INTRODUCTION: Dental caries is the most frequent oral disease worldwide and the main cause of tooth loss in children and young adults. One of the most frequently affected areas is the occlusal surfaces of the first permanent molars (FPM) due to their morphological complexity. At present, several preventive treatments can reduce the incidence of this disease in school populations. In Mexico, the most commonly used technologies are those derived from some presentation of fluoride; on the other hand, research on this topic has been limited. OBJECTIVE: To determine the cost-effectiveness of two different methods for preventing the incidence of caries on the FPM of schoolchildren (6-8 years of age) from public primary schools. MATERIAL AND METHODS: This is a randomized experimental design. Participants will be assigned to two treatment groups of 114 each. In the first group, pit and fissure sealants will be applied, whereas the second group will receive a fluoride varnish. The work will be carried out in schoolchildren that attend public elementary schools in the state of Hidalgo, Mexico. The result variable will be the incidence of caries and the total cost of each of the interventions will be calculated in order to calculate the intervention's cost-effectiveness. CONCLUSION: This work will allow us to compare the cost-effectiveness of the pit and fissure sealants and the fluoride varnish in order to determine which offers the best results.

Indicators of oral health in older adults with and without the presence of multimorbidity: a cross-sectional study.

PURPOSE: The aim of this study was to determine whether there are differences in the distribution of various indicators of oral health among elderly people with and without multimorbidity (ie, two or more chronic diseases). SUBJECTS AND METHODS: A cross-sectional, comparative study was conducted using a sample of Mexican elderly individuals aged ≥60 years. The average age of the cohort was 79.06±9.78 years, and 69.1% were women. The variables indicating oral health were as follows: functional dentition, edentulism, hyposalivation, xerostomia, root caries and periodontitis. The multimorbidity variable was operationally categorized as follows: 0= subjects with no chronic disease or one chronic disease and 1= subjects with two or more chronic diseases. Questionnaires were used to collect information on various variables regarding general health. Likewise, the participants underwent a clinical oral examination. The analysis was performed using Stata 11.0. RESULTS: The overall prevalence of multimorbidity was 27.3%. The prevalences of various oral health indicators were as follows: without functional dentition 89.9%; hyposalivation 59.7%; edentulism 38.9% and self-reported xerostomia 25.2%. Dental caries were observed in 95.3% of the subjects, and the prevalence of severe periodontitis was 80%. We found a significant difference only in edentulism; its prevalence was higher among subjects with multimorbidity (55.3% vs 32.7%, P=0.015) than among those without multimorbidity. CONCLUSION: The presence of edentulism in this sample of Mexican older adults was higher in subjects with multimorbidity. Multimorbidity and oral diseases constitute a true challenge in elderly people, because they affect quality of life and are associated with high health care costs.

Supernumerario invertido en paladar de un infante: reporte de un caso clínico

Introducción: La hiperdoncia, es una anomalía de número en la que se forman dientes o estructuras parecidas a dientes en exceso con respecto a la cantidad normal, teniendo como resultado órganos dentales llamados supernumerarios. Presentación del caso: Paciente masculino de 7 años 11 meses de edad con dentición mixta y retraso en la erupción de los incisivos centrales y laterales superiores. En la radiografía panorámica se observa una zona radiopaca entre el incisivo central superior permanente (OD 21) y el incisivo lateral superior permanente (OD 22) diagnosticando un diente supernumerario. Con ayuda de una radiografía oclusal y una periapical de la zona se valoró y se determinó su extracción bajo anestesia local. Se realizó la cirugía sin complicaciones y se derivó al paciente a la clínica de ortodoncia. Conclusiones: En el presente reporte se pudo observar que llevando un buen control del caso y con la ayuda de estudios radiográficos se puede lograr un avance significativo sin dañar la integridad bucal del paciente en un futuro. Significancia clínica: El diagnóstico precoz puede mejorar con ayuda de los diversos tipos de radiografías disponibles en odontología, así se evitan complicaciones al paciente infantil.

