[Association between socioeconomic status and oral hygiene among preschoolers enrolled in the IMSS preventive dental program in Campeche]. / Asociación del nivel socioeconómico con la higiene bucal en preescolares bajo el programa de odontología preventiva del IMSS en Campeche.

OBJECTIVE: Determine the association between socioeconomic status and oral hygiene in the primary dentition of preschool children. MATERIALS AND METHODS: We undertook a cross-sectional study of 1,303 children attending 10 schools in Campeche, Mexico. Every child was clinically examined in a portable dental chair by one of four examiners. We used a questionnaire addressed to the mothers to collect data on socioeconomic and socio demographic variables--including attitudinal variables dealing with the perceived importance of oral health. Oral hygiene was assessed appraising the frequency of tooth brushing and the presence of dental plaque. Data analysis included non-parametric tests using STATA 8.2. RESULTS: Mean age was 4.36 +/- 0.79 years and 48.3% of children were girls. Of the study population, 17.8% (n = 232) were classified as having inadequate oral hygiene, 50.9% (n = 663) having moderate oral hygiene, and 31.3% (n = 408) having adequate oral hygiene. Children who were rated more frequently as having inadequate hygiene (p < 0.05) had mothers with a negative attitude toward oral health, were users only of public medical insurance (as opposed to users of private services), and had not used dental services in the year prior to the study. Finally, we observed a decrease in the adequacy of oral hygiene associated with a decrease in socioeconomic status. CONCLUSIONS: Our findings showed that oral hygiene was closely associated with socioeconomic status. This implies that if a reduction of oral health inequalities is to be achieved, the strategies and resources targeting these goals must take into account the existing differences between population groups with more or fewer social disadvantages.

Asociación del nivel socioeconómico con la higiene bucal en preescolares bajo el programa de odontología preventiva del IMSS en Campeche / Association between socioeconomic status and oral hygiene among preschoolers enrolled in the IMSS preventive dental program in Campeche

Objetivo. Determinar la asociación entre el estado socioeconómico y la higiene bucal en la dentición primaria de niños preescolares. Material y métodos. Se realizó un estudio transversal en 1,303 niños de 10 escuelas de Campeche, México. Todos los sujetos fueron examinados clínicamente en una silla dental portátil por uno de cuatro examinadores. Se aplicó un cuestionario dirigido a las madres para la recolección de las variables socioeconómicas y sociodemográficas, incluyendo variables de actitud hacia la importancia de la salud bucodental. Se evaluó la higiene bucal tomando en consideración la frecuencia de cepillado dental y la presencia de placa dentobacteriana. El análisis se realizó en STATA 8.2® utilizando pruebas no paramétricas. Resultados. La media de edad fue 4.36 ± 0.79 años y 48.3% de los niños examinados fueron mujeres. Del total de los niños bajo estudio, 17.8% (n = 232) fueron asignados al grupo de higiene bucal inadecuada, 50.9% (n = 663) al de regular, y 31.3% (n = 408) al de adecuada. Quienes presentaron más frecuentemente higiene bucal inadecuada (p < 0.05) fueron los hijos de madres con actitud negativa hacia la salud bucal, los que solamente tenían acceso a servicios públicos de salud, y los que no utilizaron servicios dentales en el año previo al estudio. Finalmente, se observó disminución de higiene bucal apropiada conforme disminuía el nivel socioeconómico (NSE). Conclusiones. Los hallazgos de este estudio muestran que la higiene bucal estuvo asociada al NSE. Esto implica que si se desea disminuir las desigualdades en salud bucal, las estrategias que se diseñen y los recursos que se destinen a estos objetivos deben tener en cuenta las diferencias existentes entre los grupos con mayor y menor desventaja social.

OBJECTIVE: Determine the association between socioeconomic status and oral hygiene in the primary dentition of preschool children. MATERIALS AND METHODS: We undertook a cross-sectional study of 1,303 children attending 10 schools in Campeche, Mexico. Every child was clinically examined in a portable dental chair by one of four examiners. We used a questionnaire addressed to the mothers to collect data on socioeconomic and socio demographic variables--including attitudinal variables dealing with the perceived importance of oral health. Oral hygiene was assessed appraising the frequency of tooth brushing and the presence of dental plaque. Data analysis included non-parametric tests using STATA 8.2. RESULTS: Mean age was 4.36 +/- 0.79 years and 48.3% of children were girls. Of the study population, 17.8% (n = 232) were classified as having inadequate oral hygiene, 50.9% (n = 663) having moderate oral hygiene, and 31.3% (n = 408) having adequate oral hygiene. Children who were rated more frequently as having inadequate hygiene (p < 0.05) had mothers with a negative attitude toward oral health, were users only of public medical insurance (as opposed to users of private services), and had not used dental services in the year prior to the study. Finally, we observed a decrease in the adequacy of oral hygiene associated with a decrease in socioeconomic status. CONCLUSIONS: Our findings showed that oral hygiene was closely associated with socioeconomic status. This implies that if a reduction of oral health inequalities is to be achieved, the strategies and resources targeting these goals must take into account the existing differences between population groups with more or fewer social disadvantages.

