Dental caries experience and associated factors in 12-year-old-children: a population based-study

Abstract Relevant public policies in oral health have been implemented in Brazil since 2004. Changes in the epidemiological status of dental caries are expected, mainly in the child population. This study aimed to assess the dental caries experience and associated factors among 12-year-old children in the state of São Paulo, Brazil. A cross-sectional population-based study was conducted with data obtained from 415 cities, including a total of 26,325 schoolchildren who were included by the double-stage cluster technique, by lot and by systematic sampling. The statistical model included data from the São Paulo Oral Health Survey (SBSP 2015), the Human Development Index (HDI) and the Social Vulnerability Index (SVI). A theoretical-conceptual model categorized the variables into three blocks, namely, contextual (HDI, SVI, region of residence and fluoridation of water), individual (sex and ethnicity) and periodontal conditions (gingival bleeding, dental calculus and the presence of periodontal pockets), for association with the experience of caries (DMFT). Statistically significant associations were verified by hierarchical multivariate logistic (L) and Poisson (P) regression analyses (p < 0.05). The results showed that 57.7% of 12-year-old children had caries experience. Factors that determined a greater prevalence of dental caries in both models were nonwhite ethnicity (ORL = 1.113, ORP = 1.154) and the presence of gingival bleeding (ORL = 1.204, ORP = 1.255). Male children (ORL = 0.920 ORP = 0.859) and higher HDI (ORL = 0.022), ORP = 0.040) were associated with a lower prevalence of dental caries experience. Water fluoridation was associated with a lower DMFT index (ORP = 0.766). Dental caries experience is still associated with social inequalities at different levels. Policymakers should direct interventions towards reducing inequalities and the prevalence of dental caries among 12-year-old children.

Perfil clínico epidemiológico de salud oral en comunidades nativas peruanas / Clinical epidemiological profile of oral health in Peruvian native communities

Introducción: Las comunidades nativas forman uno de los grupos humanos más olvidados donde se reagudizan las inequidades y desigualdades en salud oral. Objetivo: Determinar el perfil clínico epidemiológico de salud oral en pobladores de las comunidades nativas de Potsoteni, Boca Sanibeni y Unión Puerto Ashaninka del distrito de Mazamari, provincia de Satipo, departamento de Junín, Perú. Material y Métodos: Se realizó un estudio observacional descriptivo de corte transversal. La muestra estuvo integrada por 169 adultos de las comunidades nativas, se tomaron en cuenta criterios de inclusión y exclusión, y se siguieron las normas éticas en investigación científica. Se evaluó la salud oral mediante una ficha epidemiológica con los indicadores: Índice CPOD, índice de significancia de caries dental (SIC), índice de higiene oral simplificado (IHO-S), índice de necesidad de prótesis dentales de la OMS, clasificación de maloclusión de Angle, índice de consecuencias clínicas de caries no tratadas (PUFA), la evaluación fue realizada con luz natural por observadores calibrados. Los datos se analizaron en el programa STATA v 14 mediante tablas de distribución de frecuencias y figura. Resultados: El 100 por ciento de los pacientes estudiados tenía caries dental (CPO-D = 13,23; SIC=19,01), IHO-S: 5,02 (DS=0,51), la mayoría presentó un tipo de maloclusión y consecuencias clínicas de caries no tratadas 116 (68,63 por ciento ) y 115 (68 por ciento ) respectivamente, la prótesis dental unitaria fue la que más se necesitó en ambos maxilares. Conclusiones: El estado de salud bucal fue preocupante, es necesario fomentar políticas que permitan un mejor acceso a los servicios de salud a fin de revertir estos indicadores(AU)

Introduction: Native communities are one of the most forgotten human groups where inequities and inequalities in oral health are exacerbated. Objective: To determine the epidemiological and clinical profile of oral health in residents of the native communities of Potsoteni, Boca Sanibeni and Union Puerto Ashaninka of Mazamari district, Satipo province, Junín department, Peru. Material and Methods: A cross-sectional descriptive observational study was conducted. The sample consisted of 169 adults from native communities who fulfilled inclusion and exclusion criteria, following the ethical norms in scientific research. Oral health was evaluated through an epidemiological fact sheet with the following indicators: DMFT index, Significant Caries Index (SCI), simplified oral hygiene index (OHI-S), prosthetic need WHO index, classification of Angle malocclusion, and index of clinical consequences of untreated dental caries (PUFA). The evaluation was made with natural light by calibrated observers. The data was analyzed in the STATA v 14 program by means of frequency and figure distribution tables. Results: It was determined that 100 percent of the patients studied had dental caries (DMFT = 13.23, SCI = 19.01), OHI-S: 5.02 (SD = 0.51), the majority of them presented a type of malocclusion and clinical consequences of untreated caries; 116 (68.63 percent) and 115 (68 percent), respectively. The unitary dental prosthesis was the most needed in both jaws. Conclusions: The state of oral health was worrisome; it is necessary to promote policies that allow better access to health services in order to revert these indicators(AU)

Association of added sugar intake and caries-related experiences among individuals of Mexican origin.