Introduction: Hyperdontia is a number anomaly in which teeth or structures similar to teeth are formed in excess of the normal amount, resulting in supernumerary dental organs. Case presentation: a male patient 7 years 11 months of age with mixed dentition and delayed eruption of the central and upper lateral incisors presented for evaluation. The panoramic radiograph showed a radiopaque area between the permanent upper central incisor (OD 21) and the permanent upper lateral incisor (OD 22). A supernumerary tooth was diagnosed. With the help of an occlusal and a periapical radiograph of the area, the tooth was evaluated and an extraction under local anesthesia was planned. The surgery was performed without complications and the patient was referred to the orthodontic clinic. Conclusions: In the present report, we note that time intervention and with the help of radiographic studies, a significant result can be achieved without damaging the patient's future oral integrity. Early diagnosis can be improved with the help of the various types of radiographs available in dentistry, thus avoiding complications in infants.

Prevalence of Functional Dentition in a Group of Mexican Adult Males.

OBJECTIVE: To determine the prevalence of functional dentition and associated periodontal variables in a sample of Mexican adult males. METHODS: A cross-sectional study of 161 policemen in Campeche, Mexico, was carried out. A clinical examination using an electronic probe was used to collect variables (dental plaque, periodontal pockets, gingival recession, suppuration, and bleeding on probing) on 6 periodontal sites (a maximum of 168 sites, excluding third molars). Sociodemographic, socioeconomic, and behavioral variables were collected through a self-administered survey. Functional dentition was defined as having 21 or more natural teeth. Data were analyzed with STATA 11.0, using logistic regression models. RESULTS: Mean age was 38.3 (±10.9) years. The prevalence of having a functional dentition was 83.8% in the sample. The odds of having a functional dentition declined with age (odds ratio [OR] = 0.93), having diabetes (OR = 0.27) and with having a high percentage of sites with plaque (OR = 0.77), with bleeding on probing (OR = 0.97), and with gingival recession (OR = 0.82). CONCLUSION: While a large proportion of subjects had a functional dentition in this community-dwelling sample of adult Mexican males, the likelihood of their having a functional dentition decreased with age, with their having been diagnosed with diabetes, and with assorted negative indicators of periodontal/gingival status.

Dientes natales y neonatales: una revisión de la literatura

Los dientes que erupcionan antes de tiempo, desde el nacimiento o posterior a éste, son denominados comúnmente dientes natales o neonatales. Se clasifican de acuerdo al grado de maduración o apariencia. La prevalencia varía de 1 en 44 a 1 en 30,000 nacimientos. Son más frecuentes los dientes natales que los neonatales. Por lo general, pertenecen a la dentición primaria, ocurren de forma bilateral y predominan entre las mujeres. Todavía de etiología desconocida, la teoría más aceptable es que el germen dental tiene una localización superficial. Clínicamente se ven como dientes primarios normales, suelen ser más pequeños, algunas veces de forma cónica. Generalmente son móviles por la falta de formación radicular y presentan alteraciones del esmalte; pueden revelar una apariencia inmadura con hipoplasia del esmalte de bordes irregulares y agudos; su coloración puede ser marrón-amarillento / opaco blanquecino. Radiográficamente hay ausencia de raíz. Histológicamente, la mayoría de los dientes natales y neonatales pueden seguir un patrón de mineralización normal, pero también presentan alteraciones tanto en el esmalte como en la dentina. Otros descubrimientos incluyen ausencia de la capa basal de Weil, vaina de Hertwig y cemento; además de un incremento en el número de vasos sanguíneos dilatados en la pulpa. El tratamiento debe ser adaptado a cada diente y cada niño. Los tratamientos disponibles son: la extracción o el mantenimiento del diente en la arcada. La complicación más común de los dientes neonatales o natales es la ulceración traumática de la parte ventral de la lengua debido a la fricción, llamada úlcera de Riga Fede. No hay reporte de broncoaspiración. El tratamiento de los dientes natales y neonatales deben valorarse con mucho cuidado; estimando su movilidad, integridad, compromiso de la alimentación y la presencia de alguna úlcera.