Factors influencing the use of dental health services by preschool children in Mexico.

PURPOSE: The purpose of this study was to identify the factors associated with dental health services utilization (DHSU) within a publicly funded oral health program for preschool children in Campeche, Mexico. METHODS: A cross-sectional study in 1,303 preschoolers (3 to 6 years old) enrolled in 10 public schools was conducted. The independent variables were: (1) sex; (2) age; (3) tooth-brushing frequency; (4) caries severity; (5) enamel defects; (6) mother's maximum education level; (7) mother's attitude toward oral health; (8) health services availability; and (9) family's socioeconomic status. The mothers completed a questionnaire, and their children were clinically examined. The DHSU (none vs any) in the previous 12 months was the dependent variable. Data were analyzed using binary logistic regression (BLR). RESULTS: Average age was 4.3 +/- 0.8 years, and 52% of participants were boys. The prevalence of DHSU any was 31%. The variables associated with DHSU were: (1) moderate and high oral health needs; (2) access to private health services; and (3) older age. The authors' model supported an interaction between tooth-brushing frequency and the importance that the mother ascribed to her child's oral health. CONCLUSIONS: A low prevalence of DHSU was observed. The source of health services and oral health needs determined DHSU in this population, with some attitudes and behaviours modifying utilization. These findings have implications for designing oral health care policies to improve the supply of services to children.

Dental caries experience and factors among preschoolers in southeastern México: a brief communication.

OBJECTIVE: To examine the association between dental caries prevalence and selected variables in preschool children. METHODS: A cross-sectional study was carried out with 1,303 preschoolers (ages 3-6 years old), and the mothers completed questionnaires. The children were examined by one of three standardized dental examiners. Logistic regression was performed to identify associations between dental caries and other factors. RESULTS: Mean dmft was 1.54+2.47, with 44.1% of children having dmft>0. Caries prevalence was associated with older children (OR=1.39); medium (OR=1.66) and low (OR=2.41) socioeconomic levels; mediocre (OR=1.71) and inadequate (OR=2.25) hygiene; negative attitude toward oral health (OR=1.51); and the presence of enamel defects (OR=1.74). CONCLUSION: Both overall caries prevalence and dmft index were relatively low. The results of this study substantiate previous reports in the international literature for clinical, behavior, socio-demographic, and socio-economic variables that contribute to dental caries in Mexican children.

Introducing a clinical-behavioural scoring system for children's oral hygiene.

OBJECTIVES: Developing and testing a clinical-behavioural scoring system for assessing children's oral hygiene. MATERIALS AND METHODS: One clinical variable (the presence of dental plaque, measured using Silness and Loe's index) and one behavioural variable (self-reported tooth brushing frequency) were combined into secondary data analysis of research databases for 3-6-year-olds and 6-13-year-olds in a Mexican community. The combined scoring is an ordinal scale that depicts suitable, moderate and inadequate hygiene. Blinded dental examiners also collected dmft/DMFT data in standardised conditions. Data was analysed with Spearman's rho, Kruskall-Wallis, non-parametric tests for trends and Pearson's chi2 tests. RESULTS: 1303 children aged 3-6 years old and 1644 children aged 6-13 years old participated in the study. Clear relationships existed between the combined scoring system and dmft (p < 0.01) and between the scoring system and DMFT (p < 0.01), suggesting that the combined clinical-behavioural scoring system is a reasonably accurate measurement of the relationship between caries experience and oral hygiene in children in the given setting. CONCLUSIONS: The combined clinical-behavioural scoring system is a simple, easy-to-use tool that incorporates clinical and behavioural data commonly found in dental systems. Whether the clinical-behavioural scoring system can be generalised remains to be established.

Introducing a clinical-behavioural scoring system for children's oral hygiene

Objectives: Developing and testing a clinical-behavioural scoring system for assessing Children's oral hygiene. Materials and Methods One clinical variable (the presence of dental plaque, measured using Silness and LõeâǙs index) and one behavioural variable (self-reported tooth brushing frequency) were combined into secondary data analysis of research databases for 3-6-year-olds and 6-13-year-olds in a Mexican community. The combined scoring is an ordinal scale that depicts suitable, moderate and inadequate hygiene. Blinded dental examiners also collected dmft/DMFT data in standardised conditions. Data was analysed with Spearman's rho, Kruskall-Wallis, non-parametric tests for trends and Pearson's chi2 tests. Results 1 303 children aged 3-6 years old and 1,644 children aged 6-13 years old participated in the study. Clear relationships existed between the combined scoring system and dmft (p<0.01) and between the scoring system and DMFT (p<0.01), suggesting that the combined clinical-behavioural scoring system is a reasonably accurate measurement of the relationship between caries experience and oral hygiene in children in the given setting. Conclusions The combined clinical-behavioural scoring system is a simple, easy-to-use tool that incorporates clinical and behavioural data commonly found in dental systems. Whether the clinical-behavioural scoring system can be generalised remains to be established

