Caries y hábitos de higiene oral en un grupo de adultos mayores del Estado de México / Caries and oral health habits in a group of elderly from the State of Mexico

Introducción: La caries es una enfermedad multifactorial que se ha asociado con hábitos de higiene bucal deficientes. La Federación Dental Internacional establece el cepillado con una pasta fluorada dos veces por día como el patrón básico de higiene dental personal. Objetivo: Describir la frecuencia de caries y hábitos de higiene oral en un grupo de adultos mayores. Material y métodos: Se realizó un estudio de tipo observacional, prolectivo, transversal, descriptivo, en 74 adultos mayores del Estado de México con una media de edad de 63.4 (± 5.9); 73% (54) del sexo femenino y 27% (20) del masculino. Se valoraron la higiene dental con el índice IHOS y la experiencia de caries con el CPOD, y se aplicó un cuestionario sobre hábitos de higiene oral, que incluía las preguntas de frecuencia de cepillado y uso de hilo dental. Resultados: La experiencia de caries dental medida a través del índice CPOD para el total de la población fue de 20.0 (± 4.5); la categoría más alta del índice fue cariado con una media de 9.3 (± 6.0), al análisis por sexo se observó que el 70% (38) de las mujeres y el 65% (13) de los hombres presentan más de seis dientes con lesión cariosa ­no se encontró una diferencias estadísticamente significativa­. A la pregunta de cuántas veces se cepilla los dientes, el 32% (24) no lo hacía o lo realizaba sólo una vez al día; de éstos, 17 presentaban ≥ 6 lesiones cariosas. El 94% (66) usa para el cepillado de dientes pastas comerciales con flúor; cuatro usan alternativas como jabón de baño, detergente, pasta naturista, bicarbonato; dos adultos mayores usan sólo agua. La valoración de la higiene dental en el 70% (52) de los adultos mayores se califica como deficiente; 20 adultos mayores ­de ellos, 16 son mujeres­ reportan el uso de hilo dental. Conclusión: Los hábitos de higiene oral en los adultos mayores aún se encuentran lejos del patrón establecido por la Federación Dental Internacional, lo que contribuye al incremento de enfermedades bucodentales, entre éstas, las enfermedades periodontales y la caries radicular que, junto con las enfermedades sistémicas, coadyuvan al deterioro de la calidad de vida de los ancianos (AU)

Introduction: Caries is a multifactorial disease that has been associated with deficient oral hygiene habits. The FDI Word Dental Federation establishes brushing with a fluoridated paste twice a day as the basic standard of personal oral hygiene. Objective: Describe the frequency of tooth decay and oral hygiene habits in a group of elderly. Material and methods: An observational, prolective, cross-sectional, descriptive study was conducted in 74 elderly of the State of Mexico with an average age of 63.4 (± 5.9); 73% (54) female and 27% (20) male. The oral hygiene with the IHOS index, the cavity experience with the DMFT was assessed, and a questionnaire on oral hygiene habits was applied, which included the questions of frequency of brushing and flossing. Results: The tooth decay experience measured through the CPOD index for the total population was 20.0 (± 4.5); the highest category of the index was decayed with an average of 9.3 (± 6.0), to the analysis by sex it was observed that, 70% (38) of the women and 65% (13) of the men present more than six teeth with a carious lesión ­no statistically significant differences were found­. To the question of how many times you brush your teeth, 32% (24) did not do it or did it only once a day, of these, 17 had ≥ 6 carious lesions. 94% (66) uses for tooth brushing, commercial pastes with fluoride; four ethereal, naturist paste like soap or detergent, bicarbonate; two senior adult uses only water. The evaluation of oral hygiene in 70% (52) of the elderly is classified as deficient; 20 senior adults ­of whom 16 are women­ report the use of dental floss. Conclusion: Oral hygiene habits in senior adults are still far from the pattern established by the FDI which contributes to the increase of oral diseases, including periodontal diseases and root decay which, together with systemic diseases contribute to deterioration of the quality of life of the elderly (AU)

Relationship between gender, income and education and self-perceived oral health among elderly Mexicans. An exploratory study.

The aim of this study was to identify the relationship between sociodemographic factors and self-perceived oral health (SPOH) among the elderly. A cross-sectional, exploratory examination of 150 elderly subjects whose ages ranged from 60-86 was conducted. These subjects used the Geriatric Oral Health Assessment Index (GOHAI) to assess their SPOH. In addition, sociodemographic data were collected from study participants. Data were analyzed using Student's t-test, the examination of odds ratio (OR) of logistic regression analysis, the chi-square test, and analysis of variance (ANOVA). The mean decayed, missing, and filled teeth (DMFT) index for the study participants was 20.1 ± 5.8; 21.3% of subjects were edentulous, and 69.3% of subjects wore removable dentures. 62.7% of study participants had poor SPOH (defined as GOHAI score <44). Poor SPOH was significantly more frequent among males (OR = 2.72, 95% CI: 1.03-7.13, p < 0.05), low-income individuals (OR = 2.7, 95% CI: 1.3 -5.8, p < 0.01), and subjects with less education (OR = 2.26, 95% CI: 1.1-4.6, p < 0.05) than among the overall subject population. The findings suggest that gender (male), low income and low educational levels have a significant influence on the self-perceived oral health status of elderly individuals, irrespective of tooth loss.