Teeth that erupt early are commonly referred to as natal or neonatal teeth. They can be classified according to the degree of maturity or appearance. Their prevalence varies from 1 in 44 to 1 in 30,000 births. Natal teeth are more frequent than neonatal teeth, and they often belong to the primary dentition; they occur bilaterally and principally among women. The etiology of these teeth is unknown, and the most acceptable theory is that the tooth germ is located superficially. Clinically, they resemble normal primary teeth, although they are often smaller and sometimes conical. They are generally characterized by a lack of root formation, changes in enamel and dentin, an immature appearance with hypoplastic enamel and sharp irregular and edges, and yellowish-brown/white opaque coloration. Radiographically there is no root. Histologically, most natal and neonatal teeth may follow a pattern of normal mineralization, but also have alterations in both enamel and dentin. Other findings include absence of the basal layer of Weil, Hertwig's sheath and cement; besides an increase in the number of blood vessels in dilated pulp. Treatment should be tailored to each tooth and each child. Available treatments include extraction or maintenance of the tooth in the arch. The most common complication of neonatal teeth or natal is traumatic ulceration of the ventral portion of the tongue due to friction, called Fede-Riga disease (ulcer). No reports of aspiration exist in the literature. The treatment of natal and neonatal teeth should be assessed very carefully to estimate their mobility, integrity, feeding baby, and the presence of some ulcers.

Contribution of prosthetic treatment considerations for dental extractions of permanent teeth.

Background. Tooth loss is an easily identifiable outcome that summarizes a complex suite of factors in an individual's history of dental disease and its treatment by dental services over a lifetime. Assessment of overall tooth loss data is essential for epidemiologically evaluating the adequacy of dental care provided at a systems level, as well as for placing in context tooth loss for non-disease causes. For example, when derived from prosthetic treatment planning, the latter may unfortunately lead to some teeth being extracted (pulled) for the sake of better comprehensive clinical results. The objective of the present manuscript was to identify the contribution to overall tooth loss, by extraction of permanent teeth because of prosthetic treatment reasons. Material and Methods. A cross-sectional study included sex, age, total number of extractions performed by subject, sextant (anterior vs. posterior), group of teeth (incisors, canines, premolars and molars), upper or lower arch, and the main reason underlying extraction (extraction for any reason vs. prosthetic treatment), in patients 18 years of age and older seeking care at a dental school clinic in Mexico. A multivariate logistic regression model was generated. Results. A total of 749 teeth were extracted in 331 patients; 161 teeth (21.5% of total) were extracted for explicit prosthetic treatment indications. As age increased, the likelihood of having an extraction for prosthetic reasons increased 3% (OR = 1.03, p < 0.001). Women (OR = 1.57, p < 0.05) were more likely to be in this situation, and molars (OR = 2.70, p < 0.001) were most at risk. As the total number of extractions increased, the risk of having an extraction for prosthetic reasons decreased (OR = 0.94, p < 0.05). Conclusions. A significant amount (21.5%) of the extractions of permanent teeth were performed for prosthetic reasons in this dental school clinical environment; age, sex, type of tooth, and the total number of extractions moderated such pattern.

Tooth-Loss Experience and Associated Variables among Adult Mexicans 60 Years and Older.

OBJECTIVE: This study was conducted to determine the experience of tooth loss, as well as its associated variables, in a sample of adult Mexicans, aged 60 years and older. MATERIALS AND METHODS: This cross-sectional study was part of a larger project to measure diverse oral health indicators in a convenience sample: it included 139 adult Mexican seniors (69.1% of whom were women), ages 60 years and older, either living in long-term care facilities or living independently and participating in adult day care services. Each participant underwent an oral examination to determine the number of missing teeth. Questionnaires were administered to collect sociodemographic, socioeconomic, and behavioral data. Statistical analyses were performed using nonparametric tests and negative binomial regression. RESULTS: The mean age was 79.06 (±9.78 years). The mean number of missing teeth was 20.02 (±8.61; median, 24); 99.3% of the participants had at least 1 missing tooth, and only 14 had 20 teeth or more. Using a negative binomial regression multivariate model, we found that for each year's increase in age, the mean number of teeth lost increased by 1% (p<0.05). In individuals who brushed their teeth fewer than two times a day, who had received radiotherapy, or who were currently smokers, the average tooth loss increased 49.2%, 22.6%, and 19.0%, respectively (p<0.01). CONCLUSION: Tooth-loss experience in these Mexican seniors was very high (20.02±8.61). Older age (within the range of this group of seniors), tooth-brushing patterns, the receipt of radiation therapy, and (current) tobacco use were associated with higher experience of tooth loss.