OBJECTIVE: Determine the association between key dental outcomes and added sugar intake using a survey instrument to assess added sugars, which was specifically tailored to immigrant and US-born adults of Mexican origin. METHODS: Hispanic adults of Mexican origin (n = 326; 36.2 ± 12.1 years) completed a self-administered survey to gather acculturation, self-reported dental experiences and self-care practices (eg brushing, flossing, pain, bleeding gums), and socio-demographic information. The survey included a culturally tailored 22-item Added Sugar Intake Estimate (ASIE) that assessed added sugar intake from processed foods and sugar-sweetened beverages in a semiquantitative food frequency questionnaire format. Linear regression, 2-sample t test, and ANOVA were used to evaluate associations of demographic and dental outcomes with daily added sugar intake. RESULTS: Of the mean total daily added sugar intake (99.6 ± 94.6 g), 36.5 ± 44.4 g was derived from sugar-containing foods and snacks, and 63.1 ± 68.2 g from beverages. Participants who reported greater added sugar intake were more likely to have reported the presence of a toothache in the preceding 12 months, having been prescribed antibiotics for dental reasons, being less likely to floss daily, have reported eating or drinking within 1 hour before bed and have lower psychological acculturation (P < .05 for all). Results were comparable when assessing intake from sugar-containing foods/snacks and sugar-sweetened beverages. CONCLUSIONS: This study confirmed the association between added sugar intake and self-reported dental outcomes among adults of Mexican origin and points to an urgent need to improve dietary behaviours in this population.

Caries prevalence among Brazilian indigenous population of urban areas based on the 2010 National Oral Health Survey.

It is important to have an epidemiological understanding of oral diseases among indigenous persons, in order to contribute with the organization of health services for these populations. The SB Brasil 2010 database was used to compare the prevalence of dental caries among 308 self-identified indigenous and 37,211 non-indigenous individuals from urban areas, in the following age/age-groups: 5, 12, 15-19, 35-44, 65-74. The study also analyzed the effect of the complex sample design and the sample weight in the outcomes. Kruskal-Wallis, Wilcoxon Scores (Rank Sums), logistic and multiple linear regressions were used for statistical analysis. The mean dmft index for indigenous and non-indigenous children aged five were 4.02 ± 4.01 and 2.41 ± 3.35, respectively, and 46% of non-native and 30.8% of native children were caries-free. The mean DMFT for indigenous and non-indigenous were 10.90 ± 11.69 and 10.93 ± 11.58, respectively, for all age groups when not taking into account the sample weight effect. When considering the complex sample design and the sample weight effect, the study found a statistical significant difference. The results lend credence to suspicions that in Brazil there are disparities in the patterns of caries between self-identified indigenous and non-indigenous individuals.

Dental caries in peoples of Xingu Indigenous Park, Brazil, 2007 and 2013. / Cárie dentária em povos do Parque Indígena do Xingu, Brasil, 2007 e 2013.

OBJECTIVE: to describe the prevalence of dental caries and the supply of dental care in the population of Xingu Indigenous Park, Brazil, at 5, 12 and 15-19 years old, in 2007 and 2013. METHODS: cross-sectional study panel, with secondary data provided by the Indigenous Special Sanitary District of Xingu and Project Xingu. RESULTS: 368 indigenous people were examined in 2007 and 423 in 2013; there was no significant difference between the means of the number of decayed, missing and filled teeth at 5 years (6.43 [2007], 5.85 [2013]; p=0.29), and at 12 years (2.54 [2007], 2.78 [2013]; p=0.81); this difference was significant at 15-19 years (6.89 [2007], 4.65 [2013]; p<0.01); the dental care index decreased from 21.7 to 7.1%, 44.1 to 16.4%, and 63.1 to 41.1%, respectively at 5, 12, and 15-19 years. CONCLUSION: the prevalence of caries remained high in children, with a reduction in adolescents (15-19 years old); there was a decrease in the supply of dental care.

MMP20 rs1784418 Protects Certain Populations against Caries.