Relationship between gender, income and education and self-perceived oral health among elderly Mexicans. An exploratory study / Relação entre gênero, renda e educação com a autopercepão da saúde bucal em idosos mexicanos. Um estudo exploratório

The aim of this study was to identify the relationship between sociodemographic factors and self-perceived oral health (SPOH) among the elderly. A cross-sectional, exploratory examination of 150 elderly subjects whose ages ranged from 60-86 was conducted. These subjects used the Geriatric Oral Health Assessment Index (GOHAI) to assess their SPOH. In addition, sociodemographic data were collected from study participants. Data were analyzed using Student's t-test, the examination of odds ratio (OR) of logistic regression analysis, the chi-square test, and analysis of variance (ANOVA). The mean decayed, missing, and filled teeth (DMFT) index for the study participants was 20.1 ± 5.8; 21.3% of subjects were edentulous, and 69.3% of subjects wore removable dentures. 62.7% of study participants had poor SPOH (defined as GOHAI score <44). Poor SPOH was significantly more frequent among males (OR = 2.72, 95% CI: 1.03-7.13, p < 0.05), low-income individuals (OR = 2.7, 95% CI: 1.3 -5.8, p < 0.01), and subjects with less education (OR = 2.26, 95% CI: 1.1-4.6, p < 0.05) than among the overall subject population. The findings suggest that gender (male), low income and low educational levels have a significant influence on the self-perceived oral health status of elderly individuals, irrespective of tooth loss.

O objetivo deste estudo foi identificar a relação entre os fatores sociodemográficos com a autopercepção da saúde bucal (SPOH) em idosos. Realizou-se um estudo transversal exploratório de 150 idosos. Para avaliar a sua percepção da saúde bucal utilizou-se o Geriatric Oral Assesment Index (GOHAI) e também foram coletados dados sociodemográficos. Os dados foram analisados utilizando o teste T Student, a razão de chances (OR) de análise de regressão logística, o teste Chi Quadrado (p < 0.05) e análise de variância ANOVA. A média do índice de dentes cariados, perdidos ou obturados (CPO-D) dos participantes no estudo foi de 20.1 ± 5.8; 21.3% foram edêntulos e 69.3% eram portadores de prótese removível. O 62.7% dos participantes no estudo teve pobre autopercepção da saúde bucal (definida com uma suma de GOHAI < 44), a qual foi significativamente mais frequente nos homens (OR = 2.72, 95% Cl: 1.03-7.13, p < 0.05), com baixa renda (OR = 2.7, 95% Cl: 1.3 - 5.8, p < 0.01), e com menor escolaridade (OR = 2.26, 95% Cl: 1.1-4.6, p <0.05) do que entre a população em geral. Os resultados presentes sugerem que nos idosos a baixa renda e a menor escolaridade têm influência significativa na autopercepção da saúde bucal, independentemente da perda dentária.

[Preventive and remineralization effect over incipient lesions of caries decay by phosphopeptide-amorphous calcium phosphate]. / Efecto preventivo y de remineralizacion de caries incipientes del fosfopeptido de caseina fosfato de calcio amorfo.

INTRODUCTION. Dental caries continues to affect a large percentage of Mexican children and currently advises that if diagnosed at an early stage can be reversed with minimally invasive treatments. The casein phosphopeptide amorphous calcium phosphate known as CPP-ACP is a phosphoprotein capable of releasing calcium and phosphate ions in the oral environment promoting remineralization. OBJECTIVE. To evaluate the effect of CPP-ACP with fluoride added in a scholar preventive program. MATERIAL AND METHODS. A cuasi- experimental study was conducted in 104 schools of six years old. The children were classified into three groups and received six months biweekly applications of different treatments: casein phosphopeptide amorphous calcium phosphate added fluoride (CPP-ACPF), sodium fluoride (NaF) and a control group. Clinical evaluation was performed with the laser fluorescence technique (Diagnodent model 2095). 1340 teeth were included: 294 teeth with incipient lesions and 1,046 healthy teeth. Statistical tests of χ2 y Mc Nemar were used. RESULTS. In the group that received the application of CPP-ACPF, 38% of incipient carious lesions were remineralizing compared with 21% in the group receiving the NaF (p < 0.001) and 15% in the control group (p < 0.0001) The percentage of teeth free of caries were preserved in the therapy group phosphoprotein was the biggest. This group also showed the lower proportion of deep carious lesion development (p < 0.0001). CONCLUSION. The application biweekly for six months of CPP-ACPF showed a protective and remineralizing effect on incipient carious lesions. His action was better than the application of NaF. However, to reduce the impact from dental caries in schoolchildren is important to have a comprehensive preventive approach that includes promoting self-care, as well as the application of sealants.

