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

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

[Socioeconomic inequalities in oral health service utilization any time in their lives for Mexican schoolchildren from 6 to 12 years old]. / Desigualdades socioeconómicas en la utilización de servicios de salud bucal (USSB) alguna vez en la vida por escolares Mexicanos de 6-12 años de edad.

OBJECTIVE: To determine the prevalence and the existence of socioeconomic inequalities in dental health service utilization (DHSU) any time in the life of Mexican schoolchildren aged 6-12 years of Pachuca Hidalgo, Mexico. MATERIAL AND METHODS: We performed a cross-sectional study in 1,404 school children 6-12 years of age from 14 public schools in the city of Pachuca, Hidalgo, Mexico. Questionnaires were distributed to determine socioeconomic position variables (SEP). The dependent variable was DHSU once in life (0 = No, 1 = Yes). The analysis was performed in Stata 9 using chi-square tests. RESULTS: The mean age was 8.97 ± 1.99 years, 50.1% were boys. The prevalence of DHSU any time in life was 71.4%. The DHSU percentage increased according increasing age (p < 0.05). Significant differences (p < 0.05) in percentages of USSB through SEP variables: health insurance, car ownership in the home, dwelling and household characteristics, a better level of SEP increased prevalence of DHSU. Although in the mother's schooling no differences were observed (p > 0.05), father's schooling was associated (p < 0.05) inversely to expectations. CONCLUSIONS: The findings of this study demonstrate that the prevalence of DHSU was not 100%; 28.6% of children have never had contact with a dentist. We identified certain indicator variables of SEP associated with DHSU, indicating the existence of inequalities in this oral health indicator.

Tooth brushing frequency in Mexican schoolchildren and associated socio-demographic, socioeconomic, and dental variables.

BACKGROUND: Tooth brushing (with fluoridated toothpaste) is the most cost-effective intervention in dentistry and it is widely recommended to preserve good oral health. We aimed to determine the frequency of tooth brushing and the variables associated with this practice in schoolchildren living in southeast Mexico. MATERIAL AND METHODS: A cross-sectional study was carried out in 1644 schoolchildren, 6 to 13 years old. Questionnaires with socio-demographic, socioeconomic, and dental variables were administered to mothers/guardians of children. The dependent variable was the frequency of tooth brushing, which was categorized as 0 = tooth brushing less than once a day and 1 = tooth brushing at least once a day. A logistic regression model was used to evaluate the final results. RESULTS: Mean age was 9.06±2.02 years and 49.1% were girls. The prevalence of tooth brushing at least once a day was 49.8%. In the multivariate model, characteristics related to tooth brushing frequency (p<0.05) were: older age (OR=1.11), being female (OR=1.64), having a larger family (OR=0.87), having had a visit to a dentist during the year preceding the study (OR=1.37), and having had fluoride applications by a professional (OR=1.39). CONCLUSIONS: The results suggested that different variables (demographic, socioeconomic and dental) are associated with the frequency of tooth brushing. Family size (proxy variable for socioeconomic status) may indicate certain oral health inequalities in this population.

[Experience, prevalence, severity, treatment needs for dental caries and care index in Mexican adolescents and young adults]. / Experiencia, prevalencia, severidad necesidades de tratamiento para caries dental e índice de cuidados en adolescentes y adultos jócenes mexicanos.

OBJECTIVE: To determine the experience, prevalence and severity of dental caries as well as to establish the treatment needs and restorative care in adolescents and young adults. MATERIAL AND METHODS: This cross-sectional study included 638 subjects 16-25 years old candidates to enter to state public university of San Luis Potosí, México. For caries detection was used the DMFT index (sum of decayed teeth + missing teeth + filled teeth in the permanent dentition). With DMFT index data were calculated the experience, the prevalence and the severity of caries. Also are reported the significant caries index (SiC), the treatment needs index (TNI) and the care index (CI). Statistical analysis was performed using nonparametric tests. RESULTS: The mean DMFT index was 4.24 ± 3.85, prevalence 76.5% and severity of 52.3% for DMFT > 3 and 26.2% for DMFT > 6. The SiC index was 8.7. The TNI was 43.0% and 52.8% CI. No variation was observed (p > 0.05) on the experience, prevalence and severity of caries by age. The component "filled teeth" showed differences by age (p < 0.05). Women had higher caries experience and severity than men (p < 0.05), equally "decay teeth" and "filled teeth" (p < 0.05). CONCLUSIONS: We observed high levels of experience, prevalence and severity of dental caries in this sample of adolescents and young adults. We found almost 40% of untreated caries lesions. We found some differences by sex.