This work aimed to further evaluate the association of MMP20 rs1784418 C>T and dental caries experience with the hypothesis that MMP20 rs1784418 C>T is a risk factor for dental caries. 184 children 4-7 years of age had their caries experience determined and buccal cheek swabs collected for DNA extraction to test for association with the MMP20 rs1784418 C>T using standard statistical approaches. A meta-analytic approach was also implemented to compile previous discrepant reports of the same association. We found an association between MMP20 rs1784418 C>T and dental caries experience in primary dentition (p = 0.01). The meta-analysis showed that this association appears to favor individuals born in Brazil and not Turkey. MMP20 rs1784418 C>T appears to protect against dental caries, but its effects are likely to be more marked in certain populations.

Income as a Protective Factor for Dental Caries among Indigenous People from Central Brazil.

The objective of this paper was to evaluate the association between eligibility for a conditional cash transfer program, based on household income, and dental caries in 12-year-old children from three Indigenous ethnic groups living in Mato Grosso do Sul state, Central Brazil. A population-based cross-sectional study was performed in three ethnic groups: Kaiwoá, Guarani, and Terena. The study population was drawn by stratified sampling according to each ethnic group with a probability proportional to the village size. The number of untreated decayed permanent teeth as a count variable was the outcome measure. Ethnic group and eligibility for the conditional cash transfer program showed significant association with untreated caries. Children from Guarani and Terena presented respectively two-fold and 2.8-fold higher caries rate (p<.001) compared with Kaiwoá in the adjusted model, while children from no eligible cash transfer program households had a 40% lower caries rate (p=.034).

A Multilevel Approach on Self-Reported Dental Caries in Subjects of Minority Ethnic Groups: A Cross-Sectional Study of 6440 Adults.

Regional contextual factors and dental caries using multilevel modeling related to adults in minority ethnic groups have been scantily explored. The influence of the socioeconomic context on self-reported dental caries (SRDC) in individuals of minority ethnic groups (IEG) in Colombia was studied. Data from the 2007 National Public Health Survey were collected in 34,843 participants of the population. The influence of different factors on SRDC in IEG was investigated with logistic and multilevel regression analyses. A total of 6440 individuals belonged to an ethnic group. Multilevel analysis showed a significant variance in SRDC that was smaller in IEG level than between states. Multilevel multivariate analysis also associated SRDC with increasing age, lower education level, last dental visit >1 year, unmet dental need and low Gross Domestic Product (GDP). Minority ethnic groups were at risk to report higher dental caries, where low GDP was an important variable to be considered.

Inquidades entre adolescentes brasileiros relacionadas a raça/etnia: a cárie dentária como indicador de saúde bucal / Inequalities among brazilian adolescents related to race/ethnicity: dental caries as oral health indicator

Esta tese contempla três estudos epidemiológicos e uma revisão sistemática cujo objetivo foi avaliar a iniquidade entre adolescentes brasileiros relacionadas à raça/etnia e experiência de cárie dentária, cárie não tratada, dentes perdidos e restaurados e, testar se indicadores socioeconômicos explicam as diferenças observadas. Realizou-se uma revisão sistemática nas bases de dados PubMed e Scopus para avaliar a associação entre raça/etnia e experiência de cárie. Os dados do Projeto SB Brasil 2003 (n=16.833) e 2010 (n=5.367) foram utilizados para análises de prevalência, teste qui-quadrado, modelo conceitual hierárquico e mediação. Entre 2003 e 2010 observou-se uma diminuição na prevalência de experiência de cárie, cárie não tratada, dentes perdidos e restaurados, e constatou-se a persistência das iniquidades relacionadas à raça/etnia. Brancos tiveram uma redução significativa de na experiência de cárie (19,4%) e apenas 10,2% de cárie não tratada, enquanto entre Indígenas houve uma diminuição de cárie não tratada (17,4%) e 15,5% entre Pardos. Entretanto, em 2003, Negros tiveram 19% menos chances, e em 2010, 32% mais chance de terem experiência de cárie do que Brancos. Ainda, em 2003, Pardos e Brancos tiveram chances semelhantes de terem experiência de cárie, e em 2010, Pardos tiveram 69% mais chance do que Brancos. E, em 2010, Negros, Pardos e Indígenas tiveram mais chance de terem dentes cariados não tratados do que Brancos. A prevalência de dentes perdidos diminuiu entre todos os grupos e observou-se uma redução de 17,2% de dentes restaurados entre Brancos e um aumento de 14,8% entre Pardos, sendo que em 2010, Pardos tiveram 21% mais chance de terem dentes restaurados do que Brancos. A análise do modelo conceitual hierárquico realizada nos dados do SB Brasil 2010 confirmou a associação entre a experiência de cárie, cárie não tratada, dentes perdidos e restaurados e raça/etnia. Pardos e Amarelos tiveram 1,44 e 1,81 vezes, respectivamente, mais chance de terem experiência de cárie; Pardos tiveram 1,52 vezes mais chance de terem dentes perdidos; e Negros e Pardos tiveram 0,67 e 0,85 vezes, respectivamente, menos chance de terem dentes restaurados quando comparados com Brancos. Os resultados da análise de mediação confirmaram que as iniquidades observadas foram mediadas através das variáveis educação e renda. A revisão sistemática sugere uma associação das iniquidades raciais/étnicas na experiência de cárie, sendo raça/etnia um constructo social que precisa ser combinado com outros fatores determinantes para melhor compreensão e abordagem. Apesar das políticas públicas vigentes no Brasil, as análises dos dados demonstraram uma persistência das iniquidades e os adolescentes Brancos têm se beneficiado mais da redução da cárie dentária, apresentando melhor condição de saúde bucal

