Molar-Incisor Hypomineralization Is Associated with the Prevalence of Thinness among Schoolchildren in Communities with Different Fluoride Levels in the Drinking Water.

Objective: To examine the association between molar-incisor hypomineralization (MIH) and the prevalence of thinness among Mexican schoolchildren in communities with different fluoride levels in the drinking water. Methods: A cross-sectional study on Mexican children (n = 488) selected from two communities presenting different concentrations of fluoride in the drinking water (1.0-1.40 ppm/F). The World Health Organization (WHO) growth standards were used to calculate BMI-for-age z-scores, with BMI z-score cutoff points of <-2.0, >+1.0, >+2.0 recommended for defining thinness, being overweight, and obesity. The presence and severity of MIH were evaluated using the European Academy of Paediatric Dentistry (EAPD) criteria. Multiple logistic regression analyses were used to assess the association, adjusting for confounders. Results: The proportion of children presenting thinness, being overweight, and obesity was 8.2%, 23.6%, and 28.7%, respectively, while 21.5% of the schoolchildren had MIH, classified, by severity, as 9.6% mild, 6.4% moderate, and 5.5% severe. Of those schoolchildren presenting thinness, 16.2% had MIH, and only 6.0% did not (p < 0.001). Finally, schoolchildren presenting thinness were more likely to present MIH (OR = 2.76 (CI 95% 1.33-5.73); p=0.006) than children with a normal BMI. Conclusion: The present study found a relationship between thinness and the presence of MIH in schoolchildren, indicating the need for strategies and interventions aimed at preventing and controlling micronutrient deficiencies in the child population.

An inverse relationship between dental fluorosis and Molar Incisor Hypomineralization in Mexican schoolchildren in an area with a high concentration of fluoride in drinking water: A cross-sectional study.

AIM: To evaluate the association between the frequency and severity of dental fluorosis and Molar Incisor Hypomineralization (MIH) in 8-12-year-old schoolchildren living in an area with a high concentration of fluoride in the drinking water. METHODS: The present cross­sectional study was conducted on Mexican children (n = 573) selected from one community presenting a drinking water fluoride concentration of 1.39 ppm/F. The prevalence of dental fluorosis was ascertained using the Thylstrup and Fejerskov Index (TFI). The presence and severity of MIH was evaluated using the European Academy of Pediatric Dentistry (EAPD) criteria. A multinomial regression model was used to estimate the odds ratio (OR) and the 95% confidence intervals (CI), using the severity of MIH as the result. RESULTS: The prevalence of MIH was 37.7% and, by severity, was 16.1% mild, 14.3% moderate, and 7.3% severe. The prevalence of dental fluorosis in permanent dentition was 70.9% (TFI ≥1) and, by severity, was 29.2% (TFI = 0), 45.6% (TFI 1-3) and 25.3% (TFI ≥4), while 54.5% of subjects were found to have poor oral hygiene. Schoolchildren with fluorosis (TFI ≥4) were 49% less likely [OR = 0.51; p = 0.025] to present mild MIH than children with fluorosis (TFI <4). Similarly, children with fluorosis (TFI ≥4) were 53% [OR = 0.47; p = 0.019] and 62% [OR = 0.38; p = 0.036] less likely to present moderate and severe MIH than children with fluorosis (TFI <4). CONCLUSION: An inverse relationship between the presence of fluorosis and MIH was found. The results obtained by the present study may contribute to both the early identification of disorders affecting the enamel and the creation and implementation of long-term oral health prevention, promotion, and intervention programs in the affected population.

Association Between Self-Reported Health and Education with Past-year Dental Visits among Older Mexican Adults: Results of the Mexican Health and Aging Study 2018.

PURPOSE: To explore the relationship between of self-reported health (SRH) and educational attainment with pastyear dental visits in older adults in México. MATERIALS AND METHODS: For this cross-sectional study, data were derived from the Mexican Health and Aging Study 2018 (MHAS-2018), which used a nationally-representative sample of older adults (50 years or older) in Mexico (n = 14,085). Variables taken from the MHAS questionnaire included residence (rural/urban), years of education, SRH, multimorbidity, pain severity, and past-year dental visits. A logistic regression model was used to identify the association between the variables and past-year dental visits. RESULTS: While the percentage of past-year dental visits reported was 39.8%, this number declined with age [OR=0.76, p < 0.001], with older adults living in rural areas 34% less likely to report past-year dental visits than older adults living in urban areas. Older adults with no formal education were 73% less likely (OR=0.27; p < 0.001) to report past-year dental visits than older adults ≥10 years education. Older adults with poor SRH were 32% less likely (OR=0.68; p < 0.001) to report past-year dental visits than older adults with good/very good/excellent SRH. Sex, degree of multimorbidity, and pain level ([OR=1.37; p < 0.001] [OR=1.37; p < 0.001] and [OR=1.17; p < 0.001]) were all found to be positively associated with past-year dental visits in the study population. CONCLUSION: The present study highlights the association between poor SRH, a low level of educational attainment, and less frequent past-year dental visits, as well as the finding that past-year dental visits declined with age in the older adults sampled.