Relationship between premature loss of primary teeth with oral hygiene, consumption of soft drinks, dental care, and previous caries experience.

We determine the relationship between premature loss of primary teeth and oral hygiene, consumption of soft drinks, dental care and previous caries experience. This study focused on 833 Mexican schoolchildren aged 6-7. We performed an oral examination to determine caries experience and the simplified oral hygiene index. The dependent variable was the prevalence of at least one missing tooth (or indicated for extraction) of the primary dentition; this variable was coded as 0 = no loss of teeth and 1 = at least one lost primary tooth. The prevalence of at least one missing tooth was 24.7% (n = 206) (95% CI = 21.8-27.7). The variables that were associated with the prevalence of tooth loss (p < 0.05) included: the largest number of decayed teeth (OR = 1.11), the largest number of filled teeth (OR = 1.23), the worst oral hygiene (OR = 3.24), a lower frequency of brushing (OR = 1.60), an increased consumption of soda (OR = 1.89) and use of dental care (curative: OR = 2.83, preventive: OR = 1.93). This study suggests that the premature loss of teeth in the primary dentition is associated with oral hygiene, consumption of soft drinks, dental care and previous caries experience in Mexican schoolchildren. These data provide relevant information for the design of preventive dentistry programs.

Gravedad de caries empleando un criterio del tamaño de la lesión y variables asociadas en una muestra de escolares mexicanos / Caries severity using a criterion according to size of lesion among Mexican schoolchildren

Objetivo: Determinar la gravedad de caries (tamaño de la lesión) y las variables asociadas en niños escolares mexicanos. Materiales y Métodos: Se realizó un estudio transversal en 1373 escolares de 6 a 12 años de edad inscritos en escuelas públicas de Campeche, México. Se distribuyeron cuestionarios para determinar una serie de variables sociodemográficas, socioeconómicas y conductuales. Se realizó un examen bucal a cada niño para establecer el tamaño de las lesiones de caries de acuerdo al índice llamado "criterio de magnitud de la lesión cariosa" y asignarlo de acuerdo al número de lesiones presentes a uno de 4 grupos de riesgo para desarrollar caries, en donde el primer grupo representa a los menos afectados. Se generó un modelo multivariado de regresión logística multinomial. Resultados: Los grupos de riesgo a caries quedaron distribuidos de la siguiente manera: 598 (43.6%) fueron del grupo 1; 261 (19.0%) se asignaron al grupo 2; 316 (23.0%) estuvieron en el grupo 3; y 198 (14.4%) en el grupo 4. Comparando con el grupo menos afectado por lesiones cariosas, las variables asociadas en los diferentes grupos de gravedad en el modelo multivariado fueron: grupo de riesgo 2: edad, sexo y defectos de desarrollo del esmalte; grupo de riesgo 3: atención dental en el último año, actitud de la madre hacia la salud bucal y defectos de desarrollo del esmalte; grupo de riesgo 4: edad, atención dental en el último año, actitud de la madre hacia la salud bucal y defectos de desarrollo del esmalte. Conclusión: La gravedad de caries está influenciada por variables demográficas, conductuales y clínicas.