This thesis includes three epidemiological studies and one systematic review, which aimed to assess inequalities among Brazilian adolescents related to race/ethnicity in dental caries experience, untreated caries, missing and filled teeth, and test whether socioeconomic indicators explain the observed differences. A systematic review was conducted in PubMed and Scopus databases to evaluate the association betweenrace/ethnicity and caries experience. Data from a Brazilian National Oral Health Survey (SBBrasil) conducted in 2003 (n=16,833) and 2010 (n=5,367) were used to prevalence analysis, chi-square test, hierarchical conceptual modelling, and mediation. Between 2003 and 2010, a decrease in the prevalence of caries experience, untreated caries,missing and filled teeth between 2003 and 2010 was observed, and a persistence of inequalities related to race/ethnicity.Whites had a significant 19.4% reduction in caries experience and only 10,2% reduction in untreated caries, while among Indigenous descents and Mixed Race there was a 17,4% and 15,5% reduction, respectively, inuntreated caries. However, in 2003, African descents were 19% less likely, and in 2010, 32% more likely to have caries experience thanWhites. Although in 2003, Mixed Race and Whites had similar chances of having caries experience, in 2010, Mixed Race was 69% more likely to have caries experience than Whites. Moreover, African descents, Indigenous descents, and Mixed Race were more likely to have untreated decayed teeth than whites in 2010. Missing teeth prevalence decrease between all groups and filled teeth had a reduction of 17.2% for Whites and a rise by 14.8% for Mixed Race, being the Mixed Race in 2010, 21% more likely to have filled teeth than Whites. Hierarchical conceptual modelling analysis performed in the SBBrasil 2010 data, confirmed the association between caries experience, untreated caries, missing and filled teeth and race/ethnicity. Compared to Whites, Mixed Race and East Asian Descents were 1.44 and 1.81 times, respectively, more likely to have caries experience; Mixed Race was 1.52 times more likely to have missing teeth, and African Descents and Mixed Race were 0.67 and 0.85 times, respectively, less likely to have filled teeth. Results of mediation analysis confirmed that the observed inequalities were mediated through education and income variables. The systematic review suggested an association of racial/ethnic inequalities in caries experience, being race/ethnicity a social construct that needs to be addressed with other determinant factors to better understand and effectively address oral health inequalities. Despite the existing policies in Brazil, data analysis demonstrated a persistence in race/ethnic inequalities and that White adolescents have benefited more from the reduction of dental caries and have a better oral health condition

Inequality of Experience of Dental Caries between Different Ethnic Groups of Brazilians Aged 15 to 19 Years.

INTRODUCTION: The aim of this study was to assess inequality of experience of dental caries, based on race/ethnicity, among Brazilian adolescents aged 15 to 19 years in 2010 and test whether socioeconomic indicators fully explain ethnic differences in dental caries. METHODS: Data from a National Oral Health Survey conducted in Brazil in 2010 was analysed. Race/ethnicity was self-assigned and modified to White, African descents, East Asian descents, Mixed Race and Indigenous descents. The prevalence of caries experience by race/ethnic group in 2010(n = 5,367) was calculated. Further analysis included conceptual hierarchical modelling and mediation analysis. RESULTS: Caries experience was 76.9% in 15 to 19 year old Brazilians in 2010. While African descents were 32% more likely to have caries experience than Whites, Mixed Race were 69% more likely to have caries experience than Whites. Hierarchical conceptual modelling analysis confirmed the highly significant association between caries and race/ethnicity. Mixed Race and East Asian descents were 1.44 (95% CI 1.24-1.67) and 1.81 (95% CI 1.02-3.20) times more likely to experience caries than Whites after adjusting for age, sex, education and income. The difference in the likelihood of experiencing caries between Whites and African descents was not statistically significant after adjusting for years of education and family income. The results of mediation analysis confirmed that inequality of caries experience between Whites and Mixed Race and East Asian descents was mediated through education and income. The likelihood that Mixed Race and East Asian descents would experience caries compared to Whites was attenuated, by 14.8% and by 9.5% respectively, after adjusting for years of education and income. CONCLUSIONS: Data analysis demonstrated that Whites have benefited more from the significant reduction in dental caries experience in 15 to 19 year old Brazilians, as compared to African descents and Mixed Race. Education and income fully explained ethnic inequalities in experience of dental caries between Whites and African descents, and largely explained inequalities between Whites and Mixed Race.

