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1.
Medicine (Baltimore) ; 98(30): e16634, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348316

RESUMO

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.


Assuntos
Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Selantes de Fossas e Fissuras/uso terapêutico , Criança , Análise Custo-Benefício , Método Duplo-Cego , Feminino , Fluoretos Tópicos/administração & dosagem , Fluoretos Tópicos/economia , Humanos , Masculino , México , Selantes de Fossas e Fissuras/economia , Projetos de Pesquisa
2.
Artigo em Inglês | MEDLINE | ID: mdl-31195612

RESUMO

Aim: The objective of this study was to estimate the Out-Of-Pocket Expenditures (OOPEs) incurred by households on dental care, as well as to analyze the sociodemographic, economic, and oral health factors associated with such expenditures. Method: A cross-sectional study was conducted among 763 schoolchildren in Mexico. A questionnaire was distributed to parents to determine the variables related to OOPEs on dental care. The amounts were updated in 2017 in Mexican pesos and later converted to 2017 international dollars (purchasing power parities-PPP US $). Multivariate models were created: a linear regression model (which modeled the amount of OOPEs), and a logistic regression model (which modeled the likelihood of incurring OOPEs). Results: The OOPEs on dental care for the 763 schoolchildren were PPP US $53,578, averaging a PPP of US $70.2 ± 123.7 per child. Disbursements for treatment were the principal item within the OOPEs. The factors associated with OOPEs were the child's age, number of dental visits, previous dental pain, main reason for dental visit, educational level of mother, type of health insurance, household car ownership, and socioeconomic position. Conclusions: The average cost of dental care was PPP US $70.2 ± 123.7. Our study shows that households with higher school-aged children exhibiting the highest report of dental morbidity-as well as those without insurance-face the highest OOPEs. An array of variables were associated with higher expenditures. In general, higher-income households spent more on dental care. However, the present study did not estimate unmet needs across the socioeconomic gradient, and thus, future research is needed to fully ascertain disease burden.


Assuntos
Assistência Odontológica/economia , Países em Desenvolvimento/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Seguro Saúde , Masculino , México , Fatores Socioeconômicos , Inquéritos e Questionários
3.
Clin Interv Aging ; 14: 219-224, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30787597

RESUMO

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.


Assuntos
Inquéritos de Saúde Bucal/estatística & dados numéricos , Indicadores Básicos de Saúde , Multimorbidade , Saúde Bucal/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Cárie Dentária/epidemiologia , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Boca Edêntula/epidemiologia , Prevalência , Qualidade de Vida , Autorrelato , Inquéritos e Questionários
4.
Clin Interv Aging ; 13: 1129-1133, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29942121

RESUMO

Background: Aging is one of the most prominent features in recent population dynamics around the world. As populations age, the prevalence of simultaneous chronic diseases increases, which is known as multimorbidity. Objective: The aim of the present study was to determine the prevalence of multimorbidity and associated factors in a sample of elderly Mexican subjects. Materials and methods: A cross-sectional descriptive study was performed on a convenience sample of 139 subjects aged ≥60 years. The dependent variable was the multimorbidity diagnosis performed by a physician, which was categorized as 0 for subjects with no chronic disease or only 1 disease and 1 for subjects with 2 or more chronic diseases. Questionnaires were used to collect the information on the different variables. A statistical analysis was performed in Stata 11.0. Results: The mean age was 79.06±9.78 years, and 69.1% of the subjects were women. A total of 69.1% (95% confidence interval =61.3-76.8) reported at least 1 morbidity. The mean morbidity by subject was 1.04±1.90. Cardiovascular diseases (25.9%), hypertension (20.1%), musculoskeletal disorders (19.4%), and diabetes (13.7%) were the most frequently reported conditions. The prevalence of multimorbidity (2 or more diseases) was 27.3% (95% confidence interval =19.8-34.8). No significant differences were observed in the independent variables. Conclusion: In conclusion, the prevalence of multimorbidity in this sample of elderly Mexican subjects was relatively low. The distribution across the included variables was not significantly different. Interventions focused on the health care of older adults with multimorbidity should pay special attention to cardiovascular diseases, hypertension, and musculoskeletal disorders.


Assuntos
Doença Crônica/epidemiologia , Países em Desenvolvimento , Multimorbidade , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência
5.
Sci Rep ; 7: 40686, 2017 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-28094800

RESUMO

We determined the prevalence of hyposalivation and xerostomia in older Mexicans (≥60 years), and its relationship with diverse factors. A cross-sectional study was realized in elderly subjects from Pachuca, Mexico. Chewing-stimulated saliva was collected under standardized conditions and salivary flow was measured; subjects were considered to have hyposalivation if their stimulated salivary flow was less than 0.7 mL per minute. Xerostomia was evaluated by asking subjects 'Does your mouth feel dry?'. Hyposalivation was present in 59.7%, and xerostomia in 25.2% of subjects. 16.5% of subjects had both conditions. Xerostomia was present in 27.7% of subjects with hyposalivation and 21.4% of subjects without hyposalivation, but the difference was not significant (p > 0.05). Thus, 68.3% of older Mexicans had xerostomia and/or hyposalivation. Factors associated with hyposalivation were: using fewer devices in oral hygiene, lacking social benefits for retirement/pension, living in a public retirement home, brushing teeth less than twice a day and lacking teeth without dentures. None of the factors included in this study were associated with xerostomia. We concluded that several variables studied were associated with hyposalivation, but none for xerostomia. Additional research should examine the amount of hyposalivation and factors associated with hyposalivation especially in elderly with increased risk for hyposalivation.


Assuntos
Xerostomia/epidemiologia , Xerostomia/etiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Xerostomia/terapia
6.
Sci Rep ; 6: 36383, 2016 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-27805027

RESUMO

Dental demineralization was determined in patients at three time points during fixed orthodontic treatment. A multiple cross-sectional study included 108 patients divided into three different groups: (1) beginning of orthodontic treatment; (2) one year into treatment; and (3) two years into treatment. Demineralization was estimated using a DIAGNOdent pen. We obtained data from multiple tooth-by-tooth demineralization readings combined with salivary pH and patients' oral hygienic and dietary behaviors. A t-test for independent samples and Spearman´s correlation were performed. No demineralizations differences were found between the initial stage and one year into treatment. Between one and two years small differences were observed, but demineralization increased between the initial stage and second treatment year, predominating in upper right central incisors (p = 0.056), upper left lateral incisors (p = 0.040), both upper canines (p = 0.055 and p = 0.040, respectively) and first left premolars (p = 0.034 and p = 0.053, respectively). We did not find associations between oral hygiene and dietary behaviours or salivary pH. In conclusion, demineralization occurred in first year of treatment and increased during second year, predominating in the upper arch and the left side mainly in upper right central incisors, upper left lateral incisors, both upper canines, and first left premolars.


Assuntos
Braquetes Ortodônticos/efeitos adversos , Desmineralização do Dente/diagnóstico , Adolescente , Estudos Transversais , Dieta , Feminino , Humanos , Concentração de Íons de Hidrogênio , Masculino , Higiene Bucal , Fatores de Risco , Saliva/química , Desmineralização do Dente/etiologia , Adulto Jovem
7.
PeerJ ; 4: e2015, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27441103

RESUMO

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

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