Planes, políticas públicas y estrategias de salud bucal en Latinoamérica y el Caribe (1991-2018) / Plans, public policies and strategies of oral health in Latin America and Caribbean (1991-2018)

Introducción: La identificación de políticas públicas y estrategias en salud bucal, así como lo relacionado con sus propósitos, acciones y limitaciones, es un paso importante en la acción intersectorial en salud para alcanzar equidad. Objetivo: Describir las características principales de los documentos relacionados con planes, políticas y estrategias en salud bucal en Latinoamérica y el Caribe. Métodos: Estudio exploratorio mediante el análisis documental de fuentes secundarias de información disponibles en las páginas web de los ministerios de salud de 23 países, y rastreo sistemático en el buscador Google, sin restricción espacio-temporal. Se realizó análisis de contenido cuantitativo y cualitativo. Resultados: Se analizaron 85 documentos. Los países con mayor número de documentos relacionados con el tema propuesto fueron Colombia (n = 14), México (n = 8) y Panamá (n = 7). Una buena parte centran su atención en poblaciones específicas; por ejemplo: gestantes, comunidades vulnerables, escolares, maestros, entre otras. Tienen como propósito la disminución de factores de riesgo para las principales enfermedades bucales, desde enfoques relacionados con los determinantes sociales. El enfoque de género es más tímido y centra su atención en necesidades especiales de las mujeres en embarazo, parto y posparto. Los objetivos de la mayoría de los documentos analizados consistían en una atención integral sobre el estado de salud bucodental, mediante acciones de educación, promoción y actividades clínicas a la población, según sus necesidades. Conclusiones: Se encontró una representación importante de países que tienen documentos relacionados con programas y planes nacionales o locales y con indicadores que reflejan su cumplimiento. También existen guías prácticas de actuación. Aunque en el diseño y construcción de los documentos intervienen profesionales, sobre todo de la estomatología, falta la participación de otras áreas del conocimiento que ayudarían a lograr una visión más amplia hacia la determinación social de la salud(AU)

Introduction: The identification of public policies and strategies in oral health, as well as its purposes, actions and limitations is an important step in intersectoral action in health to achieve equity. Objective: To describe the main characteristics of the documents related to oral health plans, policies and strategies in Latin America en the Caribbean. Methods: An exploratory study was conducted by means of documentary analysis of secondary sources of information available on the websites of the ministries of health of 23 countries, and systematic search in the Google, without spatio-temporal restriction. Quantitative and qualitative content analysis was performed. Results: 85 documents were analyzed. The countries with the highest number of documents related to the research topic were Colombia (n = 14), Mexico (n = 8) and Panama (n = 7). A good part is focused on specific populations, such as pregnant women, socially vulnerable communities, school children, teachers, among others. Their purpose is to reduce risk factors for the main oral diseases, making important advances in approaches related to social determinants. However, the gender approach is more timid by focusing attention on the oral health special needs of women in pregnancy, childbirth and postpartum. The main objectives of most of the documents analyzed consisted of an integral attention on the state of oral health, applying education, promotion and clinical activities to the population, according to their needs. Conclusions: An important representation of countries with documents related to national or local programs and plans were found and they have indicators that reflect their compliance. Also practical action guides were described. Although many professionals, especially in dentistry, intervene in the design and construction of documents, the participation of other areas of knowledge is lacking, what will help to achieve a broader vision towards the social determination of health(AU)

The implementation of a decision-tree did not increase decision-making in patients with temporomandibular disorders in the public dental health service.

OBJECTIVE: Many patients with temporomandibular disorders (TMD) seem to go undetected within primary dental health care. Primarily we evaluated if the implemented intervention increased the clinical decision-making for TMD patients; secondarily we evaluated if other factors could be identified that predicted performed or recommended TMD treatment. MATERIAL AND METHODS: This case-control study was carried out within the Public Dental Health service in Västerbotten County, Sweden. An intervention based on a decision-tree with three screening questions for TMD (3Q/TMD) was implemented during 2015 in four clinics and compared with the remaining county. A total of 400 individuals were selected-200 3Q-positives and 200 3Q-negatives. The 3Q/TMD consists of Q1-frequent jaw pain, Q2-frequent pain on function, and Q3-frequent catching and/or locking of jaw. The 3Q/TMD answers were analyzed in relation to TMD treatment and any TMD related decision that was collected from the digital dental records. RESULTS: The intervention did not increase the frequencies of traceable clinical decisions among patients with TMD. CONCLUSIONS: Despite the implemented intervention aimed, the indicated undertreatment of patients with TMD remains. Future studies are still needed to gain a deeper understanding of the clinical decision-making process for TMD patients in general practice dentistry.