Objetivos: Desarrollar un sistema de puntaje clínico-conductual para medir la higiene bucal en niños. Material y Métodos La investigación se realizó en dos etapas: 1) detección y selección de componentes de la higiene bucal, y 2) evaluación de la asociación con la caries dental. Una variable clínica (presencia de placa dentobacteriana usando el índice de Silness y Lõe) y una variable conductual (reporte de la frecuencia de cepillado) fueron combinadas en un análisis secundario de dos bases de datos de investigaciones epidemiológicas en niños de 3-6 años y de 6-13 años de edad en una comunidad mexicana. El puntaje combinado es en una escala ordinal que describe higiene bucal adecuada, moderada e inadecuada. Los examinadores también colectaron los índices ceod/CPOD. Los datos se analizaron con las pruebas de rho de Spearman, Kruskall-Wallis, no-paramétrica para tendencias, y ji2 de Pearson. Resultados 1 303 niños de 3-6 años de edad, y 1 644 niños de 6-13 años de edad participaron en los estudios. Se encontró una lara relación entre el sistema y el índice ceod (p<0.01), y entre el sistema y el índice CPOD (p<0.01), sugiriendo que este sistema es una medida adecuada de la higiene bucal en esta población. Conclusión El sistema de puntaje clínico-conductual para medir la higiene bucal es una herramienta simple y fácil de usar que incorpora datos clínicos y conductuales comúnmente encontrados en investigaciones dentales. El potencial del sistema de puntaje clínico-conductual para medir la higiene bucal para usarse en otras poblaciones necesita establecerse en estudios subsecuentes.

[Caries severity and associated factors in preschool children aged 3-6 years old in Campeche City, Mexico]. / Severidad de caries y factores asociados en preescolares de 3-6 años de edad en Campeche, México.

OBJECTIVE: To identify individuals affected by severe carious lesions, according to the size of lesion, and to determine the associated factors. METHODS: A cross-sectional study was carried out in 1303 children aged 3 to 6 from 10 public preschools with a public preventive dental program. Presence and severity of dental caries were diagnosed using standard criteria (magnitude of carious lesion), which contained four lesion types based on their severity or size. The mothers completed questionnaires to supply information on hygienic habits of the child, and socio-demographics and socioeconomic status variables for the family. Children were examined by one of three calibrated and standardized examiners (kappa>0.85). Adjusted ordinal logistic regression (odds proportional model) was performed to identify associations between caries severity and risk indicators. RESULTS: The percentages of subjects in severity groups I, II, III and IV were 77.3%, 4.8%, 12% and 5.9%, respectively. We observed that subjects with dmft>4 (sum of decayed, indicated for extraction, and filled primary teeth), presented the severest carious lesions (71.4% vs 6.7%; p<0.001). The variables associated to caries severity were: older age of the child, mother's negative attitude toward dental health, regular and inadequate level of oral hygiene, and an interaction between low socioeconomic level and presence of structural enamel defects. CONCLUSION: We observed a low percentage (17.8%) of subjects affected by severe lesion of dental caries (groups III & IV). Well-defined arrays of variables were associated with caries severity.

Severidad de caries y factores asociados en preescolares de 3-6 años de edad en Campeche, México / Caries severity and associated factors in preschool children aged 3-6 years old in Campeche City, Mexico

OBJETIVO: Identificar a los sujetos afectados por lesiones de caries severas, por medio del tamaño de la lesión, y determinar los factores asociados. MATERIAL Y MÉTODOS: Se realizó un estudio transversal en 1 303 niños de 3 a 6 años de edad asistentes a 10 escuelas preescolares. Para la detección de la severidad de caries se empleó el "criterio de magnitud de la lesión cariosa", el cual asigna al diente a uno de cuatro tipos de lesiones basadas en su severidad o extensión. Un cuestionario dirigido a las madres fue utilizado para explorar las variables independientes; y sus hijos fueron evaluados clínicamente. Para el análisis estadístico se emplearon pruebas no paramétricas. Se conformó un modelo multivariado de regresión logística ordinal del tipo momios proporcionales. RESULTADOS: El porcentaje de sujetos en los grupos de severidad I, II, III y IV fue de 77,3, 4,8, 12 y 5,9 por ciento, respectivamente. Los sujetos con dientes primarios cariados, indicados para extracción, u obturados >4 (ceod>4), presentaban las lesiones cariosas de mayor severidad (71,4 por ciento vs 6,7 por ciento; p<0.001). Las variables asociadas a la severidad de caries fueron: la edad del niño, la importancia de la madre en la salud bucal de su hijo, la higiene bucal y una interacción entre nivel socioeconómico y la presencia de defectos estructurales del esmalte. CONCLUSIONES: Observamos un bajo porcentaje (17,8 por ciento) de sujetos afectados por lesiones de caries severas (grupos III y IV) y existen variables de diversos tipos que se encuentran asociadas a la severidad de caries.