Association between sociodemographic factors and noncavitated and cavitated caries lesions in 8- to 12-year-old Mexican schoolchildren.

ABSTRACT: The aim of this study was to evaluate the association between sociodemographic factors and noncavitated and cavitated caries lesions in Mexican schoolchildren.This cross-sectional study was conducted in 2020 on 8-to-12-year-old schoolchildren of different socioeconomic status (SES). The caries was evaluated using ICDAS II, SES was evaluated using three categories---a high, middle, or low-income level---of the CONAPO. Multinomial logistic regression analyses were performed in order to ascertain the associations between socioeconomic factors and noncavitated and cavitated caries lesions.The prevalence of noncavitated lesions was 38.0% and cavitated lesions was 43.4% in permanent dentition. In all the samples, 50.6% of schoolchildren had poor oral hygiene. About 52.5% of the mothers and 64.7% of the fathers had less than 9 years of education. Schoolchildren with a low-income level have more cavitated lesions (ICDAS II 4-6) than schoolchildren with high-income level (56.3% vs 15.8%, P = .009). The multinomial logistic regression models showed that mother's level of education <9 years and low-income level were significantly associated with cavitated caries lesions (ICDAS II 4-6), [odds ratio = 1.79 (1.17 - 2.75); P = .007], [OR = 2.21 (1.23 - 3.97); P = .008], respectively. The socioeconomic level was not associated with noncavitated caries lesions (ICDAS II 1-3).An association was found between the presence of cavitated caries lesions and the subject's mother's level of education and a low-income level. Socioeconomic factors were found to be associated with inequalities in caries distribution in the age group studied.

Evaluating the changes in molar incisor hypomineralization prevalence: A comparison of two cross-sectional studies in two elementary schools in Mexico City between 2008 and 2017.

BACKGROUND: Little information is available on the trends over time of the prevalence of molar incisor hypomineralization (MIH). This condition may be preventing dental caries decline. AIM: (a) To compare the prevalence of MIH, in Mexico City schoolchildren, evaluated in 2008 with a group evaluated in 2017, (b) to identify the association of MIH with dental caries, and (c) to assess the mother's perception of her child's oral health status. DESIGN: Two cross-sectional studies performed in 2008 and in 2017 were compared. The oral examiner and the selected schools were the same in both surveys. RESULTS: A total of 549 schoolchildren were evaluated. The prevalence of MIH in the first survey was 20.3%, and 31.9 % in the second survey, (p = .002). Children with MIH were more likely to have dental caries. The odds ratio was 2.24 (p = .036) and 4.18 (p ˂ .001) in the first and second surveys, respectively. Mothers of children with MIH perceived worse oral health status of their children than the mothers whose children did not have MIH (odds ratio = 4.47, p ˂ .001). CONCLUSION: The findings portray a clear increase in prevalence of MIH and highlight the need for increased awareness about this condition among dentists and the general population.

Prevalence and Severity of Molar-Incisor Hypomineralization, Maternal Education, and Dental Caries: A Cross-Sectional Study of Mexican Schoolchildren with Low Socioeconomic Status.