Dental Public Health Practice, Infrastructure, and Workforce in the United States.

Dental public health is a unique specialty of dentistry that focuses on prevention of oral diseases among populations rather than individual patients. It encompasses several complementary disciplines and greatly varies in its functions and activities. Several federal, state, local, and nonpublic entities operationalize the mission of dental public health to improve population oral health through a diverse and vibrant workforce.

Impacto de la salud oral en la calidad de vida de la gestante / Impact of oral health on the quality of life of pregnant woman

RESUMEN Objetivo Identificar los factores determinantes de la calidad de vida relacionada con la salud oral (OHIP-14) en una población de mujeres embarazadas. Métodos En el estudio participaron 90 pacientes embarazadas, 45 inmigrantes y 45 españolas. Las participantes completaron el cuestionario de OHIP-14 (versión española) y se les exploró el índice CAOD (presencia de caries, ausencia de dientes por caries y dientes obturados) en el segundo trimestre de embarazo. Se realizó un estudio analítico bivariante y multivariante. Resultados La edad media de las participantes inmigrantes fue 30,2 años y de las españolas de 34,4. La puntuación media de OHIP-14 fue de 5,83±6,57, siendo en el grupo de inmigrantes de 8,15 y en las nacionales de 3,51, manifestando una diferencia estadísticamente significativa (p=0.001). Las puntuaciones más altas del OHIP-14 se presentaron en los dominios de dolor (110), seguido del malestar psicológico (81). Tomando como punto de corte el valor de la mediana en la puntuación del OHIP-14 (≥3), el Odds ratio de sentir una salud oral que interfiere en la calidad de vida fue de 3,294 y este riesgo se potenció con el padecimiento de caries (4,323) pero no con la edad. Conclusiones Dado que la experiencia de caries, pudiera ser uno de los determinantes en la valoración de percibir una peor calidad de vida oral durante el embarazo, se necesitarían más estudios que lo corroborasen, y así ampliar las expectativas preventivas en el desarrollo de la salud oral por parte de la política sanitaria.(AU)

ABSTRACT Objective To identify the factors that determine quality of life related to oral health (OHIP-14) in a population of pregnant women. Methods This study included ninety pregnant women, 45 immigrants and 45 from Spain. Participants completed the Oral Health Impact Profile questionnaire (OHIP-14) -Spanish version- and the DMFT index (decayed, missing, and filled teeth) was explored during the second trimester of pregnancy. A bivariate and multivariate analytical study was performed. Results The average age of immigrant participants was 30.2, and of Spanish women 34.4. The mean OHIP-14 score was 5.83±6.57 (8.15 in the immigrant group and 3.51 in the Spanish group), showing a statistically significant difference (p=0.001). The highest OHIP-14 scores were related to pain (110), followed by psychological distress (81). Considering the median value in the OHIP-14 score as a cut-off (≥3), the odds ratio for oral health that interferes with quality of life was 3.294, and this risk was increased by caries (4.323) but not by age. Conclusions Since the DMFT could be one of the determining factors for worst quality of life in pregnant patients, more studies to corroborate this information are necessary in order to expand preventive expectations in the practice of oral health in relation to policies.(AU)

Acceptance of Minimally Invasive Dentistry Among US Dentists in Public Health Practices.

PURPOSE: Little is known about use or acceptance of minimally invasive dentistry (MID) in the USA, particularly in public health settings. The purpose of this study was to assess opinions concerning MID among dentists in public-health practices. MATERIALS AND METHODS: A cross-sectional study was conducted to assess the views of dentists in public-health practices concerning MID using an online survey instrument among National Network for Oral Health Access (NNOHA) and American Association of Community Dental Programs (AACDP) members. Specific questions focused on diagnostic and preventive techniques, and whether MID was considered to meet the standard of care in the US Results: Overall, 86% believed that MID met the standard of care for primary teeth, and 77% did so for permanent teeth. The majority of respondents also agreed that fluoride varnish prevents caries and atraumatic restorative techniques (ART) are an effective caries treatment for children and adults. According to logistic regression results, dentists who had continuing education courses in MID and agreed that ART was an effective treatment for adults were more likely to report that MID met the standard of care for permanent teeth. Subjects who believed that fluoride varnish was effective as caries prevention for children were more likely to view MID as meeting the standard of care for primary teeth. CONCLUSIONS: There appears to be a paradigm shift toward a MID philosophy, and most responding public health dentists believed that MID meets the standard of care for primary and permanent teeth in the US.

