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.

Impact of Non-Surgical Periodontal Treatment on the Concentration and Level of MRP-8/14 (Calprotectin) as an Inflammatory Biomarker in Women with Periodontitis and Rheumatoid Arthritis: A Quasi-Experimental Study.

The aim of this study was to evaluate the impact of non-surgical periodontal treatment (NS-PT) on periodontal parameters and inflammatory biomarkers in the concentration and level of calprotectin (CLP) in women with periodontitis and rheumatoid arthritis (RA). In this quasi-experimental study, we evaluated 30 women (mean age: 52.0 ± 5.8 years) with periodontitis and RA who had been diagnosed and treated for RA for more than 3 years and whose activity markers remained at similar values without significant reduction over three consecutive months. Patients underwent NS-PT, which included plaque control, scaling, and root planing. Serum and saliva samples, periodontal indices, RA activity markers, Disease Activity Score-28 (DAS28), the erythrocyte sedimentation rate (ESR), and the C-reactive protein (CRP) and CLP contents were measured at the beginning of the study and 6 and 12 weeks after NS-PT. Parametric and nonparametric tests were used in the analysis. The mean age was 52.0 ± 5.8 years. Compared to the baseline results, all periodontal indices were significantly reduced 6 and 12 weeks after NS-PT (p < 0.001). DAS28 was also significantly reduced after 12 weeks (p < 0.0001). Similarly, the serum CLP concentration decreased 6 and 12 weeks after NS-PT (p < 0.0001). Of the patients, 100% presented lower levels of CRP and ESR (p < 0.0001). Overall, NS-PT reduced inflammation and disease activity, highlighting the importance of oral health in the control and treatment of systemic diseases such as RA and confirming that NS-PT effectively reduces periodontitis activity and plays a key role in modulating RA activity. Therefore, NS-PT should be considered as an adjunct treatment for RA.

Prevalence, and Risk Indicators of Coronal and Root Caries in Mexican Older Adults in Nursing Homes.

Background: Several factors are associated with coronal and root caries in older persons. The purpose of this study was to determine the experience, prevalence, and risk indicators (socioeconomic, sociodemographic, and dental variables) of coronal and root caries in older persons residing in nursing homes in Mexico. Methods: A cross-sectional study was carried out in 227 dentate participants with natural teeth. Convenience sample, where all dentate residents were invited to participate. The dependent variables were coronal caries and root caries, which were determined through an oral clinical examination. The independent variables were sociodemographic factors, location, type of center, surfaces free of dental biofilm and calculus, surfaces with recession, retainers in contact with surfaces with recession, xerostomia, smoking, and the previous use of dental services. The binary logistic regression model was used in the analysis. Results: The mean age of the participants in this study was 77.7±8.8 years, and 69.2% were women. Moreover, 71.8% live in long-term care facilities, and 48.0% live in Mexico City. The prevalence of coronal and root caries was found to be 67.8% and 50.7%, respectively. Being male and living in Mexico City were risk indicators for coronal caries, and with a 1% increase in surfaces with no biofilm, the risk decreased by 2%. Being widowed, having government or no social security, denture retainers, and coronal caries were risk indicators for root caries, while the utilization of dental services indicated lower risk. Conclusion: Several variables that differ in nature were found to be risk indicators for coronal and root caries. Coronal caries increases the risk of root caries. Prevention should be aimed at identifying persons at higher risk, and dental care should be improved for persons living in long-term care institutions.

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.

Association Between Gender, Age, and Skeletal Class With Mandibular Condyle Morphology: A Retrospective Study.