[Oral hygiene customs in 6-12 year old schoolchildren]. / Uso de auxiliares para la higiene bucal y su distribucion por edad u sexo en escolares de seis a 12 anos de edad.

OBJECTIVE. To characterize utilization of oral hygiene devices and customs in schoolchildren. MATERIAL AND METHODS. We performed a cross-sectional study in 1,404 schoolchildren (6- 12 year olds) from 14 public schools in Pachuca, Hidalgo, México, using a questionnaire for sociodemographic variables and 1) Tooth brushing frequency (<1/d vs. at least 1/d), 2) Use of toothpaste (not always vs. always), 3) Flossing (never, does not know vs. at least 1/week), 4) Use of mouthwash (never, does not know vs. at least 1/week). Analyses were performed with nonparametric tests. RESULTS. Mean age was 8.97 ± 1.99 years; 50.1% were male. Prevalence of utilization of oral hygiene devices and associated customs were 85.5% tooth brushing, 90.9% toothpaste, 19.4% flossing, and 28.2% mouthwash. Only 11.8% of participants reported utilization in all 4 categories. We observed differences (p < 0.05) across sexes only in the use of toothpaste, as women used it more often. Differences across age were observed (p < 0.05) for tooth brushing (younger children brushed more often) and flossing (older children flossed more often). CONCLUSIONS. Tooth brushing was the oral hygiene practice more often performed in this sample, with other frequencies being relatively low. There were differences by age and sex across some variables.

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

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

Full Pulpotomy as a Treatment for Irreversible Pulpitis in Permanent Teeth: A Systematic Review of the Literature Based on Case Reports.

The objective of this systematic review was to evaluate the current evidence of case reports where the treatment for permanent teeth with a diagnosis of irreversible pulpitis was a full pulpotomy. This study was carried out by two reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic electronic search was carried out in the PubMed, Google Scholar, and Scopus databases until the year 2022 to find articles in English where the treatment for irreversible pulpitis in permanent teeth was a full pulpotomy. Literature reviews, in vitro or animal studies, abstracts, and unpublished data were excluded. The intervention, control, and outcome parameters were selected following the "Population, Interventions, Control, and Outcome" (PICO) guidelines. A total of 636 articles were found, and 14 articles were selected to be included in this review. The selected articles describe cases of full pulpotomies in mature permanent teeth with a diagnosis of irreversible pulpitis with a total of 34 (100%) successful cases, where 18 were men and 16 were women, with an average age of 19.20 ± 10.59 years and an average follow-up of 35.82 ± 26.39 months, with 12 months being the minimum follow-up time. The material used most frequently for obturation of the full pulpotomy was mineral trioxide aggregate in 16 cases (47.06%). Within the limitations of this review, full pulpotomy presents a high success rate regardless of the tooth, age, or sex as a treatment for teeth diagnosed with irreversible pulpitis.

Clinical and socio-demographic factors associated with dental extractions in a clinical sample.

The objective of the present study was to identify the reasons for dental extractions in patients seeking dental care in a university dental clinic in Mexico. This is a cross-sectional study that assessed 284 consecutive patients at the School of Dentistry, Autonomous University of the State of Mexico between August 2017 and November 2018. In total, 505 extractions were performed. The dependent variable was the reason for extraction: 0) dental caries and ensuing sequels (reference category); 1) periodontal disease and ensuing sequels; and 2) other reasons. Sociodemographic, socioeconomic, and clinical variables were included as independent variables. The analysis was done with multinomial logistic regression (Stata 14.0). Out of all extractions, 63.6% (n=321) were due to dental caries and ensuing sequels; 22.0% (n=111) were due to periodontal disease and ensuing sequels; 5.3% (n=27) endodontic failure; 5.1% (n=26) prosthetic indications; 1.6% (n=8) orthodontic indications; and the rest (2.4%) were due to other reasons. In the multivariate model extractions due to periodontal disease vs dental caries were associated with occasionally smoking tobacco (Odds Ratio, OR=3.90) or daily tobacco use (OR=3.19); the tooth to be extracted having been previously restored (OR=2.35); extracted anterior as opposed to posterior teeth (OR =2.63); and patients with multiple extractions (OR=2.68). In the case of extractions due to "other reasons", no variable was significant. Dental caries and periodontal disease were the main reasons for dental extraction in this sample. Several variables, mostly clinical, were associated with extractions for periodontal reasons.

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

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

Experience and Prevalence of Dental Caries in 6 to 12-Year-Old School Children in an Agricultural Community: A Cross-Sectional Study.