Objective: To determine the severity of caries (lesion size) and associated variables in Mexican schoolchildren. Material and Methods: A cross-sectional study was conducted in 1373 schoolchildren 6-12 years old enrolled in public schools in Campeche, Mexico. Questionnaires were distributed to determine demographic, socioeconomic and behavioral variables. Dental examination was performed to each child to establish the size of caries lesions according "Criterion of carious lesion magnitude" index and to allocate according to the number of lesions present to one of four risk groups for developing cavities wherein the first group represents the least affected. A multivariate multinomial logistic regression model was generated. Results: Caries risk groups were distributed as follows: 598 (43.6%) were in group 1; 261 (19.0%) were assigned to group 2; 316 (23.0%) were in group 3; and 198 (14.4%) in group 4. Comparing with the least affected group by carious lesions, associated variables for severity in the multivariate model were "Risk Group 2": age, sex and developmental enamel defects; "Risk Group 3": dental care in the past year, mother's attitude toward oral health and developmental enamel defects; "Risk Group 4": age, dental care in the past year, mother's attitude toward oral health and developmental enamel defects. Conclusion: Severity of decay is influenced by demographic, behavioral and clinical variables.

Tooth brushing frequency in Mexican schoolchildren and associated socio-demographic, socioeconomic, and dental variables.

BACKGROUND: Tooth brushing (with fluoridated toothpaste) is the most cost-effective intervention in dentistry and it is widely recommended to preserve good oral health. We aimed to determine the frequency of tooth brushing and the variables associated with this practice in schoolchildren living in southeast Mexico. MATERIAL AND METHODS: A cross-sectional study was carried out in 1644 schoolchildren, 6 to 13 years old. Questionnaires with socio-demographic, socioeconomic, and dental variables were administered to mothers/guardians of children. The dependent variable was the frequency of tooth brushing, which was categorized as 0 = tooth brushing less than once a day and 1 = tooth brushing at least once a day. A logistic regression model was used to evaluate the final results. RESULTS: Mean age was 9.06±2.02 years and 49.1% were girls. The prevalence of tooth brushing at least once a day was 49.8%. In the multivariate model, characteristics related to tooth brushing frequency (p<0.05) were: older age (OR=1.11), being female (OR=1.64), having a larger family (OR=0.87), having had a visit to a dentist during the year preceding the study (OR=1.37), and having had fluoride applications by a professional (OR=1.39). CONCLUSIONS: The results suggested that different variables (demographic, socioeconomic and dental) are associated with the frequency of tooth brushing. Family size (proxy variable for socioeconomic status) may indicate certain oral health inequalities in this population.

Cuidados de la dentición primaria de escolares de 6 y 7 años de edad / Care index for primary teeth in schoolchildren aged 6 and 7 years

Determinar la existencia, prevalencia y gravedad de caries dental, así como establecer las necesidades de tratamiento y el índice de cuidados en la dentición primaria de niños mexicanos de 6 y 7 años de edad. Material y métodos: Este estudio transversal incluyó 357 escolares de la ciudad de Campeche, México. El índice de dientes cariados, indicados para extracción/extraídos y perdidos (índice ceod) fue utilizado para determinar la existencia de caries dental, y con él se calcularon igualmente la prevalencia (ceod > 0), la gravedad (ceod ≥ 4), así como las necesidades de tratamiento (INT) y el índice de cuidados. Se utilizaron cuestionarios para identificar las variables sociodemográficas, socioeconómicas y de conductas de salud bucal. En el análisis se empleó el modelo de regresión logística binaria. Resultados: El índice ceod global fue de 2.29 ± 2.95. La prevalencia y la gravedad fueron 52.4% y 29.1%, respectivamente. El porcentaje del INT fue de 88.1% y el índice de cuidados de 11.4%. En el modelo multivariado, la actitud negativa hacia la salud bucal (odds ratio [OR] = 2.32; intervalo de confianza [IC] del 95%: 1.36-3.94) y las visitas al dentista en el año previo al estudio (OR = 1.93; IC 95%: 1.44-2.54), resultaron asociadas a la prevalencia de caries. Conclusiones: Más de la mitad de los escolares presentan lesiones de caries en la dentición primaria. Se observó un alto porcentaje de lesiones cariosas con necesidad de tratamiento. Observamos que la actitud que tiene la madre hacia la salud bucal de su hijo tiene cierto grado de influencia sobre la prevalencia de caries en la dentición primaria. Es necesario implementar estrategias que permitan mejorar la salud bucal de los escolares...