OBJECTIVES: This study aimed to examine the impact of demographic variables on mandibular condyle morphology, a critical factor in orthodontic treatment and maxillofacial surgery. The investigation focuses on the relationship between gender, age, and skeletal class with the morphological dimensions of the condyle, utilizing panoramic radiography as a diagnostic tool. METHODOLOGY: A retrospective analysis was conducted on 150 panoramic radiographs from individuals stratified into six groups according to gender and skeletal class. Skeletal classes were determined using Steiner and McNamara cephalometry. The Kodak Carestream software (Rochester, NY: Carestream Health) was employed to measure condylar height, width, and morphology. Statistical evaluations included ANOVA, correlation assessments, and multivariate binary logistic regression to discern the differences and associations among the variables studied. RESULTS: The findings revealed notable differences in condylar dimensions between genders across different skeletal classes, with males typically presenting larger condylar dimensions than females. The data also showed a moderate positive correlation between condyle height and width. Round-shaped condyles were the most common form found, with significant gender differences observed in certain skeletal classes. Additionally, logistic regression analysis identified significant associations between gender, age, and condylar width and shape. CONCLUSIONS: The study concludes that demographic factors, such as gender and age, significantly affect mandibular condyle morphology. These factors should be carefully considered in clinical evaluations using panoramic radiography to enhance the precision of diagnoses and the effectiveness of subsequent orthodontic and maxillofacial treatments. The results provide valuable insights for healthcare professionals in regions where more advanced imaging techniques may not be readily available.

Impact of COVID-19 on Dental Practices in El Salvador and Mexico: A Comprehensive Survey Analysis.

BACKGROUND AND OBJECTIVES: This study aimed to identify the relationship between prevention measures and protective barriers in dental practice in El Salvador and Mexico during the COVID-19 pandemic in 2020 and 2021. MATERIALS AND METHODS: A longitudinal study was conducted from June 2020 to December 2021, involving 1,719 dentists divided into four groups based on location and year. A 20-question survey in Spanish was utilized and validated with a Cronbach's alpha value of 0.84. RESULTS: The use of phone triage (OR = 1.3), thermometers (OR = 1.4), physical distancing (OR = 1.7), and face shields (OR = 2.6) was significantly associated with dental practice in both countries during the pandemic. CONCLUSIONS: During 2020 and 2021, dental care in El Salvador and Mexico was significantly linked to COVID-19 preventive measures. Phone triage, thermometers, distancing, and face shields positively correlated with dental services. National health agencies should promote the use of minimum preventive measures in dental care, preparing for potential reinfections or new pandemics from emerging virus variants.

Innovative Curved-Tip Reactor for Non-Thermal Plasma and Plasma-Treated Water Generation: Synergistic Impact Comparison with Sodium Hypochlorite in Dental Root Canal Disinfection.

Non-thermal plasmas (NTPs), known as cold atmospheric plasmas (CAPs), hold great potential for diverse medical applications, including dentistry. However, traditional linear and rigid dielectric barrier discharge reactors used for NTP generation encounter limitations in accessing oral cavities and root canals. To address this issue, we have developed an innovative NTP reactor featuring an angled end for improved accessibility. The central copper electrode, with a 0.59 mm diameter and adjustable length for desired angulation, is coated with zircon powder (ZrSiO4) to ensure stable NTP generation. This central electrode is housed within a stainless steel tube (3 mm internal diameter, 8 mm external diameter, and 100 mm length) with a 27° angle at one end, making it ergonomically suitable for oral applications. NTP generation involves polarizing the reactor electrodes with 13.56 MHz radio frequency signals, using helium gas as a working medium. We introduce plasma-treated water (PTW) as an adjunctive therapy to enhance biofilm eradication within root canals. A synergistic approach combining NTP and PTW is employed and compared to the gold standard (sodium hypochlorite, NaOCl), effectively neutralizing Enterococcus faecalis bacteria, even in scenarios involving biofilms. Moreover, applying NTP in both gaseous and liquid environments successfully achieves bacterial inactivation at varying treatment durations, demonstrating the device's suitability for medical use in treating root canal biofilms. The proposed NTP reactor, characterized by its innovative design, offers a practical and specific approach to plasma treatment in dental applications. It holds promise in combatting bacterial infections in root canals and oral cavities.