OBJECTIVE: To describe the experience and prevalence of dental caries in schoolchildren aged 6-12 years belonging to agricultural manual worker households. MATERIAL AND METHODS: A comparative cross-sectional study was conducted in two groups of schoolchildren: One considered "children of agricultural worker migrant parents" (n = 157) and the other "children of agricultural worker non-migrant parents" (n = 164). Epidemiological indices for dental caries were calculated for primary (dmft) and permanent (DMFT) dentitions, and compared in terms of age, sex, and the Simplified Oral Hygiene Index (SOHI). Two binary logistic regression models for caries prevalence in primary and permanent dentitions were generated in Stata. RESULTS: For primary dentition, we observed the following dmft index: Non-migrants = 1.73 ± 2.18 vs. migrants = 1.68 ± 2.14. Additionally, we recorded the following caries prevalence: Non-migrants = 59.1% vs. migrants = 51.3%. For permanent dentition, we observed the following DMFT index: Non-migrants = 0.32 ± 0.81 vs. migrants = 0.29 ± 0.95. Further, we recorded the following caries prevalence: Non-migrants = 17.6% vs. migrants = 12.8%. No differences were observed for either dentition (p > 0.05) in caries indices and their components or in caries prevalence. When both caries indices (dmft and DMFT) were combined, the non-migrant group had a higher level of caries experience than the migrant group (p < 0.05). No relationship (p > 0.05) with migrant status was observed in either multivariate models of caries prevalence. However, age did exhibit an association (p < 0.05) with caries. Only the plaque component of SOHI was associated (p < 0.05) with caries in permanent dentition. CONCLUSIONS: Although over half of school children from agricultural manual worker households had caries in either or both dentitions and a considerable proportion were untreated lesions, the prevalence levels were somewhat lower than other reports from Mexico in similar age groups. No statistically significant differences were found in caries experience or prevalence in either dentition between non-migrant and migrant groups.

Association of Edentulism with Various Chronic Diseases in Mexican Elders 60+ Years: Results of a Population-Based Survey.

OBJECTIVE: To determine the association of edentulism with different chronic diseases and mental disorders in Mexicans aged 60 years and over. MATERIAL AND METHODS: A cross-sectional study was carried out using data from the World Health Survey for Mexico, in a probabilistic, multi-stage cluster sampling framework. Data for self-report of chronic diseases (diabetes, arthritis, angina pectoris and asthma), mental disorders (depression and schizophrenia) and edentulism were analyzed. Edentulism data were available for 20 of the 32 States of Mexico. Statistical analysis was performed in Stata 14.0 using the svy module for complex sampling (Complex nature under which individuals are sampled). RESULTS: In total 4213 subjects were included, representing a population of 7,576,057 individuals. Mean age was 70.13 ± 7.82 years (range 60 to 98); 56.2% were women. Chronic diseases' prevalence and mental disorders prevalence were as follows: diabetes 15.0% (N = 1,132,693); arthritis 13.2% (N = 1,001,667); depression 5.5% (N = 414,912); angina pectoris 4.5% (344,315); asthma 3.6% (N = 269,287); and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which pertained to 1,993,463 people aged 60 years and over. Angina in women aged 60 to 69 years (p < 0.05) and depression in men aged 70 years and over (p < 0.0001) were associated with higher prevalence of edentulism. CONCLUSIONS: There was generally sparse association between edentulism on chronic diseases and mental disorders included in the study, except for women aged 60 to 69 years for angina, and in men aged 70 and over, for depression. Although our findings are misaligned with previous reports, longitudinal studies are required to test causal and temporal relationships between edentulism with chronic diseases and mental disorders.

Self-Reported Dental Caries by Mexican Elementary and Middle-School Schoolchildren in the Context of Socioeconomic Indicators: A National Ecological Study.

The objective of the present research was to quantify the association between dental caries self-report and socioeconomic indicators in Mexican children. An ecological study included a self-report of dental caries in schoolchildren enrolled in public elementary and middle schools derived from the National School Health Survey. A total of 73,560 schoolchildren (representing 19,745,366 students) aged 5 to 16 years were included. Socioeconomic variables included were scales depicting physical characteristics of housing, purchasing power, etc. used in national surveys in Mexico to measure deprivation, poverty, and income inequality in official data. Data were analyzed in Stata using Spearman's correlation test. For the most part, no association (p > 0.05) was found between caries self-report, socioeconomic variables, or the Gini index. However, caries self-report in elementary schoolchildren and total (elementary + middle-school) schoolchildren groups was positively correlated (p < 0.05) with two poverty variables: extreme poverty by income (value of personal food purchases per month) and poverty by income (value of personal food and non-food purchases per month). National data for dental caries self-report were associated-at the ecological level-with a few socioeconomic indicators but not with most of the usual and customary indicators used in national surveys in Mexico.