Prevalence of caries and malocclusion in an indigenous population in Chiapas, Mexico.

OBJECTIVES: To assess the prevalence of caries and malocclusion in Mayan Mexican adolescents, 14-20 years of age, living in Chiapas, Mexico. METHODS: This was a cross-sectional, population-based, quantitative, epidemiological study. Sites were chosen to capture subjects representative of the state's Mayan population. A total of 354 subjects were recruited. Caries experience was quantified, via visual inspection, using the Decayed, Missing and Filled Surface (DMFS) index. Malocclusion was quantified using the Index of Complexity, Outcome and Need (ICON). RESULTS: Our data showed that 99% of the population had caries experience, with a median DMFS score of 8. Of the 99% with caries experience, over half had caries affecting more than five tooth surfaces. Thirty-seven per cent of the students had unmet orthodontic treatment need, and 46.46% presented a Class II, and 39.09% a Class III, anterior-posterior relationship. CONCLUSIONS: Less than 1% of the population had any exposure to orthodontics, demonstrating the lack of access to care. Likewise, only 1% of the population was found to have no caries experience, exhibiting a large unmet treatment need. The median DMFS score of 8 was also high in comparison with the median DMFS in the USA of 6. Our data suggest a correlation between the lack of access to care and high prevalence of caries and malocclusion in Mexican Mayans who inhabit Chiapas, Mexico.

Dental pain and associated factors among pregnant women: an observational study.

The present study aimed to determine the prevalence of dental pain during pregnancy and its association with sociodemographic factors and oral health conditions among 315 pregnant women in South Brazil. Participants were interviewed to obtain sociodemographic data, such as age, educational level, employment status, family income, and marital and parity status. Medical and dental histories were also collected, including the occurrence of dental pain and the use of dental services during pregnancy. Clinical examinations were performed to assess the presence of visible plaque and gingival bleeding and to calculate the decayed, missing, and filled teeth index. Means and standard deviations of continuous variables and frequencies and percentages of categorical variables were calculated. Independent variables were included in a multivariate logistic regression analysis. A total of 173 (54.9 %) pregnant women reported dental pain during pregnancy. After adjustment of the analysis, caries activity remained the main determinant of dental pain (odds ratio 3.33, 95 % CI 1.67-6.65). The prevalence of dental pain during pregnancy was high and the presence of caries activity was a determinant of dental pain. Moreover, access to oral health care was low, despite pregnant women's increased need for dental assistance.

Maize dependence or market integration? Caries prevalence among indigenous Maya communities with maize-based versus globalized economies.

The relationship between diet and oral health is widely known, yet data on dental caries prevalence is lacking for many indigenous groups with traditional or rapidly modernizing diets. This research documents caries prevalence in two Maya communities from northern Yucatán (Mexico) with significantly different levels of market integration, subsistence, and diet: Yalsihón, with a traditional, maize-based subsistence economy, and Dzilam, with access to globalized food markets. Each sample was subdivided by sex into 15-19, 20-24, and 25-30 years-of-age classes. Caries prevalence was considered separately both when the lesion affected the enamel superficially (grade 1+) and when it reached the dentin (grade 2+). In both villages, females of all age classes manifest more caries than males. Results show higher prevalence of caries at Dzilam than at Yalsihón, except for grade 1+ caries among 15-19-year-old males and grade 2+ caries among 15-19-year-old females. Though differences are not significant, earlier pregnancies among 15-19-year-old females at Yalsihón could be a causative factor. A survey indicated a more balanced diet at Yalsihón despite a heavier intake of maize than at Dzilam. Striking differences were documented in the ingestion of soda and globalized foods; sodas were virtually absent at Yalsihón, while at Dzilam they were ingested daily in great quantities. The decline in oral health at Dzilam is inferred to result from consumption of industrially processed foods and drinks, while a traditional diet leads to less caries despite daily heavy consumption of maize, which must be considered when interpreting caries rates in archaeological samples.