Socioeconomic Inequalities in Alcohol and Tobacco Consumption: A National Ecological Study in Mexican Adolescents.

Alcohol and cigarettes are the psychoactive substances that adolescents use most frequently. When both addictions are combined, they carry the worst burden of disease globally. The objective of this study was to identify whether socioeconomic factors correlate with alcohol and tobacco consumption in Mexican adolescents aged 10 years or more and to establish the relationship in the consumption between the two substances. This ecological study utilized data describing alcohol and tobacco consumption among adolescents aged 10-16 years (n = 48,837 ≈ N = 11,621,100). Having ever consumed any alcohol-containing beverage constituted alcohol consumption. Smoking a cigarette within 30 days constituted cigarette consumption. For both variables, the state-level percentages reported in the survey were used. Diverse socioeconomic variables were collected from official sources. Data on the prevalence of tobacco use and alcohol consumption were entered into an Excel database estimated for each of the states of the Mexican Republic, as well as the socioeconomic variables. We performed the analysis using Stata 14. Consumption prevalence was 15.0% for alcohol and 4.2% for tobacco. Alcohol consumption was not correlated with any studied socioeconomic variable (p > 0.05). The prevalence of tobacco consumption among elementary school students correlated (p < 0.05) with the portion of the population living in private dwellings without sewage, drainage, or sanitation (r = 0.3853). The prevalence of tobacco consumption among middle-school adolescents correlated with the portion of the employed population that earned up to two minimum wages (r = 0.3960), the percentage in poverty by income 2008 (r = 0.4754) and 2010 (r = 0.4531), and the percentage in extreme poverty by income 2008 (r = 0.4612) and 2010 (r = 0.4291). Positive correlations were found between tobacco consumption and alcohol consumption among both elementary (r = 0.5762, p=0.0006) and middle-school children (r = 0.7016, p=0.0000). These results suggest that certain socioeconomic factors correlate with tobacco consumption but not alcohol consumption. A correlation between alcohol consumption and tobacco consumption was observed. The results can be used for developing interventions in adolescents.

Lip and Oral Cavity Cancer Incidence and Mortality Rates Associated with Smoking and Chewing Tobacco Use and the Human Development Index in 172 Countries Worldwide: An Ecological Study 2019-2020.

Tobacco use is associated with diseases worldwide, including cancer. This is one of the major public health problems globally, causing more than 19 million new cases in 2020. Lip and oral cavity cancer (LOCC) is neoplastic growth in the tongue, gums, and lips. The objective of this ecological study was to quantify the strength of the association between incidence and mortality of LOCC, with tobacco use and with the Human Development Index (HDI). Incidence and mortality data on LOCC were obtained for 172 countries in 2020, from the Global Cancer Observatory (GLOBOCAN). The prevalence of tobacco smoking and chewing was obtained from reports conducted in 2019. The inequality in human development was estimated using the HDI from the United Nations Development Program, Human Development Report (2019). Statistically significant correlations were observed between the incidence of LOCC and tobacco smoking and chewing prevalence, except for negative correlations between the prevalence of tobacco smoking LOCC mortality in women, just as in the case of the HDI. No statistically significant differences were found between the prevalence of tobacco chewing only and the incidence of LOCC overall and by sex. A higher LOCC incidence overall and by sex was associated with higher HDI. In conclusion, the present study found positive correlations for various HDI socioeconomic indicators and tobacco use with the incidence and mortality of LOCC, but also a few inverse correlations.

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.

Trends in Cleft lip and/or Palate Prevalence at Birth in Mexico: A National (Ecological) Study Between 2003 and 2019.