Nationwide 2.5-Year School-Based Public Health Intervention Program Designed to Reduce the Incidence of Caries in Children of Grenada.

UNLABELLED: This paper describes an innovative public health intervention, called 'Smile Grenada', targeting the oral health of children in Grenada utilizing the resources of a US dental school, several oral health care companies, local governmental and public health authorities, and Grenadian school personnel. METHODS: Preintervention visual/tactile caries examinations were collected from 1,092 schoolchildren (mean age 9.9 years, standard deviation, SD = 3.7) in 2010. The intervention included: (1) classroom-based toothbrushing with fluoridated toothpaste, (2) fluoride varnish applied by trained dental students, teachers and local providers 3 times a year and (3) glass ionomer sealants placed on first permanent molars in children aged 6-8 years. Postintervention data were collected in May, 2013 (n = 2,301, mean age 9.8 years, SD = 3.7). Decayed and demineralized surfaces were examined for the whole sample and decay/demineralization and sealant retention on 6-year molars were examined separately (ages 6-8 in 2013 cohort). RESULTS: The number of decayed/demineralized surfaces declined across all age groups. The average number of decayed surfaces dropped from 9 at baseline to just over 6 (F1, 3,393 = 69.8, p < 0.0001) and the average number of demineralized surfaces dropped from 6 to less than 2 (1.8 surfaces; F1, 3,393 = 819.0, p < 0.0001). For children aged 6-8 years, there were statistically significantly fewer decayed surfaces (t1, 2,086 = 12.40, p < 0.0001; mean baseline 0.93, SD = 1.75; mean follow-up 0.23, SD = 0.83) and demineralized surfaces (t1, 2,086 = 19.7, p < 0.0001; mean baseline 2.11, SD = 2.74; mean follow-up 0.50, SD = 0.97) on 6-year molars. The Smile Grenada program successfully demonstrated a locally sustainable model for improving oral health in children in a developing country.

A dental public health approach based on computational mathematics: Monte Carlo simulation of childhood dental decay.

This study developed a Monte Carlo simulation approach to examining the prevalence and incidence of dental decay using Australian children as a test environment. Monte Carlo simulation has been used for a half a century in particle physics (and elsewhere); put simply, it is the probability for various population-level outcomes seeded randomly to drive the production of individual level data. A total of five runs of the simulation model for all 275,000 12-year-olds in Australia were completed based on 2005-2006 data. Measured on average decayed/missing/filled teeth (DMFT) and DMFT of highest 10% of sample (Sic10) the runs did not differ from each other by more than 2% and the outcome was within 5% of the reported sampled population data. The simulations rested on the population probabilities that are known to be strongly linked to dental decay, namely, socio-economic status and Indigenous heritage. Testing the simulated population found DMFT of all cases where DMFT<>0 was 2.3 (n = 128,609) and DMFT for Indigenous cases only was 1.9 (n = 13,749). In the simulation population the Sic25 was 3.3 (n = 68,750). Monte Carlo simulations were created in particle physics as a computational mathematical approach to unknown individual-level effects by resting a simulation on known population-level probabilities. In this study a Monte Carlo simulation approach to childhood dental decay was built, tested and validated.

Variables asociadas al uso de los servicios de salud bucodental por la población preescolar en España: un análisis de la encuesta nacional de salud / Variables associated with the use of dental services among preschool population in Spain: a national health survey analysis