OBJECTIVES: The aims of this study were to identify the prevalence of molar-incisor hypomineralization (MIH) in a group of low-income schoolchildren and to evaluate the role of maternal education on MIH and dental caries in these children. MATERIALS AND METHODS: This cross-sectional study enrolled 686 schoolchildren. To evaluate dental caries, the International Caries Dental Assessment System II (ICDAS) criteria were utilized. MIH was assessed by using the European Academy of Paediatric Dentistry criteria. Mixed-effects models were applied for the data analysis. RESULTS: The prevalence of MIH was 35.4% (244). Most children exhibited moderate MIH (163, 67.1%), followed by mild MIH (45, 18.5%) and severe MIH (35, 14.4%). Caries presence in the first permanent molars, evaluated using ICDAS score, indicated that the mean number of noncavitated and cavitated lesions (ICDAS ≥2) was 0.90 (±0.30); the mean number of lesions with ICDAS ≥3 was 0.36 (±0.48). Odds ratio (OR) analysis of MIH severity revealed that the children of mothers with low education were more likely to exhibit MIH (OR 2.13; 95% confidence interval [CI]: 1.25-3.85). Modeling of dental caries (ICDAS ≥3) revealed that low maternal education (OR 2.27; 95% CI: 1.25-4.16) and the presence of MIH (OR 4.37; 95% CI: 3.05-6.25) were associated with dental caries. CONCLUSIONS: There were associations between low maternal education and both MIH and dental caries. The presence of both initial and cavitated caries lesions was associated with MIH. Dentists should offer adequate advice to mothers with children with MIH, based on their educational background.

Relationship between Molar Incisor Hypomineralization (MIH) severity and cavitated carious lesions in schoolchildren.

The aim of this study was to identify the relationship between Molar Incisor Hypomineralization (MIH) severity and cavitated carious lesions in schoolchildren. This crosssectional study included 506 schoolchildren selected from public schools. The prevalence and severity of MIH was evaluated using the European Academy of Pediatric Dentistry criteria (EAPD), while the prevalence and severity of caries was evaluated by applying the ICDAS (International Caries Detection and Assessment System). The prevalence of MIH was 42.4%, with a severity of 21.7% mild, 7.7% moderate, and 13.0% severe. Prevalence was 61.6% for incipient lesions and 34.0% for cavitated lesions. The prevalence of ICDAS II ≥4 lesions was higher in schoolchildren with MIH than in those without MIH (55.8% vs. 44.2%, p<0.001). In the multinomial model, children with MIH in the moderate/ severe category were more likely (OR=3.28; CI95% 1.01 - 10.6, p<0.048) to present cavitated lesions. The presence of MIH at mild levels was not associated with cavitated carious lesions. A high prevalence of MIH was observed. Moderate and severe levels of MIH were associated with cavitated carious lesions. To prevent dental caries, it is important to identify MIH in children, particularly in the moderate and severe categories.

El objetivo de este estudio fue identificar la asociación entre la severidad de la Hipomineralización IncisivoMolar (HIM) y las lesiones cavitadas de caries en escolares. Estudio transversal que incluyó a 506 escolares seleccionados de escuelas públicas. La prevalencia y la severidad de HIM se evaluó utilizando los criterios de la European Academy of Pediatric Dentistry (EAPD), mientras que la prevalencia y severidad de caries se evaluó mediante los criterios del ICDAS (International Caries Detection and Assessment System). La prevalencia de HIM fue del 42.4%, por severidad: 21.7% leve; 7.7% moderado y 13.0% severo. La prevalencia de lesiones incipientes fue de 61.6% y 34.0% para lesiones cavitadas de caries. La prevalencia de ICDAS II ≥4 lesiones fue mayor en escolares con HIM que en aquellos sin HIM (55.8% vs 44.2%, p<0.001). En el modelo multinomial, los niños con HIM en la categoría moderada / severa tienen mayor probabilidad (RM = 3.28; IC95% 1.0110.6, p<0.048) de presentar lesiones cavitadas de caries. La presencia de HIM en niveles leves no se asoció con la presencia de lesiones cavitadas de caries. Se observó una alta prevalencia de HIM. Los niveles moderados y severos de HIM se asociaron con lesiones cavitadas de caries. Para prevenir la caries dental, es importante identificar la HIM en los niños, particularmente en las categorías moderada y severa.

[Comparison of varnishes and fluoridated toothpaste for the prevention of dental caries in school children]. / Comparación de barnices y dentífrico con flúor en la prevención de caries en escolares.