OBJECTIVE: To describe trends in cases and prevalence at birth rates of cleft lip and/or palate (CL/P) in Mexico between 2003 and 2019. DESIGN: Ecological study. SETTING: Multiple data sources systematically collected into a national epidemiological surveillance data warehouse. PARTICIPANTS: National Live Birth Information System. MAIN OUTCOME MEASURE(S): Both cases and prevalence at birth rates of CL/P in Mexico within a 17-year period were used as dependent variables. RESULTS: At the national level there were 23 184 new cases of CL/P (average of 1364 per year) in the 32 states of Mexico, with an average prevalence at birth rate of 0.53 per 1000 live births. The states with the highest prevalence at birth rates of CL/P during the period were Hidalgo (1.59) and Jalisco (1.32), while the states with the lowest rates were Nayarit (0.22) and Durango (0.29). A slight decrease in both cases (z = -2.41, P = .016) and prevalence at birth rates (z = -2.58, P = .010) of CL/P was observed at the national level. States such as Durango, Puebla, Chiapas, Guerrero, Oaxaca, Mexico City, State of Mexico, Coahuila and Jalisco showed a clear downward trend (P < .05) in their prevalence at birth of CL/P between 2003 and 2019, while in Hidalgo its trend was upward (P = .05). Significant differences by sex and region were observed (P < .05). CONCLUSION: Some states consistently had the highest or lowest prevalence of CL/P. Decreasing trends in the overall prevalence at birth rates were observed. More detailed, epidemiological studies are necessary to adequately characterize CL/P in the Mexican population.

Changes in oral pH before and after placing preformed metal crowns in primary dentition of Mexican children.

BACKGROUND: Prefabricated metal crowns (PMCs) have been widely used in pediatric dentistry due to their great success in various clinical situations. However, it is important to know the local effects, such as changes in pH in the oral environment. OBJECTIVE: To evaluate the pH variations before and after placement of PMCs. METHODS: A quasi-experimental study (before and after) was performed with 32 pediatric patients who needed rehabilitation with PMCs at a pediatric dentistry clinic in a public university. Measurements were made using a pH potentiometer before PMC placement, one week after, and one month after placement. ANOVA and Pearson correlation were performed in SPSS. RESULTS: The average age of the participants was 5.9 ± 1.6 years, and 53.1% were female. The average pH before, one week after, and one month after crown placement was 7.46 ± 0.37, 7.00 ± 0.32, and 7.1 ± 0.19, respectively. Significant differences (p< 0.05) were observed between the three pH measurements. We found differences when comparing the basal pH values to those at one week (p= 0.001) and one month (p= 0.002). CONCLUSION: Although there were statistically significant differences in the pH change values before and after the placement of crowns, these differences may not have a clinical impact.

Effect of nitric oxide-cyclic GMP-K+ channel pathway blockers, naloxone and metformin, on the antinociception induced by the diuretic pamabrom.

Pamabrom is a diuretic that is effective in treating premenstrual syndrome and primary dysmenorrhea. The aim of this study was to examine the effect of metformin and modulators of the opioid receptor-nitric oxide (NO)-cyclic guanosine monophosphate (cGMP)-K+ channel pathway on the local antinociception induced by pamabrom. The rat paw 1% formalin test was used to assess the effects. Rats were treated with local administration of pamabrom (200-800 µg/paw) or indomethacin (200-800 µg/paw). The antinociception of pamabrom or indomethacin was evaluated with and without the local pretreatment of the blockers. Local administration of pamabrom and indomethacin produced dose-dependent antinociception during the second phase of the test. Local pretreatment of the paws with naloxone (50 µg/paw), l-nitro-arginine methyl ester (10-100 µg/paw), or 1H-(1,2,4)-oxadiazolo[4,2-a]quinoxalin-1-one (10-100 µg/paw) reverted the antinociception induced by local pamabrom, but not of indomethacin. Similarly, the K+ channel blockers glibenclamide, glipizide, 4-aminopyridine, tetraethylammonium, charybdotoxin, or apamin reverted the pamabrom-induced antinociception, but not of indomethacin. Metformin significantly blocked the antinociception of pamabrom and indomethacin. Our data suggest that pamabrom could activate the opioid receptor-NO-cGMP-K+ channel pathway to produce its peripheral antinociception in the formalin test. Likewise, a biguanide-dependent mechanism could be activated by pamabrom and indomethacin to generate antinociception.

