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.

Experience, Prevalence, and Severity of Dental Caries in Mexican Preschool and School-Aged Children.

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% ​​and 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.

Psychometric Properties of the Iowa Fluoride Study Oral Health Questionnaire in Mexican Adolescents.

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.

Factors Associated with Self-Report of Type 2 Diabetes Mellitus in Adults Seeking Dental Care in a Developing Country.

The aims of the present study were to identify the prevalence and risk indicators of type 2 diabetes mellitus (T2DM) in urban-based Mexican adults seeking care in a university-based triage/intake dental clinic, and to develop a predictive model. A cross-sectional study was conducted on 3354 medical/dental records of adults who sought care at the triage/intake dental clinics of a public university. The dependent variable was self-report of a previous diagnosis of T2DM made by a physician. Several socio-demographic and socioeconomic covariates were included, as well as others related to oral and general health. A multivariate binary logistic regression model was generated. We subsequently calculated well-known statistical measures employed to evaluate discrimination (classification) using an (adjusted) multivariate logistic regression model (goodness-of-fit test). The average age of patients was 42.5 ± 16.1 years old and the majority were female (64.1%). The prevalence of T2DM was 10.7% (95%CI = 9.7−11.8). In the final multivariate model, the variables associated (p < 0.05) with the presence of T2DM were older age (40 to 59 years old, OR = 2.00; 60 to 95 years old, OR = 2.78), having any type of health insurance (OR = 2.33), having high blood pressure (OR = 1.70), being obese (OR = 1.41), and having a functional dentition (OR = 0.68). Although the global fit of the model and the calibration tests were adequate, the sensitivity (0.0%) and positive predictive (0.0%) values were not. The specificity (100%) and negative predictive (89.3%) values, as well as the correctly classified (89.3%) value, were adequate. The area under the ROC curve, close to 0.70, was modest. In conclusion, a prevalence of T2DM of 10.7% in this sample of Mexican adults seeking dental care was similar to national figures. Clinical (blood pressure, BMI and functional dentition), demographic (age), and socioeconomic (health insurance) variables were found to be associated with T2DM. The dental setting could be appropriate for implementing preventive actions focused on identifying and helping to reduce the burden of T2DM in the population.

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.

Disostosis cleidocraneal a tres años de tratamiento ortopédico / Cleidocraneal dysostosis at three years of orthopedic treatment

Introducción: La disostosis cleidocraneal es un trastorno genético raro con patrón hereditario. Sus rasgos patognomónicos son la aplasia clavicular, fontanelas y suturas abiertas, múltiples anomalías dentales. Su origen se relaciona con alteraciones en el gen RUNX2, importante para la síntesis de CBFA1, que a su vez funciona como un conformador óseo y un diferenciador de osteoblastos. Caso clínico: Paciente de 11 años con características clínicas de CCD, se corroboran los antecedentes genéticos hereditarios y alteraciones dentales relacionados con disostosis cleidocraneal. Resultado: A tres años de tratamiento se observa mejor definición facial, la erupción de piezas permanentes retenidas y mejor función masticatoria. Conclusión: Mejorar la calidad de vida del paciente con tratamientos interceptivos y el conocimiento de las alteraciones causadas por el síndrome, así como el trabajo interdisciplinario (AU)

Introduction: Cleidocranial dysostosis is a rare genetic disorder with a hereditary pattern. Its pathognomonic features are clavicular aplasia, fontanelles and open sutures, multiple dental anomalies. Its origin is related to alterations in the RUNX2 gene, important for the synthesis of CBFA1, which in turn functions as a bone conformer and an osteoblast differentiator. Clinical case: Patient with eleven years old with clinical characteristics of CCD, hereditary genetic background, and dental alterations related to cleidocranial dysostosis are corroborated. Result: After three years of treatment, the facial definition is better, the eruption of permanent pieces retained and better chewing function. Conclusion: Improve the quality of life of the patient with interceptive treatments and the knowledge of the alterations caused by the syndrome, as well as the interdisciplinary work (AU)

Ecological study on needs and cost of treatment for dental caries in schoolchildren aged 6, 12, and 15 years: Data from a national survey in Mexico.