Fundamentos: la salud bucodental es parte fundamental de la salud desde la erupción del primer diente. Para conseguirla, se precisa instaurar precozmente hábitos saludables como la revisión dental periódica. En nuestro medio, la caries es la enfermedad crónica pediátrica más prevalente y podría estar aumentando en los preescolares. Objetivos: a) describir la prevalencia del uso de los servicios de salud bucodental por los preescolares españoles, b) cuantificar y analizar la variabilidad entre comunidades autónomas y c) identificar las variables asociadas a dicho uso. Métodos: estudio transversal basado en la Encuesta Nacional de Salud (2006). Muestra: 2.172 niños de 2 a 5 años (ambos inclusive). Variable dependiente: haber acudido a los servicios dentales alguna vez en la vida. Variables independientes: sociodemográficas, de salud bucodental autoreferida, de hábitos y de nivel socioeconómico familiar. Análisis mediante regresión logística multivariante. Resultados: el 20,8% de los preescolares españoles refirió haber acudido a los servicios dentales. La probabilidad de uso aumentó con la edad (OR: 1,88; IC: 1,53-2,31), la frecuencia de cepillado dental diario (3 o más veces frente a menos de una vez al día: OR: 2,94; IC: 1,47-5,87) y la presencia de caries (OR: 2,60; IC: 1,22-5,51). Hay un gradiente socioeconómico en la probabilidad de uso: aumentó con el nivel socioeconómico familiar, medido a través de la clase social (baja frente a alta: OR: 0,41; IC: 0,19-0,86) y del nivel de estudios maternos (OR: 1,62; IC: 1,13-2,32). No existió variabilidad en el uso atribuible a la comunidad autónoma de residencia. Conclusiones: los preescolares españoles utilizan menos de lo deseable los servicios dentales. La promoción de su uso debería intensificarse en los niños procedentes de familias desfavorecidas (AU)

Background: oral health is integral to health from the eruption of the first tooth. To achieving, it is necessary an early establishment of healthy oral habits as regular dental checkups. In developed countries, caries is the most prevalent chronic pediatric disease and it may be increasing in preschool age. Objectives: a) assessing prevalence of oral health services use among Spanish preschool population, b) quantifying and analyzing the existence of variability among autonomous community and c) identifying variables associated with such use. Methods: cross-sectional study about Spanish National Health Survey (2006). Sample: 2,172 children aged between 2 and 5 years (both inclusive). Dependent variable: have gone to dental services at least once during life. Independent variables: sociodemographic, self-referred dental health, habits and family socioeconomic status variables. Multivariate logistic regression analysis. Results: 20.8% of Spanish preschoolers reported had attended dental services. Probability of use increased with age (OR: 1,88; IC:1,53- 2,31), frequency of daily tooth brushing (three or more times per day vrs less than once: OR: 2,94; IC: 1,47-5,87) and presence of caries (OR: 2,60; IC: 1,22-5,51). There is a socioeconomic gradient about probability of use: it increased with family socioeconomic status measured by social class (low vrs high: OR: 0,41; IC: 0,19-0,86) and maternal educational level (OR: 1,62; IC: 1,13-2,32). There was not variability in the oral health services use attributable to the autonomous community. Conclusions: the use of dental health services among Spanish preschool population is lower than desirable. The promotion of its use should be intensified in children from disadvantaged families(AU)

Acceptance of oral health promotion programmes by dental hygienists and dental nurses in public dental service.

OBJECTIVES: The aim of this study was to analyse how dental hygienists and in-service trained dental nurses accepted new health promotion programmes, how did they experience them in practice, and how did these programmes affect their attitudes to work. METHODS: The subjects were all the dental hygienists and in-service trained dental nurses (n = 28) involved in health promotion of small children. Education and written instructions on two new programmes had been given to the professionals in two areas of Vantaa and those in the third area used the routine programme. The transtheoretical model (TTM) was selected as the theoretical framework for counselling. A structured questionnaire of 31-35 items was sent to all subjects. Independent samples Mann-Whitney U and Fisher's exact tests were used as statistical methods. RESULTS: The response rate was 89%. All respondents felt that the work they had carried out had always been important during their working career. Twenty-one of 25 respondents reported that the instructions and education were suitable for oral health promotion. The respondents within the new programmes felt they had advanced more as health professionals (P = 0.020) and acquired more confidence from the education (P = 0.018) compared with the routine programme. CONCLUSIONS: The new programmes for small children were well accepted by the dental hygienists and the in-service trained dental nurses, and the majority of them gained some new practices for their work.

Perfil epidemiológico oral y necesidad de tratamiento odontológico de pacientes VIH/SIDA / Oral epidemiological profile and the need for dental treatment for HIV/AIDS patients