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.

Comparative Analysis of Edentulism in a Sample of Mexican Adults with and without Type 2 Diabetes.

The objective of the present study was to compare the prevalence of edentulism in Mexican adults with and without a diagnosis of type 2 diabetes mellitus (T2DM) when they are seeking dental care. A cross-sectional study was conducted on 1921 medical records of Mexican adults 40 years of age and older who sought dental care at clinics of a public university in Mexico. The dependent variable was edentulism, clinically determined through an oral examination. The main independent variable was the self-report of previous T2DM diagnosis made by a physician. Sociodemographic, socioeconomic and behavioral covariates were included in a multivariate binary logistic regression model. Overall edentulism prevalence was 8.4% (95% CI = 7.1-9.6). The prevalence of T2DM was 14.3% (n = 274). The prevalence of edentulism among individuals with T2DM was 13.1%, but only 7.6% among individuals without T2DM. In the multivariate binary logistic regression model, a previous T2DM diagnosis increased the probability of being edentulous 1.61 times (95% CI = 1.03-2.50). For each year a person's age increased, the likelihood of being edentulous increased by 12% (95% CI = 10-14%). In summary, a higher prevalence of edentulism was present in Mexican adults with T2DM and in those of older age. This information may be used by dental care providers and health policymakers to improve approaches to preventive care, as well as to characterize and anticipate care needs more accurately for the adult and older adult populations.

Traumatic dental injuries in 6 to 12 years old schoolchildren: a multicenter cross-sectional study in Mexico.

The aim of this study was to determine the prevalence of dental trauma in schoolchildren 6 to 12 years of age and associated clinical, sociodemographic, and socioeconomic variables. A cross-sectional study was conducted in 477 children from public elementary schools in four locations in Mexico. The dependent variable was dental trauma, which was dichotomized in 0 = without dental trauma and 1 = with dental trauma. For the statistical analysis, a multivariate binary logistic regression model was generated in Stata. Average age was 9.06±1.94 years and 51.1% were girls. The prevalence of dental trauma was 18.2%. Falls, automobile accidents and sports had the highest number of instances (p < 0.01). In the multivariate model, it was observed that the risk of dental trauma increased with age (OR = 1.28) and among boys (OR = 1.45). Schoolchildren with decreased overjet (OR = 0.38) had lower dental trauma. Father's age (OR = 1.03) and educational level (OR = 1.78) were associated with dental trauma. Schoolchildren without health insurance (OR = 0.62) presented dental trauma less often. This study provided important information regarding the association of different sociodemographic, socioeconomic and clinical variables with dental trauma in Mexican schoolchildren. Identifying factors associated with dental trauma may support health promotion opportunities to ameliorate the prevalence of dental trauma.

Socioeconomic Inequalities and Toothbrushing Frequency among Schoolchildren Aged 6 to 12 Years in a Multi-Site Study of Mexican Cities: A Cross-Sectional Study.

