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OBJECTIVE: This 3-year multicentre randomised controlled trial compared, in 6-7-year-old Colombian children, the effectiveness of the ICCMS (International Caries Classification and Management System) with a conventional caries-management system (CCMS) in terms of individual caries-risk, caries lesions, and secondarily, oral-health-related knowledge/attitudes/practices, and number of appointments. MATERIAL AND METHODS: With ethical approval, 240 6-7-year olds from six Colombian clinics were recruited. Trained examiners conducted the following baseline/follow-up assessments: Caries risk (Cariogram-ICCMS); caries severity/activity staging (ICDAS-merged combined radiographic/visual); sealants/fillings/missing teeth, and oral-health-related knowledge, attitudes and practices. Children received their randomly allocated (ICCMS/CCMS) care from dental practitioners. Outcomes: caries-risk control (children); caries-progression control (tooth surfaces); oral-health-related knowledge/attitudes/practices improvement (parents/children), and appointments' number (children). Descriptive and non-parametric/parametric bivariate analyses were performed. RESULTS: Three-year-follow-up: n = 187 (77.9%; ICCMS: n = 92; CCMS: n = 95) disclosed a baseline-to-3-year overall high-caries-risk children decrease (ICCMS: 60.9-0%, p < .001; CCMS: 54.7-5.3%, p < .001) (p > .05). ICCMS versus CCMS showed: fewer tooth-surface caries progression (6.2% vs 7.1%, p = .010) and fewer active-caries lesions (49.8% vs. 59.1%, p < .05); higher proportion of children with ≥2/day fluoride-toothpaste tooth-brushing practice (p < .05); similar mean number of appointments (10.9 ± 5.9 vs. 10.0 ± 3.8, p = .15). CONCLUSION: Both caries-management systems showed similar effectiveness in caries-risk control, with ICCMS more effectively controlling tooth-surface caries progression and improving toothbrushing practices.
Assuntos
Cárie Dentária , Cremes Dentais , Criança , Cárie Dentária/terapia , Suscetibilidade à Cárie Dentária , Odontólogos , Fluoretos , Humanos , Papel ProfissionalRESUMO
OBJECTIVE: Evaluating maternal practice regarding diarrhoea and the common cold. METHOD: This was a cross-sectional descriptive study which was conducted on the island of Barú, near Cartagena, Colombia. It involved 127 mothers of African descent and their 138 children aged less than 5 years of age; convenience sampling was used. The Integrated Management of Childhood Illness (IMCI) instrument was used for the survey during a one-day healthcare session. The prevalence of diarrhoea and the common cold during the 7 days immediately before the survey were estimated, as were maternal practice regarding these and the occurrence of other risks and protective factors; a history of breastfeeding, complementary feeding and vaccination was compiled. Descriptive statistics were used and the χ² test was used for ascertaining the significance of the relationships between variables. RESULTS: Diarrhoea prevalence was 71.7 % (64-79 95 % CI), this being lower for girls aged 2 months to 5 years-old (p = 0,02) and common cold prevalence was 99.2 % (97-100 95 % CI), this being higher in girls aged older than 2 months (p=0.004). 86.9 % (81-92 95 % CI) of the mothers did not know how to identify warning signs for these diseases, 84.9 % (78-90 95 % CI) of the practices were inadequate and 73.3% of the mothers took their children to a doctor as their first line medical practice (p=0.05). CONCLUSIONS: Efforts must be increased regarding the implementation of the IMCI strategy in vulnerable communities, through effective channels of communication and innovative ways to reduce child morbidity and mortality indices, thereby promoting the island's social development.