Objetivo. Describir el perfil epidemiológico oral y las necesidades de tratamiento odontológico en pacientes VIH/SIDA atendidos en una institución. Diseño. Estudio descriptivo transversal. Emplazamiento. Facultad de Odontología Universidad de Cartagena. Participantes. Pacientes con diagnóstico de VIH/SIDA y bajo tratamiento antirretroviral. Mediciones principales. Se evaluaron variables sociodemográficas, estado de Higiene Oral, historia de Caries, Enfermedad Periodontal, manifestaciones orales asociadas a VIH/SIDA, necesidad de tratamiento odontológico. Resultados: De los 53 sujetos del estudio un 59,9% presentaron higiene oral regular, un 66% mostró cálculo supragingival y un 15,1% sangrado gingival. La Se observó caries en el 92,5% de los participantes y ausencia de dientes en el 73,6%. La prevalencia de manifestaciones orales de VIH/SIDA fue de un 45,3%, destacando las de origen infeccioso con un 28,3%. La presencia de lesiones no asociadas a VIH fue del 81,1%, sobresaliendo con un 28,3% las pigmentaciones orales asociadas a medicamentos antirretrovirales. El 100% de los sujetos precisó asistencia odontológica, necesitando 4 tipos de tratamiento diferentes el 60,4% de ellos. Sobresale la promoción y prevención en un 98.1% de los casos, seguida por la eliminación de cálculo en el 73,6% y la necesidad protésica en el 81,2% de los individuos. Conclusión: Se hace evidente la falta de atención y la necesidad de tratamiento de esta población. La cual presenta un estado de salud oral regular, afirmando el derecho a la atención integral que este tipo de pacientes merece(AU)

Objective. To describe the oral epidemiological profile and the needs for dental treatment for HIV/AIDS patients in an institution. Design. Cross sectional study. Location. University of Cartagena Faculty of Odontology Participants. Patients diagnosed with HIV/AIDS undergoing antiretroviral treatment. Main Measures. Socio-demographic variables, oral hygiene condition, history of tooth decay, periodontal disease, oral signs associated with HIV/AIDS, need for dental treatment were evaluated. Results: Out of 53 study subjects, 59.9% showed mediocre oral hygiene, 66% supragingival calculus and 15.1%, gingival bleeding. We observed tooth decay in 92.5% of the participants and absence of teeth in 73.6%. The prevalence of oral signs of HIV/AIDS was 45.3%, with emphasis on a 28.3% of an infectious origin. The presence of lesions not associated with HIV was 81.1%, and a significant 28.3% with oral pigmentations associated with antiretroviral medication. 100% of the subjects required dental care, with 4 different types being necessary for 60.4% of them. Promotion and prevention were significant in 98.1% of cases, followed by removal of calculus in 73.6% y the need for prosthesis in 81.2% of individuals. Conclusion: Lack of attention and the need for treatment is evident in these members of the population, who show mediocre oral health, strengthening the case for the comprehensive care this type of patient deserves(AU)

E-learning used in a training course on atraumatic restorative treatment (ART) for Brazilian dentists.

The purpose of this study was to assess the benefits of using e-learning resources in a dental training course on Atraumatic Restorative Treatment (ART). This e-course was given in a DVD format, which presented the ART technique and philosophy. The participants were twenty-four dentists from the Brazilian public health system. Prior to receiving the DVD, the dentists answered a questionnaire regarding their personal data, previous knowledge about ART, and general interest in training courses. The dentists also participated in an assessment process consisting of a test applied before and after the course. A single researcher corrected the tests, and intraexaminer reproducibility was calculated (kappa=0.89). Paired t-tests were carried out to compare the means between the assessments, showing a significant improvement in the performance of the subjects on the test taken after the course (p<0.05). A linear regression model was used with the difference between the means as the outcome. A greater improvement on the test results was observed among female dentists (p=0.034), dentists working for a shorter period of time in the public health system (p=0.042), and dentists who used the ART technique only for urgent and/or temporary treatment (p=0.010). In conclusion, e-learning has the potential of improving the knowledge that dentists working in the public health system have about ART, especially those with less clinical experience and less knowledge about the subject.

Tooth wear and erosion: methodological issues in epidemiological and public health research and the future research agenda.

BACKGROUND: This paper addresses methodological issues in the field of tooth wear and erosion research including the epidemiological indices, and identifies future work that is needed to improve knowledge about tooth wear and erosion. METHODS: The paper is result of the work done at the meetings of the Special Interest Group "Tooth Surface Loss and Erosion" at the 2008, 2009 and 2010 conferences of the European Association for Dental Public Health, and the Workshop "Current Erosion indices- flawed or valid" which took place in Basel in 2007. RESULTS: Although there is consensus about the definition and the diagnostic criteria of various forms of tooth wear, gaps in research strategies have been identified. A basic problem is that fundamental concepts of wear and erosion as an oral health problem, have not yet been sufficiently defined. To a certain extent, tooth wear is a physiological condition, and there is no consensus as to whether it can be regarded as a disease. Furthermore, the multitude of indices and flaws in existing indices, make published data difficult to interpret. CONCLUSION: Topics for the research agenda are: the initiation of a consensus process towards an internationally accepted index, and the initiation of data collection on the prevalence of various forms of wear on a population-based level. There should be an emphasis on promoting communication between basic and clinical sciences, and the area of Public Health Dentistry. Furthermore, the question of whether tooth wear is a public health problem remains open for debate.