Clinical and socio-demographic factors associated with dental extractions in a clinical sample

Abstract The objective of the present study was to identify the reasons for dental extractions in patients seeking dental care in a university dental clinic in Mexico. This is a cross-sectional study that assessed 284 consecutive patients at the School of Dentistry, Autonomous University of the State of Mexico between August 2017 and November 2018. In total, 505 extractions were performed. The dependent variable was the reason for extraction: 0) dental caries and ensuing sequels (reference category); 1) periodontal disease and ensuing sequels; and 2) other reasons. Sociodemographic, socioeconomic, and clinical variables were included as independent variables. The analysis was done with multinomial logistic regression (Stata 14.0). Out of all extractions, 63.6% (n=321) were due to dental caries and ensuing sequels; 22.0% (n=111) were due to periodontal disease and ensuing sequels; 5.3% (n=27) endodontic failure; 5.1% (n=26) prosthetic indications; 1.6% (n=8) orthodontic indications; and the rest (2.4%) were due to other reasons. In the multivariate model extractions due to periodontal disease vs dental caries were associated with occasionally smoking tobacco (Odds Ratio, OR=3.90) or daily tobacco use (OR=3.19); the tooth to be extracted having been previously restored (OR=2.35); extracted anterior as opposed to posterior teeth (OR =2.63); and patients with multiple extractions (OR=2.68). In the case of extractions due to "other reasons", no variable was significant. Dental caries and periodontal disease were the main reasons for dental extraction in this sample. Several variables, mostly clinical, were associated with extractions for periodontal reasons.

Resumo O objetivo do presente estudo foi identificar os motivos das extrações dentárias em pacientes que procuram atendimento odontológico em uma clínica odontológica universitária no México. Este é um estudo transversal que avaliou 284 pacientes consecutivos na Faculdade de Odontologia da Universidad Autónoma del Estado de México entre agosto de 2017 e novembro de 2018. No total, foram realizadas 505 extrações. A variável dependente foi o motivo da extração: 0) cárie dentária e sequelas subsequentes (categoria de referência); 1) doença periodontal e sequelas subsequentes; e 2) outros motivos. Variáveis sociodemográficas, socioeconômicas e clínicas foram incluídas como variáveis independentes. A análise foi feita com regressão logística multinomial (Stata 14.0). De todas as extrações, 63,6% (n=321) foram devidas a cárie dentária e sequelas subsequentes; 22,0% (n=111) foram devidas a doença periodontal e sequelas subsequentes; 5,3% (n=27) a insucesso endodôntico; 5,1% (n=26) a indicações protéticas; 1,6% (n=8) a indicações ortodônticas; e o restante (2,4%) foi devido a outros motivos. No modelo multivariado, as extrações por doença periodontal vs. cárie dentária foram associadas ao tabagismo ocasional (Odds Ratio, OR=3,90) ou ao uso diário de tabaco (OR=3,19); ao fato de o dente a ser extraído ter sido restaurado anteriormente (OR=2,35); à extração de dentes anteriores em vez de posteriores (OR=2,63); e a pacientes com extrações múltiplas (OR=2,68). No caso de extrações devido a "outros motivos", nenhuma variável foi significativa. A cárie dentária e a doença periodontal foram os principais motivos de extração dentária nessa amostra. Diversas variáveis, principalmente clínicas, foram associadas às extrações por motivos periodontais.

Socioeconomic Inequalities in Visits to the Dentist to Receive Professionally Applied Topical Fluoride in a Developing Country.

OBJECTIVE: To determine the frequency and associated factors of visits to the dentist in the last year by Nicaraguan schoolchildren to receive professionally applied topical fluoride (PATF). MATERIAL AND METHODS: A cross-sectional study was designed in children from public schools in the city of León, Nicaragua, were included. A series of socioeconomic, sociodemographic, and behavioural variables were collected through a questionnaire. The dependent variable was the visit to the dentist to receive professionally applied topical fluoride in the last year, which was dichotomised as (0) Did not receive PATF and (1) Yes received PATF. In the statistical analysis, binary logistic regression was used. RESULTS: The mean age of the students included was 9 years, and 49.9% were girls. The prevalence of visits to the dentist in the last year to receive PATF was 3.1%. In the multivariate model, the associated characteristics (p < 0.05) were: female (OR = 2.73, 95% CI = 1.34-4.50); the positive attitude of the mother to the oral health of her child (OR = 2.15, 95% CI = 1.03-4.50); and the best socioeconomic position (OR = 2.68, 95% CI = 1.36-5.31). CONCLUSIONS: The prevalence of visits to the dentist in the last year to receive professionally applied topical fluoride was very low (3.1%). The results of the socioeconomic position suggest the existence of certain inequalities in oral health. It is necessary to implement policies and programs aimed at improving this scenario.