To determine the treatment needs and the care index for dental caries in the primary dentition and permanent dentition of schoolchildren and to quantify the cost of care that would represent the treatment of dental caries in Mexico.A secondary analysis of data from the First National Caries Survey was conducted, which was a cross-sectional study conducted in the 32 states of Mexico. Based on dmft (average number of decayed, extracted, and filled teeth in the primary dentition) and DMFT (average number of decayed, extracted, and filled teeth in permanent dentition) information, a treatment needs index (TNI) and a caries care index (CI) were calculated.At age 6, the TNI for the primary dentition ranged from 81.7% to 99.5% and the CI ranged from 0.5% to 17.6%. In the permanent dentition, the TNI ranged from 58.8% to 100%, and the CI ranged from 0.0% to 41.2%. At age 12, the TNI ranged from 55.4% to 93.4%, and the CI ranged from 6.5% to 43.4%. At age 15, the TNI ranged from 50.4% to 98.4%, and the CI ranged from 1.4% to 48.3%. The total cost of treatment at 6 years of age was estimated to range from a purchasing power parity (PPP) of USD $49.1 to 287.7 million in the primary dentition, and from a PPP of USD $3.7 to 24 million in the permanent dentition. For the treatment of the permanent dentition of 12-year-olds, the PPP ranged from USD $13.3 to 85.4 million. The estimated cost of treatment of the permanent dentition of the 15-year-olds ranged from a PPP of USD $10.9 to 70.3 million. The total estimated cost of caries treatment ranged from a PPP of USD $77.1 to 499.6 million, depending on the type of treatment and provider (public or private).High percentages of TNI for dental caries and low CI values were observed. The estimated costs associated with the treatment for caries have an impact because they represent a considerable percentage of the total health expenditure in Mexico.

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.

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.

Consulta por extracción dental en niños nicaragüenses: una aproximación a las necesidades de atención bucal

Objetivo: Identificar los factores asociados a las visitas al dentista por motivo de extracción dental en niños nicaragüenses. Material y Métodos: Se realizó un estudio transversal en una muestra de escolares de 6 a 12 años de edad. Se incluyeron 1400 niños de escuelas públicas, a cuyos padres/tutores se les aplicó un cuestionario para determinar una serie de variables sociodemográficas, socioeconómicas y dentales. La variable dependiente fue la visita al dentista por extracción dental (VDED), la cual fue categorizada como: 0=Sin visita al dentista, 1= VDED, pero no en el último año, 2= VDED en el último año. En el análisis estadístico se emplearon pruebas estadísticas no paramétricas. Resultados: El promedio de edad fue de 9.00±2.00 años y las mujeres representaron el 49.9%. Del total de la muestra, 21.6% acudieron al dentista por extracción dental, de los cuales 9.8% lo hicieron hace más de un año y 11.8% durante al año pasado previo a la encuesta. Las variables que mostraron diferencias significativas (p<0.05) en el análisis estadístico de las VDED fueron la edad, la edad de la madre, y la posición socioeconómica. Conclusiones: Uno de cada cinco niños tuvo VDED. Las visitas al dentista por extracciones dentales podrían utilizarse como un indicador del estado de salud bucal de la población, ya que son una aproximación a las necesidades de salud que presentan.

Objective: To identify factors associated with visits to the dentist for dental extraction in Nicaraguan children. Materials and Methods: This was a cross-sectional study that was carried out in a sample of schoolchildren from 6 to 12 years of age. We included 1400 children from public schools, whose parents / guardians were given a questionnaire to determine a series of sociodemographic, socioeconomic and dental variables. The dependent variable was defined as a dental visit for dental extraction (VDED), which was categorized as: 0 = No visit to the dentist, 1 = VDED, but not in the last year, 2 = VDED in the last year. For statistical analysis, nonparametric statistical tests were used. Results: The average age was 9.00 ± 2.00 years, 49.9% of the total were females. Of the total sample, 21.6% went to the dentist for a dental extraction, of which 9.8% did so more than a year ago and 11.8% had gone during the year prior to the survey. The variables that showed significant differences (p <0.05) in the statistical analysis of the VDED were age of the patient, the age of the mother, and the socioeconomic status. Conclusions: One in five children had VDED. Visits to the dentist for dental extractions could be used as an indicator of the oral health status of the population, since they are an approximation the other health needs present in the population.