Statistical analysis for identifying mediating variables in public health dentistry interventions.

OBJECTIVE: This article provides an overview of statistical mediation analysis methods in the evaluation of public health dentistry interventions. METHODS AND RESULTS: First, reasons for conducting mediation analysis are outlined, followed by a discussion of the link between the mediation model and theoretical bases of interventions. Second, the basic statistical procedures in mediation analysis are presented. An example application to data from a hypothetical intervention is provided in Appendix A. Third, interpretation of the results from statistical mediation analysis is described along with additional information pertinent to identifying true mediation relations. CONCLUSIONS: Guidelines for describing mediation analyses in research articles related to public health dentistry intervention studies are outlined.

The assessment, monitoring, and enhancement of treatment fidelity in public health clinical trials.

OBJECTIVES: To discuss methods of preservation of treatment fidelity in health behavior change trials conducted in public health contexts. METHODS: The treatment fidelity framework provided by the National Institutes of Health's Behavioral Change Consortium includes five domains of treatment fidelity (Study Design, Training, Delivery, Receipt, and Enactment). A measure of treatment fidelity was previously developed and validated using these categories. RESULTS: Strategies for assessment, monitoring, and enhancing treatment fidelity within each of the five treatment fidelity domains are discussed. The previously created measure of treatment fidelity is updated to include additional items on selecting providers, additional confounders, theory testing, and multicultural considerations. CONCLUSIONS: Implementation of a treatment fidelity plan may require extra staff time and costs. However, the economic and scientific costs of lack of attention to treatment fidelity are far greater than the costs of treatment fidelity implementation. Maintaining high levels of treatment fidelity with flexible adaptation according to setting, provider, and patient is the goal for public health trials.

Factores Familiares asociados a la presencia de Caries Dental en Niños Escolares de Cartagena, Colombia / Family factors associated with the prevalence of caries in school children in Cartagena, Colombia

Objetivo. Identificar los factores socios demográficos y familiares y su asociación con la prevalencia de caries en niños del colegio Madre Gabriela de San Martín. Diseño. Estudio de corte transversal. Emplazamiento. Municipio de Cartagena de Indias-Colombia. Participantes. 243 estudiantes seleccionados aleatoriamente por muestreo estratificado. Mediciones Principales. Se evaluaron factores socio demográficos y familiares (unión conyugal, escolaridad y rol de los padres, estrato socioeconómico estructura y funcionalidad familiar mediante APGAR familiar) y prevalencia de caries (índice COP-D y ceo-d). Los datos fueron analizados a partir de proporciones y razones de disparidad utilizando el programa Stata 10.0. Resultados. La prevalencia de caries fue de 51% (IC 95%: 44-57), más en el sexo femenino (70%; p=0,02). Al ser relacionadas las variables familiares con la caries dental, únicamente se encontró asociación significativa con el rol ejercido por el padre como formador de hijos (OR: 0,40; IC 95%: 0,18-0,86; p<0,01). Conclusiones. Además de ser tradicionalmente un proveedor económico, el nuevo rol del padre como formador de hijo puede influir positivamente en la disminución de la caries dental y debe ser parte activa en las actividades de promoción y prevención en salud bucal(AU)

Objective. To identify sociodemographic and family factors and their association with the prevalence of caries in children attending the Madre Gabriela de San Martín. Design. Cross sectional study. Setting. Cartagena de Indias, Colombia. Participants. 243 students randomly selected by stratified sampling. Main Measurements. Sociodemographic and family factors (marital relationship, education and role of parents, socioeconomic status and family structure and function using the Family APGAR) and prevalence of caries (COP-D index and ceo-d). The data were analyzed based on proportions and odds ratio using the Stata 10.0 programme Results. The prevalence of caries was 51% (95% CI: 44-57), higher in females (70%; p=0.02). The role of the father as educator of his children was the only significant factor (OR: 0.40; 95% CI: 0.18 to 0.86; p <0.01) related to the prevalence of caries. Conclusions. In addition to being traditionally an economic provider, the new role of the father as educator of his children can have a positive effect on reducing dental caries. Fathers should be actively involved in the promotion and prevention activities in oral health(AU)