Assuntos
População Negra , Resfriado Comum/terapia , Diarreia/terapia , Comportamento Materno , Região do Caribe , Saúde da Criança , Pré-Escolar , Resfriado Comum/epidemiologia , Estudos Transversais , Prestação Integrada de Cuidados de Saúde , Diarreia/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , Inquéritos e QuestionáriosRESUMO
Objetivo: Determinar la relación entre pobreza y salud bucal en comunidades afrodescendientes vulnerables. Métodos: Estudio realizado en 240 adultos residentes en Tierra Baja, Manzanillo y Boquilla de Cartagena, Colombia. La selección fue a conveniencia en visita domiciliaria. El estudio conto con una etapa descriptiva y una analítica. En la primera etapa descriptiva se indagó por variables sociodemográficas, presencia de pobreza, condiciones de salud bucal, hábitos de higiene oral y otros nocivos. En la segunda, analítica de corte transversal, se clasificó la pobreza en objetiva, subjetiva y general, como variables independientes en tanto que la condición de salud bucal y hábitos bucales las dependientes. La valoración clínica de la población estuvo a cargo de examinadores entrenados. Los datos se analizaron a partir de frecuencias y proporciones y odds ratio por regresión logística bivariada. Resultados: De los participantes 76,7 por ciento se percibieron pobres y 89,2 por ciento contaban con sus necesidades básicas insatisfechas (pobreza objetiva); el 65,8 por ciento se clasificaron con pobreza general. Se encontraron asociaciones entre la pobreza objetiva y subjetiva y la condición de salud bucal inadecuada (odd ratio: 2,17 y 1,8 respectivamente) y entre hogares con pobreza general y frecuencia del cepillado (odd ratio: 2,18), recambio del cepillo de dientes (odd ratio: 2,3) y hábito del bruxismo (odd ratio: 2,4). Conclusiones: La pobreza ejerce influencia desfavorable en la salud bucal en comunidades afrodescendientes vulnerables. Se demuestra la necesidad de una intervención efectiva en el entorno social(AU)
Objective: To determine the relationship between oral health and the presence of poverty in african descent of Tierra Baja, Manzanillo and Boquilla, Cartagena, Colombia. Methods: Study conducted in 240 adults selected convenience in the home visit. The first descriptive stage asses sociodemographic variables, presence of poverty, oral health condition, oral health habits and other nocuous. In the second analytical stage of cross-section, the poverty classified as objective, subjective and general were the independent variables while the oral health condition and oral habits were the dependent variables. There was calibration of examiners, for clinical assessment. The data were analyzed from frequencies and proportions and odds ratio by bivariate logistic regression. Results: 76,7 percent of participants perceived poor and 89,2 percent had their Dissatisfied Basic Needs (objective poverty); 65,8 percent were classified as general poor people. There were associations between objective and subjective poverty and inadequate oral health condition (OR: 2.17 and 1.8 respectively) and among households with general poverty and frequency of brushing (OR: 2.18), toothbrush replacement (OR: 2,3) and habit of bruxism (OR: 2,4). Conclusions: Poverty has an adverse influence in oral health in vulnerable Afro-descendants communities. It is demonstrated the necessity of effective interventions in the social environment(AU)
Assuntos
Humanos , Masculino , Feminino , Pobreza/etnologia , Bruxismo/etiologia , Saúde Bucal , Dispositivos para o Cuidado Bucal Domiciliar , ColômbiaRESUMO
Resumen Objetivo: Determinar los niveles de ansiedad y miedo a la consulta odontológica en niños atendidos en la Universidad de Cartagena. Material y métodos: Mediante un diseño transversal se seleccionaron 284 niños entre tres y ocho años, excluyendo a niños con discapacidades motoras, cognitivas y síndromes. A los niños entre seis a ocho años se les aplicó la escala combinada de miedo y a los de tres a cinco años la escala de Corah modificada dirigida a los padres. Se aplicaron pruebas de estadística descriptiva y para la comparación entre los grupos las pruebas t-Student, ANOVA y Kruskal-Wallis; asumiendo un límite de significancia de 0.05. Resultados: Se encontraron altos niveles de miedo y ansiedad durante la colocación de anestesia, ruido de equipos rotatorios y aislamiento dental. Se observaron diferencias en la edad durante la consulta (p = 0.03) y el aislamiento dental (p = 0.02) y con el sexo en la profilaxis (p = 0.02). Conclusión: Existen altos niveles de miedo y ansiedad ante la consulta odontológica en niños atendidos en la Universidad de Cartagena, se sugiere que estos niveles difieren de acuerdo con la edad, sexo y procedimientos odontológicos.