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.

Socioeconomic Inequalities in Visits to the Dentist to Receive Professionally Applied Topical Fluoride in a Developing Country.

OBJECTIVE: To determine the frequency and associated factors of visits to the dentist in the last year by Nicaraguan schoolchildren to receive professionally applied topical fluoride (PATF). MATERIAL AND METHODS: A cross-sectional study was designed in children from public schools in the city of León, Nicaragua, were included. A series of socioeconomic, sociodemographic, and behavioural variables were collected through a questionnaire. The dependent variable was the visit to the dentist to receive professionally applied topical fluoride in the last year, which was dichotomised as (0) Did not receive PATF and (1) Yes received PATF. In the statistical analysis, binary logistic regression was used. RESULTS: The mean age of the students included was 9 years, and 49.9% were girls. The prevalence of visits to the dentist in the last year to receive PATF was 3.1%. In the multivariate model, the associated characteristics (p < 0.05) were: female (OR = 2.73, 95% CI = 1.34-4.50); the positive attitude of the mother to the oral health of her child (OR = 2.15, 95% CI = 1.03-4.50); and the best socioeconomic position (OR = 2.68, 95% CI = 1.36-5.31). CONCLUSIONS: The prevalence of visits to the dentist in the last year to receive professionally applied topical fluoride was very low (3.1%). The results of the socioeconomic position suggest the existence of certain inequalities in oral health. It is necessary to implement policies and programs aimed at improving this scenario.

Factors Associated with Dental Pain in Mexican Schoolchildren Aged 6 to 12 Years.

OBJECTIVE: To identify dental pain prevalence and associated factors in Mexican schoolchildren. METHODS: This cross-sectional study included 1,404 schoolchildren aged 6 to 12 years from public schools in the city of Pachuca de Soto, Hidalgo, Mexico. Data were collected through a questionnaire that addressed sociodemographic and socioeconomic factors, eating and dental hygiene habits, and behavior variables. The dependent variable was self-reported dental pain in the 12 months prior to the survey. Data were analyzed using nonparametric statistics and a binary logistical regression model. RESULTS: Dental pain prevalence among the studied children was 49.9%. The variables associated in the final model (p < 0.05) were younger mother's age, higher socioeconomic level, absence of an automobile in the home, fried food, fruit intake, lower tooth brushing frequency, never having used mouthwash or not knowing about it, and parents/guardians with regular to high levels of knowledge about oral health and a regular or good/very good perception of their child's oral health. CONCLUSIONS: One in two children in the study had experienced dental pain in the twelve months prior to the survey. The association of socioeconomic variables with dental pain suggested inequalities among the children in terms of oral health.

Edentulismo en adultos de Pachuca, México: aspectos sociodemográficos y socioeconómicos / Edentulism in Mexican adults: sociodemographic and socioeconomic aspects