Enfermedades bucales en estudiantes chinos / Oral diseases in Chinese students

Desde hace algunos años se observa en nuestras universidades de ciencias médicas estudiantes chinos de forma masiva, evento sin precedentes en nuestro país. Para el dominio de todo lo referente a su salud bucal y al proceso salud-enfermedad de los mismos. Objetivo: identificar las principales enfermedades bucales en estudiantes chinos para que de esta forma se logre una calidad en la atención de los mismos. Métodos: se realizó una investigación descriptiva transversal. Se tomó una muestra de 185 estudiantes chinos. Se le realizó un examen bucal y facial y una entrevista para obtener las variables de interés en la investigación. Resultados: las gingivitis y las maloclusiones fueron las enfermedades bucales más prevalecientes; la caries dental fue la que menos se manifestó. Tanto el sexo masculino como el femenino prevalecieron como enfermos y el origen social rural aportó los únicos pacientes discapacitados deficientes. Conclusiones: la higiene bucal es el factor de riesgo más relacionado con las Gingivitis y Caries Dental, así como el origen social rural determinó una peor condición epidemiológica(AU)

Recently, Chinese students are being massively received in our medical universities. This is an unprecedented event in our country. For mastering everything about their oral health and their health-disease process, a stomatologic study was conducted on them. Objective: to identify the main oral diseases in these subjects to provide quality health care for them. Methods: a descriptive study was conducted, taking a sample of 185 Chinese students. They had oral and facial examination and an interview for this investigation variables was applied. Results: gingivitis and malocclusions were the most prevalent oral diseases, dental caries manifested the least. Both male and female subjects prevailed as patients. Rural social background provided the only poor disabled patients. Conclusions: oral hygiene is the risk factor most related to gingivitis y dental caries. The rural social origin determined a worse epidemiological condition(AU)

Socio-behavioural factors and early childhood caries: a cross-sectional study of preschool children in central Trinidad.

BACKGROUND: Early childhood caries (ECC) is a public health problem due to its impact on children's health, development and well being. Little is known about early childhood oral health in the West Indies or the influence of social and behavioural factors on the prevalence and severity of early childhood caries in this preschool population. The aims of this study were to describe the prevalence and severity of ECC in preschool children in a region of central Trinidad and to explore its relationship with social and behavioural factors. METHOD: A cross-sectional survey was undertaken on children aged 3-5 years-old from a random sample of preschools in central Trinidad. Oral health examinations were conducted for children for whom parental consent was given, using WHO criteria (visual diagnosis / cavitation at d3). A self-reported questionnaire was distributed to all parents and caregivers. Variables included socio-demographics, oral health knowledge, attitudes and behaviours, visible caries experience and treatment need. RESULTS: 251 children were examined, 50.2% were male with a mean age of 3.7 years (SD 0.67) and 71% were of Indian ethnicity. The prevalence of ECC was 29.1% and the prevalence of severe early childhood caries (S-ECC) was 17.5%. 29.9% of children had some treatment need, with 12% in need of urgent care or referral. Poisson generalized linear mixed model analysis found a higher rate of visible caries experience for children who ate sweet snacks more than twice a day (p < 0.001), had poorer parental dental health ratings (p < 0.0001), a previous dental visit (p < 0.0001) and difficulty finding dental care (p < 0.001). CONCLUSION: The prevalence and severity of ECC in central Trinidad was related to oral health behaviours and access to dental care. Oral health promotion should include more supportive and practical advice for parents and caregivers of preschool children along with improved access to dental care to enable primary prevention and management of ECC.

Parafunciones y caries dentales en preescolares de comunidades pehuenches / Parafunctions and decay in preschool children from pehuenches communities

Introducción: las parafunciones bucales son consideradas uno de los factores causales de los trastornos temporomandibulares que han tomado mucha relevancia en las últimas décadas, especialmente en poblaciones infanto-juveniles, aunque la evidencia en preescolares es escasa y nula en grupos indígenas. El objetivo del presente estudio es determinar la prevalencia de parafunciones bucales y presencia de caries en preescolares de comunidades pehuenches, de la comuna de Alto Biobio, la más pobre de Chile, así como su posible relación con características etnodemográficas y socioeconómicas. Métodos: se tomó una muestra que estuvo conformada por 71 niños de 2 a 5 años los cuales asisten a jardín infantil. Se contó con la autorización de las autoridades locales y el consentimiento informado de los padres. Se evaluaron variables socio-etnodemográficas, presencia de caries en dientes temporales (índice ceod) de acuerdo con los criterios de la Organización Mundial de la Salud y la presencia de 8 parafunciones bucales: succión digital, de objetos, de mamadera, de chupete, labial, interposición lingual, onicofagia y respiración bucal mediante encuesta a las educadoras de los jardines. Resultados: el 9,86 por ciento de preescolares estaba libre de caries y el ceod fue 6,83 ± 4,65, lo que aumenta con la edad, 2,8 (a los 2 años) y 8,23 (a los 5 años). El promedio de parafunciones bucales por preescolar fue 1,73 ± 1,06, significativamente mayor en mujeres, pehuenches y preescolares de extrema pobreza. La prevalencia para alguna de las 8 parafunciones bucales fue de 90,86 por ciento y 77,46 por ciento para las asociadas a succión. Las más prevalentes son succión de mamadera y labial (26,76 por ciento), onicofagia (29,58 por ciento) y succión digital (47,89 por ciento). Conclusiones: la presencia de caries en estos preescolares es muy alta, mientras que la prevalencia de parafunciones bucales es similar a otras poblaciones, lo que afecta más a preescolares de extrema pobreza y pehuenches, posiblemente relacionado con las condiciones de vulnerabilidad social de la comuna. Estos resultados resaltan la urgencia de implementar medidas promocionales, preventivas y terapéuticas en esta población(AU)