Abstract Objective: To determine fear and anxiety levels with respect to dental treatment of children treated at the University of Cartagena. Material and methods: By means of a cross-sectioned design, 284 children aged 3-8 years were selected; children with cognitive and motor disabilities as well as syndromes were excluded. Combined fear scale was applied to children ages 6-8 years, children aged 3-5 received modified Corah scale directed to the parents. Descriptive statistical tests were applied; to establish comparison among groups t-Student, ANOVA and Kruskal-Wallis test were applied, assuming 0.05 significance level. Results: High levels of fear and anxiety were found during anesthesia administration, noise elicited by rotary instruments and tooth isolation. Differences were observed related to age during consultation (p = 0.03) and tooth isolation (p = 0.02) and with gender during prophylaxis (p = 0.02). Conclusion: High levels of fear and anxiety when confronted to a dental appointment were observed in children treated at the University of Cartagena. It is suggested these levels differ according to age, gender and dental procedures.
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Resumen Objetivos: Describir conocimientos, actitudes y prácticas (CAP) sobre maltrato infantil (MI) en odontólogos de Cartagena (Colombia). Materiales y métodos: Estudio descriptivo de corte transversal en 149 odontólogos, que respondieron un cuestionario estructurado anónimo de autorreporte para evaluar variables sociodemográficas, reporte de sospecha de MI y CAP frente a este. Los datos fueron analizados a través de frecuencia y proporciones. Para establecer relaciones entre la sospecha de MI con algunas variables de interés (sociodemográficas, CAP) se utilizó la prueba x 2 con un nivel de confianza del 95 %. Resultados: La ocurrencia actual de casos de sospecha de MI fue 5,3 % y alguna vez durante su práctica profesional del 34,4 %. Para el nivel de CAP sobre MI se obtuvieron puntajes promedio de 16,8/26 8,7/12 y 2,4/8, respectivamente. Al relacionar el nivel de conocimientos y variables sociodemográficas, las actitudes y prácticas, solo se encontró significancia estadística para el estrato socioeconómico (p=0,001), y entre las actitudes, con el lugar de procedencia (p=0,04) y edad (p=0,002). Conclusiones: El nivel de conocimiento sobre MI fue deficiente, mientras las actitudes fueron favorables; sin embargo, al momento de presentarse un caso de sospecha, sus prácticas son inadecuadas, al no realizar descripción de lesiones, anotaciones en la historia clínica y reporte de casos.
Abstract Objective: To describe knowledge, attitudes and practices (KAP) on child abuse (AC) in dentists from Cartagena (Colombia). Methods: Cross-sectional study performed on 149 dentists, second period 2013, an anonymous structured respondent's self-report questionnaire to assess demographic variables, reporting of suspected AC and KAP regarding this. Data were analyzed using frequency and proportions. To establish relationships between suspected AC with some variables of interest (sociodemographic, KAP) the x 2 test was used with a 95 %. Results: The current occurrence of cases of suspected CA was 5,3 % and sometime during his practice of 34,4 %. For the level of KAP on average scores of CA 16,8/26, 8,7/12, 2,4/8 they were obtained respectively. By relating the level of knowledge and sociodemographic variables, attitudes and practices, only statistical significance was found for socioeconomic status (p=0,001) and between attitudes to the birthplace (p=0,04) and age(p=0,002). Conclusions: The level ofknowledge of CA was low while attitudes were favorable; However, when presented a case of suspected practices are inadequate to stop doing the descriptions of injuries, medical records and reports do case.