Periodic toothbrushing is the most common, effective, and reliable way to mechanically remove biofilm from oral tissues. The objective of the present study was to determine the association between toothbrushing frequency and socioeconomic position for schoolchildren between 6 and 12 years of age in four cities in Mexico. A cross-sectional study was conducted on 500 Mexican schoolchildren between 6 and 12 years of age from public schools in four Mexican cities. Questionnaires were administered to the parents/guardians of the schoolchildren to obtain the variables included in the study. The dependent variable was toothbrushing frequency, dichotomized as: 0 = less than twice a day and 1 = at least twice a day. The analysis was performed in Stata. The average age of the schoolchildren was 8.9 ± 1.9 years; 50.4% were female. The prevalence of toothbrushing was 52.8% (at least twice a day) (95% CI = 48.4−57.1). In the multivariate model, the variables associated (p < 0.05) with toothbrushing frequency were older age of the schoolchild (OR = 1.14); younger age of the mother (OR = 0.93); being a girl (OR = 1.70); being enrolled in Seguro Popular (OR = 0.69); being in a household that was owned (OR = 2.43); and being a schoolchild who lived in a home that owned a car (OR = 1.31). The prevalence of toothbrushing at least twice a day was just over 50% in these Mexican children. We found demographic and socioeconomic variables to be associated with toothbrushing. Based on socioeconomic variables that were associated with toothbrushing frequency­such as health insurance, home ownership and the household owning a car­the results of the present study confirm the existence of health inequalities in toothbrushing frequency.

Evaluation of tooth demineralization using laser-fluorescence in dental school patients undergoing orthodontic treatment: A clinical study.

BACKGROUND: Adverse effects can occur during orthodontic treatment. OBJECTIVE: To evaluate the relationship between prevalence and severity of enamel demineralization using a laser-fluorescence device, with length of orthodontic treatment time. METHOD: A cross-sectional study was conducted in 60 patients in a university orthodontic clinic. A clinical examination to establish demineralization at four sites on each tooth (premolar to premolar) was performed using the DIAGNOdent pen. The dependent variable was enamel demineralization, from which the prevalence (at least one affected site), extension (percentage of affected teeth) and adjusted average (average of the mean DIAGNOdent values per tooth) were calculated. The length of time for orthodontic treatment was determined in months. Various sociodemographic and clinical covariates were included. RESULTS: Average number of months under orthodontic treatment was 26.37 ± 24.81 months. Prevalence of enamel demineralization was 80.0%, its extension was 21.9% ± 17.2 and adjusted average of DIAGNOdent values was 6.09 ± 1.75. By quadrant, the teeth most affected were 14 (34.4%), 24 (25.0%), 31 (30.2%) and 44 (33.3%). No significant relationship (p> 0.05) was observed between enamel demineralization and length of time under orthodontic treatment. CONCLUSIONS: A high prevalence of dental demineralization was observed. In this sample, no relationship was observed between months under treatment and dental demineralization, or with other variables included in the study.

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.

Citral inhibits the nociception in the rat formalin test: effect of metformin and blockers of opioid receptor and the NO-cGMP-K+ channel pathway.

The objective of the present study was to scrutinize the effect of nitric oxide (NO), cyclic GMP (cGMP), potassium channel blockers, and metformin on the citral-produced peripheral antinociception. The rat paw 1% formalin test was used to assess nociception and antinociception. Rats were treated with local peripheral administration of citral (10-100 µg/paw). The antinociception of citral (100 µg/paw) was evaluated with and without the local pretreatment of naloxone, NG-L-nitro-arginine methyl ester (L-NAME, a NO synthesis inhibitor), 1H-(1,2,4)-oxadiazolo(4,2-a)quinoxalin-1-one (ODQ, a soluble guanylyl cyclase inhibitor), metformin, opioid receptors antagonists, and K+ channel blockers. Injection of citral in the rat paw significantly decreased the nociceptive effect of formalin administration during the two phases of the test. Local pretreatment of the paws with L-NAME and ODQ did not reduced the citral-induced antinociception. Glipizide or glibenclamide (Kir6.1-2; ATP-sensitive K+ channel blockers), tetraethylammonium or 4-aminopyridine (KV; voltage-gated K+ channel blockers), charybdotoxin (KCa1.1; big conductance calcium-activated K+ channel blocker), apamin (KCa2.1-3; small conductance Ca2+-activated K+ channel antagonist), or metformin, but not the opioid antagonists, reduced the antinociception of citral. Citral produced peripheral antinociception during both phases of the formalin test. These effects were due to the activation of K+ channels and a biguanide-dependent mechanism.