Introducción La pérdida de dientes se ha convertido en un problema de salud pública bucal. Objetivo Determinar la prevalencia y distribución del edentulismo, así como las variables sociodemográficas y socioeconómicas asociadas en individuos de 35 años y más. Materiales y métodos Se realizó un estudio transversal en 656 sujetos seleccionados de forma aleatoria. En el estudio se incluyeron hombres y mujeres de 35 años y más, asistentes a las clínicas de atención dental de la Universidad Autónoma del Estado de Hidalgo (UAEH), una universidad pública de México. Para la realización de este estudio los examinadores fueron capacitados en la cumplimentación de los cuestionarios y estandarizados en el criterio diagnóstico de la pérdida de dientes. La variable dependiente fue el edentulismo. Los datos fueron analizados en Stata 11. Resultados El promedio de edad fue de 49,06 ± 10,33. Los individuos fueron principalmente mujeres (63,3%). La prevalencia general de edentulismo fue de 15,7% (IC 95%: 12,9-18,5); entre las mujeres fue de 17,6% y en los hombres de 12,5% (p = 0,081). La prevalencia de edentulismo fue mayor entre los sujetos de más edad (p < 0,001). Se observó que a mayor escolaridad (p < 0,001), a mejor nivel socioeconómico (p < 0,001) y en quienes tuvieron automóvil en el hogar (p < 0,05), la prevalencia de edentulismo fue menor. Conclusiones La prevalencia de edentulismo en adultos mayores de 35 años que acuden a las clínicas de esta universidad fue del 15,7%. Se observó diferencia de la prevalencia de edentulismo por edad, pero no por sexo. Se observaron diferencias socioeconómicas, sugiriendo ciertas desigualdades en salud bucal.

Introduction Tooth loss has become a problem of oral health. Objective To determine the prevalence and distribution of edentulism, as well as the associated sociodemographic and socioeconomic variables in subjects aged 35 and older. Materials and methods A cross-sectional study was conducted on 656 randomly selected subjects. The study included men and women aged 35 years and older attending dental care clinics at a public university in Mexico. Examiners were trained in filling out questionnaires and receiving training in order to standardise the criteria of tooth loss. The dependent variable was the presence of edentulism. The data were analysed using Stata 11. Results The mean age of the population was 49.06 ± 10.33 years, and the majority (63.3%) were women. The overall prevalence of edentulism was 15.7% (95% CI: 12.9-18.5%); the prevalence among women was 17.6% and the prevalence among men was 12.5% (P = .081). The prevalence of edentulism was higher among older subjects (P < .001). The prevalence of edentulism was lower among individuals with higher levels of education (P < .001), those with higher socioeconomic status (P < .001), and those who had a car at home (P < 0.05) Conclusions The prevalence of edentulism in adults over 35 years of age attending dental care clinics at this public university was 15.7%. Differences were observed in the prevalence of edentulism by age, but not by gender. Socioeconomic differences were observed, suggesting certain oral health inequalities.

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.

Dental plaque, preventive care, and tooth brushing associated with dental caries in primary teeth in schoolchildren ages 6-9 years of Leon, Nicaragua.

BACKGROUND: Our study aimed to evaluate the effect of various risk indicators for dental caries on primary teeth of Nicaraguan children (from Leon, Nicaragua) ages 6 to 9, using the negative binomial regression model. MATERIAL/METHODS: A cross-sectional study was carried out to collect clinical, demographic, socioeconomic, and behavioral data from 794 schoolchildren ages 6 to 9 years, randomly selected from 25 schools in the city of León, Nicaragua. Clinical examinations for dental caries (dmft index) were performed by 2 trained and standardized examiners. Socio-demographic, socioeconomic, and behavioral data were self-reported using questionnaires. Multivariate negative binomial regression (NBR) analysis was used. RESULTS: Mean age was 7.49 ± 1.12 years. Boys accounted for 50.1% of the sample. Mean dmft was 3.54 ± 3.13 and caries prevalence (dmft >0) was 77.6%. In the NBR multivariate model (p<0.05), for each year of age, the expected mean dmft decreased by 7.5%. Brushing teeth at least once a day and having received preventive dental care in the last year before data collection were associated with declines in the expected mean dmft by 19.5% and 69.6%, respectively. Presence of dental plaque increased the expected mean dmft by 395.5%. CONCLUSIONS: The proportion of students with caries in this sample was high. We found associations between dental caries in the primary dentition and dental plaque, brushing teeth at least once a day, and having received preventive dental care. To improve oral health, school programs and/or age-appropriate interventions need to be developed based on the specific profile of caries experience and the associated risk indicators.

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...