RESUMO
OBJECTIVE: Describing the association between the nutritional and oral health status of children attending a school in Cartagena, Colombia. METHOD: This was a descriptive, cross-sectional study. The sample consisted of 180 children between aged 5 to 12. Malnutrition was assessed by anthropometric and biochemical tests, a questionnaire was used for ascertaining theirdiets andgingival disease, changes in soft tissues, dental caries, enamel abnormalities and oral hygiene status were measured clinically. Descriptive statistics involved frequency distributions. Disease prevalence was estimated for inferring the results; odds ratios(OR)were used for assessing the strength of association between variables (95 % confidence interval)and the X² test was used determining statistical significance. RESULTS: 2 % (0.0-4.4 95 % CI)chronic malnutrition was found. The most prevalent oral diseases were dental caries (82 %;77-88 95 % CI), periodontal disease (66 %;59-73 95 % CI), fluorosis (30 %; 23-37 95 % CI), hypocalcification (11 %; 6-15 95 % CI) and hypoplasia (6 %;3-10 95 % CI). Malnutrition and hypoplasia and the risk of malnutrition andfluorosis had the highest estimates of association (OR=18.5; 2.33-147.2 95 % CI; p=0.000 and OR=2.63;1.02-6.76 95 % CI;p=0.04, respectively). CONCLUSIONS: A direct association between malnutrition and oral pathologies could not be determined;alterationssuch as fluorosis and hypoplasia could be influenced by malnutrition.
Assuntos
Desnutrição/complicações , Estado Nutricional , Saúde Bucal , Doenças Periodontais/etiologia , Doenças Dentárias/etiologia , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Colômbia/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Desnutrição/epidemiologia , Avaliação Nutricional , Razão de Chances , Doenças Periodontais/epidemiologia , Prevalência , Instituições Acadêmicas , Doenças Dentárias/epidemiologiaRESUMO
ABSTRACT. Introduction: the goal of this study was to describe the social skills, behavior, and related problems of children during dental consultation at a teaching care center in the city of Cartagena, Colombia. Methods: this was a cross sectional study in 205 children aged 5 to 8 years receiving dental treatment in the area of study and evaluated by the Frankl scale, the Preschool and Kindergarten Behavior Scales (PKBS), and a survey about family and socio-demographic factors. The analysis was performed by means of averages (±DE), t-tests, one-way analysis of variance (Anova), and Chi square tests. Results: the Frankl scale showed higher positive behaviors. The findings obtained in the social skills dimension for the "help a friend in trouble" item showed higher averages as age progressed: age 5 (1.46), age 6 (1.57), age 7 (1.74), age 8 (1.77) (p<0.03). There was a difference for the type of clinic where care was provided (p<0.05). Concerning behavioral problems, some items showed differences in terms of age (p<0.05), sex (p<0.05), and type of clinic (p<0.05). Conclusions: some environmental factors and personal relationships influence the social skills, behavior, and related problems in children.
RESUMEN. Introducción: el objetivo del presente trabajo es describir habilidades sociales, conducta y problemas de comportamiento en niños durante la consulta odontológica en un centro docente-asistencial en la ciudad de Cartagena (Colombia). Métodos: estudio transversal realizado en 205 niños entre 5 y 8 años, atendidos en consulta odontológica en el área de estudio y evaluados mediante la escala de Frankl, escala para comportamiento preescolar y jardín infantil (PKBS) y cuestionario para factores socio-demográficos y familiares. Para el análisis se usaron promedios (±DE), pruebas t, Anova de una vía y chi cuadrado. Resultados: según la escala de Frankl, se observó conducta positiva con mayor frecuencia. Con la dimensión de habilidades sociales, para el ítem "ayuda a un amigo en dificultades" se evidenciaron mayores promedios a medida que avanzaba la edad; 5 años (1,46), 6 años (1,57), 7 años (1,74), 8 años (1,77) (p<0,03), y hubo diferencia para el tipo de clínica donde se realizó la atención (p<0,05). De acuerdo a la dimensión de problemas de conducta, en algunos ítems hubo diferencia para edad (p< 0,05), sexo (p<0,05) y tipo de clínica (p<0,05). Conclusiones: en las habilidades sociales, conducta y problemas de comportamiento infantil, influyen algunos factores del entorno y relaciones personales.