Introduction: Oral parafunctions are considered one of the causal factors of temporomandibular disorders and have gained importance in recent decades, especially in child and young populations, although evidence is scarce in the preschool children and nonexistent in the indigenous groups. The objectives of this study were to determine the prevalence of oral parafunctions and the presence of caries in pehuenche preschool children, from Alto Biobio commune , the poorest one in Chile, as well as the possible association of the ethnodemographic and the socioeconomic characteristics. Methods: A sample comprised 71 children from 2 to 5 years attending kindergarten; the permission of local authorities and the informed consent of parents were granted. Socio-ethno-demographic variables, decay presence in primary teeth (dmft index) according to WHO criteria and the presence of 8 oral parafunctions: finger sucking, object sucking, sucking on bottle, pacifier and lip sucking, tongue thrust, onychophagia and mouth breathing, were all evaluated through a survey made to kindergarten educators. Results: Of the studied children, 9.86 percent were caries-free and the dmft index was 6.83 ±4.65, increasing with the age, hence, it was 2.8 at age 2 and 8.23 at age 5. Oral parafunctions average was 1.73 ±1.06 per child, significantly higher in women, pehuenches and extremely poor children. Prevalence for any of the 8 oral parafunctions was 90.86 percent and for those associated with non-nutritive sucking was 77.46 percent. The most prevalent were bottle and labial sucking (26.76 percent), onychophagia (29.58 percent) and finger sucking (47.89 percent). Conclusions: Decay presence in these preschool children is very high, whereas the prevalence of oral parafunctions is similar to that of other populations, affecting more children in extreme poverty setting and pehuenches. All this is possibly related to the social vulnerability of the commune. These results highlighted the urgent need of implementing preventive, promotional and therapeutic strategies in this population(AU)

Severidad de caries y pérdida de dientes de una población pre-Hispánica del norte de Chile / Caries severity and tooth loss in an ancient pre-Columbian culture in the north of Chile

El conocer la historia natural de las patologías bucales sin intervenciones modernas, permite comparar el desarrollo de éstas con los datos actuales. Este estudio tiene como objetivo conocer la severidad de caries dental y de pérdida de dientes en una muestra de restos humanos de la cultura Atacameña (500 DC) en San Pedro de Atacama en el norte de Chile. Se estudiaron 139 restos humanos, en cada uno de ellos se realizó un examen clínico, consignado la información en una ficha individual donde se registró, el número de dientes presentes y perdidos pre y post mortem y el número de lesiones de caries. Estas variables permitieron calcular el índice CPD (Obturadas=0). El análisis estadístico incluyó una descripción de frecuencias y el cálculo de estadísticas de dispersión y tendencia central para las variables continuas. Los resultados muestran que el índice CPD mínimo, asume que las piezas perdidas post mortem estaban sanas fue 17.14 con un promedio de 3.93 lesiones de caries y 13.2 dientes perdidos en vida. Los restos humanos de la población estudiada presentan un gran daño de su salud bucal. Gran cantidad de piezas dentarias perdidas en vida y bajo número de dientes sanos.

The aim of this study was to determine the severity of dental caries and tooth loss in a sample of 139 human remains of the Atacama culture (500 AD) in San Pedro de Atacama, northern Chile. A clinical examination was performed on each remain by a calibrated examiner. The number of present and missing teeth in pre-and post-mortem stages and the number of carious lesions were recorded. The DMT index (filled = 0) was calculated. Statistical analysis included a description of frequency and calculation of statistical dispersion and central tendency for continuous variables. The results reveal a DMT of 17.14 with an average of 3.93 carious lesions and 13.2 teeth lost in life. The oral health situation of the studied population presented severe damage, high rate of tooth loss and DMT scores.