Objective To compare preventive effect on dental caries of two frequencies of fluoridated varnish (FV) applications and a group given brushing instructions and using fluoridated toothpaste. Materials and Methods Follow-up study of 203 children attending an elementary school in the municipality of Tláhuac, Mexico City. The children were followed for 22 months. The students were randomly assigned to one of the following groups: 1) brushing instructions with fluoridated toothpaste, 2) FV every six months, 3) three FV applications per week per year. The FV contained fluorosilane (1000 ppm F) and NaF dentifrice (1450 ppm F). The DMFT-caries index and the presence of white spots were recorded (ICDAS, International Caries Detection and Assessment System). Results At baseline, the mean age of the children was 9.3 (SD 0.76) years, white lesions 0.63 (SD 1.48) and DMFT =0.70 (SD 1.11). Averages of the initial and final DMFT scores in the three groups were 0.67 and 1.17 for the toothpaste group, 0.77 and 1.46 for FV twice a year group, and 0.67 y 1.03 for the three-applications-FV group. According to the results of the GEE (Generalized-Estimating Equations) model, there were no significant differences in the rate of white lesions or the increase of the DMFT index. The results for the DMFT were: for bi-annual applications of FV, RR=1.24 (p=0.178) and for the three consecutive applications of FV, RR=0.83, (p=0.298) in comparison with the brushing-instructions group using fluoridated toothpaste, among the three treatment groups, controlling for age, sex, and initial-caries index in primary teeth and brushing frequency. Conclusions Schoolchildren showed a low incidence of caries using any of the three preventive regimens applied.

Comparación de barnices y dentífrico con flúor en la prevención de caries en escolares / Comparison of varnishes and fluoridated toothpaste for the prevention of dental caries in school children

Objetivo Comparar el efecto preventivo de caries dental de dos frecuencias de aplicación de barniz fluorado (BF) con un grupo que utilizó instrucciones de cepillado con dentífrico fluorado. Materiales y Método Se siguieron durante 22 meses a 203 niños de una escuela primaria en la delegación Tláhuac, Ciudad de México, quienes fueron asignados aleatoriamente a uno de los siguientes grupos: 1) instrucciones de cepillado con dentífrico fluorado 3 veces al año, 2) BF semestral, 3) BF tres aplicaciones semanales al año. El BF contenía fluorosilano (1000 ppm F), el dentífrico NaF (1450 ppm F). Se registró el índice de caries CPOD y la presencia de manchas blancas usando los criterios del ICDAS (International Caries Detection and Assessment System). Resultados Al inicio del estudio, el promedio de edad fue 9,3 (DE 0,76) años, el promedio de lesiones blancas 0,63 (DE 1,48) y del CPOD 0,70 (DE 1,11). CPOD inicial y final en los tres grupos fueron: instrucciones de cepillado usando dentífrico fluorado 0,67 y 1,17, BF semestral 0,77 y 1,46 y grupo BF 3 aplicaciones 0,67 y 1,03, respectivamente.. De acuerdo a los resultados del modelo GEE (Generalized Estimating Equations), no se detectaron diferencias significativas en el incremento de lesiones blancas o en el CPOD para el índice de caries (CPOD) entre los tres grupo; para el CPOD las aplicaciones semestrales mostraron RR=1,24 (p=0,178) y para 3 aplicaciones RR=0,83, (p=0,298), comparando con el grupo de instrucciones de cepillado con dentífrico fluorado, controlando por edad, sexo, cpod inicial y frecuencia de cepillado. Conclusiones Los escolares mostraron una baja incidencia de caries utilizando cualquiera de los tres regímenes preventivos aplicados.(AU)

Objective To compare preventive effect on dental caries of two frequencies of fluoridated varnish (FV) applications and a group given brushing instructions and using fluoridated toothpaste. Materials and Methods Follow-up study of 203 children attending an elementary school in the municipality of Tláhuac, Mexico City. The children were followed for 22 months. The students were randomly assigned to one of the following groups: 1) brushing instructions with fluoridated toothpaste, 2) FV every six months, 3) three FV applications per week per year. The FV contained fluorosilane (1000 ppm F) and NaF dentifrice (1450 ppm F). The DMFT-caries index and the presence of white spots were recorded (ICDAS, International Caries Detection and Assessment System). Results At baseline, the mean age of the children was 9.3 (SD 0.76) years, white lesions 0.63 (SD 1.48) and DMFT =0.70 (SD 1.11). Averages of the initial and final DMFT scores in the three groups were 0.67 and 1.17 for the toothpaste group, 0.77 and 1.46 for FV twice a year group, and 0.67 y 1.03 for the three-applications-FV group. According to the results of the GEE (Generalized-Estimating Equations) model, there were no significant differences in the rate of white lesions or the increase of the DMFT index. The results for the DMFT were: for bi-annual applications of FV, RR=1.24 (p=0.178) and for the three consecutive applications of FV, RR=0.83, (p=0.298) in comparison with the brushing-instructions group using fluoridated toothpaste, among the three treatment groups, controlling for age, sex, and initial-caries index in primary teeth and brushing frequency. Conclusions Schoolchildren showed a low incidence of caries using any of the three preventive regimens applied.(AU)