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Assistência Odontológica , Comportamento Infantil , Colômbia , Habilidades Sociais , Transtornos MentaisRESUMO
Objetivo: Asociar caries dental con el nivel de riesgo familiar total en escolares de la Boquilla, Cartagena. Metodología: Estudio de corte transversal, en 202 escolares. Se evaluó clínicamente la prevalencia, experiencia y severidad de las lesiones de caries dental (índice COP, ICDAS II) en escolares y a través de un cuestionario aplicado a las familias de los niños se evaluaron los factores socio demográficos y familiares (estructura, rol y autoridad de los padres, antecedentes médicos familiares), el nivel de riesgo familiar total (RFT 5-33) y la funcionalidad familiar (Apgar Familiar). Se realizó estadística descriptiva y estimación de razones de disparidad (OR). Resultados: La prevalencia de caries dental fue del 95% (IC 95%; 92-98). El 55% (IC 95%; 48 - 61,9) de las familias se encuentran en el nivel de riesgo familiar de amenaza. Para el nivel de riesgo familiar total no se encontró asociado con la presencia de caries dental pero al asociar los factores de riesgo de manera individual se encontró asociación entre ingresos < de 1 Salario Mínimo Legal Vigente (SMMLV) (OR: 3,83; IC 95%: 1,04-14; p = 0,04), presencia de antecedentes médicos familiares (OR: 5,14; IC 95% 1,06-24,8; p = 0,04), rol no ejercido por el padre (OR: 0,25; IC 95%: 0,06-0,94; p = 0,04) y la presencia de caries dental en niños. Conclusiones: Las familias con ausencia de figuras paternas, escasos recursos económicos y con presencia de antecedentes médicos familiares comprometen la salud bucal de los niños.
Objective: To associate dental caries with total family risk level of the school from Boquilla, Cartagena. Methods: Cross-sectional study in 202 schools. Prevalence was evaluated clinically, experience and severity of dental caries (COP index, ICDAS II) in school and through a questionnaire given to the families of the children were assessed socio-demographic and family factors (structure, role and authority of parents, family medical history), the total family risk level (RFT 5-33) and family functioning (family Apgar). Descriptive statistics and estimated odds ratios (OR). Results: The prevalence of dental caries was 95% (95% CI 92-98). 55% (95% CI 48- 61.9) of families are on the level of familial risk of threat. The total family risk level are not associated with the presence of tooth decay but to associate risk factors individually was found between income <1 legal minimum wage (SMMLV) (OR: 3.83, 95%: 1.04-14; p = 0.04), presence of family medical history (OR: 5.14, 95% CI 1.06-24.8; p = 0.04), no role exercised by the parent (OR: 0.25, 95% CI 0.06-0.94, p = 0.04) and the presence of dental caries in children. Conclusions: Families with no father figures, low income and the presence of family medical history compromise children's oral health.
Objetivo: associar o nível de risco de cárie dental familiar total da escola, Boquilla, Cartagena. Métodos: Estudo transversal em 202 escolas. A prevalência foi avaliada clinicamente, experiência e severidade da cárie dentária (COP índice, ICDAS II) na escola e através de um questionário às famílias das crianças foram avaliadas fatores sociodemográficos e familiares (papel, estrutura e autoridade dos pais, história médica familiar), o nível de risco total da família (RFT 5-33) e funcionamento da família (Apgar familiar). Estatística descritiva e cerca de odds ratio (OR). Resultados: A prevalência de cárie foi de 95% (95% CI 92-98). 55% (95% CI 48-61,9) das famílias são sobre o nível de risco familiar de ameaça. O nível de risco total da família não está associado com a presença de cárie dentária, mas a associar fatores de risco individualmente foi encontrada entre a renda <1 salário mínimo legal (SMMLV) (OR: 3,83, 95 % de 1,04 a 14 p = 0,04), presença de histórico médico familiar (OR: 5,14, IC 95% 1,06-24,8, P = 0,04), nenhum papel exercido pelo pai (OR: 0,25, 95% CI 0,06-0,94, P = 0,04) e a presença de cárie dentária em crianças. Conclusões: Famílias sem figuras paternas, baixa renda e a presença de crianças de Saúde da Família de histórico médico de compromisso da oral.