Perfil de salud bucodental en un grupo de adultos mayores del estado de Hidalgo / Bucco-dental health profile of a group of senior citizens in the state of Hidalgo

Introducción: acciones como la promoción de la salud contribuyen contribuyen al incremento de la esperanza de vida, con el constante aumento en el número de personas ancianas. Objetivo: Determinar el perfilepidemiológico de salud bucodental en un grupo de adultos mayores del estado de Hidalgo. Metodología: Estudio observacional, prolectivo, transversal y descriptivo en 102 adultos mayores del estado de Hidalgo. La evaluación de higiene bucal se realizó con el IHOS,la experiencia de caries con el CPOD, caries radicular con el índice de Katz (ICR) y las periodontopatías con el índice de Russell (IP). Resultados: El valor del IHOS de los adultos mayores fue de 1.7 (± 0.8); en los > 70 años de edad, la higiene bucodental es defi ciente(p < 0.04). El promedio del índice CPOD fue de 19.7 (± 6.1), la categoría más alta del índice fue diente perdido (11.1 ± 9.2); por sexo se presentaron diferencias estadísticamente signifi cativas en cariado (p < 0.002) y perdido (p < 0.04). La caries radicular fue de 24.9 por ciento (IC95 por ciento 20.7-29.1), aun cuando no se encontraron diferencias estadísticamente significativas se observa que, el ICR es mayor en: sexo masculino (28.3 por ciento; IC95 por ciento 21.1-35.5), mayores de 70 años (25.9 por ciento; IC95% 19.7-32.1) y escolaridad > 6 años (25.5 por ciento; IC95 por ciento 15.0-36.0)...

Introduction:Actions such as promoting health help increase life expectancy and contribute to the ever-increasing number of seniors in our society. Objective: To determine the epidemiological profi le of bucco-dental health in a group of senior citizens from the state of Hidalgo. Methodology: We carried out a descriptive, cross-sectional, observational, prolective study involving 102 senior citizens from the state of Hidalgo. The subjects’ oral hygiene was evaluated using the Simplifi ed Oral Hygiene Index (OHI-S); their history of caries using the DMFT Index; root caries using Katz’s root caries index (RCI); and periodontal diseases using Russell’s periodontal index (PI). Results:The value of the OHI-S of the subjects was 1.7 (± 0.8); at > 70 years old, bucco-dental hygiene was defi cient (p < 0.04). The average DMFT Index was 19.7 (± 6.1); the highest category in the index was tooth loss (11.1 ± 9.2). There were statistically signifi cant differences between the sexes in terms of caries (p < 0.002) and tooth loss (p < 0.04). The prevalence of root caries was 24.9% (IC95% 20.7-29.1). Though there were no signifi cant statistical differences, we did fi nd the RCI to be higher in males (28.3%; IC95% 21.1-35.5), people over 70 (25.9%; IC95%19.7-32.1), and people with > 6 years of formal education (25.5%; IC95% 15.0-36.0).

Manejo estomatológico del paciente con prótesis valvular cardíaca / Dental management of the patient with valvular prosthesis

El paciente portador de prótesis valvular puede presentar riesgos durante su atención estomatológica, entre los que se encuentran la endocarditis bacteriana y las hemorragias. El objetivo fue determinar el manejo estomatológico en pacientes con prótesis valvular cardiaca del Hospital de Cardiología Centro Médico Nacional Siglo XXI. El estudio se realizó en 23 pacientes de ambos sexos de 3 a 78 años de edad portadores de prótesis valvular, que requerían atención estomatológica. Los resultados mostraron que el manejo estomatológico de estos pacientes requirió de la premedicación con antibioticoterapia para evitar endocarditis bacteriana, además fue necesario suspender el anticoagulante y utilizar hemostáticos para prevenir hemorragia; a pesar de las medidas tomadas, tres pacientes presentaron sangrado continuo, cediendo en dos de ellos al suspender el anticoagulante y al hacer uso de hemostáticos locales y en otro al administrar plasma fresco congelado. Se concluye que la atención estomatológica del paciente con prótesis valvular cardiaca debe realizarse a nivel hospitalario, con un equipo multidisciplinario y los recursos necesarios para proteger la vida del paciente.