Perfil epidemiológico da cárie dentária em escolares de 5 e 12 anos residentes no Município de Bayeux, Paraíba / Epidemiological profile of dental caries in school children, aged 5 to 12 years of age, who live in the Municipality of Bayeux, Paraiba

Objetivo: analisar o perfil epidemiológico para cárie dentária de crianças com 5 e 12 anos de idade pertencentes a escolas da rede pública e privada de ensino do município de Bayeux, PB. Materiais e métodos: a amostra constituiu-se por 411 indivíduos, sendo 277 de 5 anos 134 com 12 anos de idade, distribuídas em 10 setores censitários do município. Os exames clínicos foram realizados por uma cirurgiã-dentista calibrada (Kappa= 0,82) de acordo com os critérios de diagnóstico recomendados pelo SB BRASIL 2010. Foram investigados os índices ceod e CPOD. Os dados coletados foram registrados e analisados no programa Excel, sendo realizada análise descritiva. Resultados: Verificou-se que o ceo-d/CPO-D para 5 e 12 anos foram, respectivamente, 2,86 (+3,07) e 4,19 (+2,66). Aos 5 anos, 32,1% das crianças não apresentaram experiência com a doença cárie. Para aquelas identificadas com experiência de cárie, 96,5% do ceo-d eram do componente cariado. Aos 12 anos, o percentual da amostra com todos os dentes hígidos foi de 9,0%. Em relação aqueles indivíduos com CPO-D maior ou igual a 1, o componente cariado apresentou maior percentual na composição do índice (80,9%). Conclusões: A presença de cárie dentária aos 5 e aos 12 anos foi alta. Houve predominância, em ambos os índices, do componente cariado.

Prevalencia de caries dental y fluorosis en áreas de fluorosis endémica en el Estado Portuguesa, Venezuela / Prevalence of dental caries and flurosis endemic fluorosis areas of Portuguesa State, Venezuela

Determinar la prevalencia y severidad de caries y fluorosis dental en una zona de fluorosis endémica en Portuguesa. 187 individuos entre 2-62 años de edad de cuatro comunidades del Municipio Santa Rosalía fueron evaluados para caries dental según el índice CPOD/ceo (OMS) y para fluorosis dental de acuerdo al Índice de Dean. Todos los participantes en la presente investigación firmaron un consentimiento informado. Cada paciente respondió un cuestionario estructurado a tal fin y los datos fueron registrados. El examen clínico fue realizado por un examinador calibrado y se utilizó sonda WHO, espejo plano #5 y luz natural. Según el género, de los 187 pacientes, 96 fueron masculino (51%) y 91 femeninos (49%) y 90,9% de la población estudiada pertenecía a los estratos 4 y 5 de Graffar. El 69% de pacientes estaban libres de caries dental y los índices promedio CPOD y ceo fueron 1,7±3,62 y 0,41±1,15, respectivamente siendo el índice CPOD en Cogote significativamente menor (p<0,05) al compararlos con los observados en San Pablo y Playón (p>0,05), pero sin diferencias significativas al compararlo con el de Punto Fijo. El 76,9% de los individuos evaluados presentaban fluorosis dental siendo el grado de severidad promedio la categoría de moderado (Grado 4). Se le debe dar una alta prioridad a la defluoruración del agua, y en caso de que no sea posible, se debe proveer a la población de agua con concentraciones de fluoruro óptimas. No se observó asociación entre el grado de severidad de fluorosis dental y los niveles de fluoruro en el agua. Estudio parcialmente financiado por la Facultad de Odontología, UCV.

The purpose of this study was to determine the prevalence and severity of dental caries and fluorosis in an endemic area of Portuguesa State. One hundred eighty seven individuals, age ranging between 2-62 years, from four communities of Santa Rosalía Municipality were evaluated for dental caries index DMFT/dmf according to the WHO criteria and dental fluorosis using the Dean index. All participants signed the written consent to be enrolled for the study. The clinical examination was done by a calibrated examiner using the WHO probe, mirror #5 and natural light. The results from the study showed that 96/187 (51%) were male and 91/187 (49%) were female. According to socioeconomic status 90.9% of the studied population was level 4 and 5 according to Graffar criteria. Sixty nine percent of the patient was dental caries free and the mean indexes DMFT/dmf were 1.7±3.62 and 0.41±1.15, respectively. The lower DMFT scores were observed in Cogote (p<0.05) with statistical significant differences when compared to San Pablo and Playón but without differences when compares to Punto Fijo community (p>0.05). When analyzing the presence of dental fluorosis, 76.9% of the subjects had the condition being moderate (Grade 4). We may conclude that water defluoridation is of high priority in these communities, as well as to provide the population with optimal fluoride concentration in water. Our results indicate the absence of association between the fluoride concentration for water consumption and the dental fluorosis severity in endemic areas. Study partially supported by the Faculty of Dentistry, UCV.