Assuntos
Humanos , Criança , Pré-Escolar , Risco , Cárie Dentária , Medicina de Família e ComunidadeRESUMO
Objetivo Describir la asociación entre el estado nutricional y la salud oral de escolares de una Institución Educativa de Cartagena, Colombia. Método Estudio descriptivo de corte transversal. La muestra fue 180 niños entre 5 y 12 años, evaluándose la desnutrición por pruebas antropométricas y bioquímicas, la dieta por cuestionario y las enfermedades gingivales, alteraciones en tejidos blandos, caries dental, alteraciones del esmalte y estado de higiene oral se midieron clínicamente. Para el análisis se utilizó la estadística descriptiva a través de distribuciones de frecuencia. Para la inferencia de los resultados se estimó la ocurrencia de la enfermedad por prevalencias y para la fuerza de asociación entre variables se utilizaron razones de disparidad, "OR" con intervalos de confianza del 95 por ciento y la prueba X² para la significancia estadística. Resultados Se encontró una ocurrencia de desnutrición crónica del 2 por ciento (IC 95 por ciento; 0,0-4,4). De las patologías orales las más prevalentes fueron; caries dental con 82 por ciento (IC 95 por ciento; 77-88), enfermedad periodontal con 66 por ciento (IC 95 por ciento; 59-73), fluorosis con 30 por ciento (IC 95 por ciento; 23-37), hipocalcificación con 11 por ciento (IC 95 por ciento; 6-15) e hipoplasia con 6 por ciento (IC 95 por ciento; 3-10). Con relación a los estimadores de asociación, la desnutrición con hipoplasia y el riesgo de desnutrición con fluorosis fueron los eventos que presentaron los más altos estimadores (OR=18,5; IC 95 por ciento; 2,33-147,2; P=0,000) y (OR=2,63; IC 95 por ciento; 1,02-6,76; p=0,04), respectivamente. Conclusiones Aunque no fue posible determinar asociación directa entre la desnutrición y las patologías orales, alternaciones como fluorosis e hipoplasia pueden estar influidas por la desnutrición.
Objective Describing the association between the nutritional and oral health status of children attending a school in Cartagena, Colombia. Method This was a descriptive, cross-sectional study. The sample consisted of 180 children between aged 5 to12. Malnutrition was assessed by anthropometric and biochemical tests, a questionnaire was used for ascertaining theirdiets andgingival disease, changes in soft tissues, dental caries, enamel abnormalities and oral hygiene status were measured clinically. Descriptive statistics involved frequency distributions. Disease prevalence was estimated for inferring the results; odds ratios(OR)were used for assessing the strength of association between variables (95 percent confidence interval)and the X² test was used determining statistical significance. Results 2 percent (0.0-4.4 95 percent CI)chronic malnutrition was found. The most prevalent oral diseases were dental caries (82 percent;77-88 95 percent CI), periodontal disease (66 percent;59-73 95 percent CI), fluorosis (30 percent; 23-37 95 percent CI), hypocalcification (11 percent; 6-15 95 percent CI) and hypoplasia (6 percent;3-10 95 percent CI). Malnutrition and hypoplasia and the risk of malnutrition andfluorosis had the highest estimates of association (OR=18.5; 2.33-147.2 95 percent CI; p=0.000 and OR=2.63;1.02-6.76 95 percent CI;p=0.04, respectively). Conclusions A direct association between malnutrition and oral pathologies could not be determined;alterationssuch as fluorosis and hypoplasia could be influenced by malnutrition.