Alejandro José Casanova-Rosado

Dental caries and associated factors in Mexican schoolchildren aged 6–13 years

The objectives of the present study were to establish dental caries prevalence (percentage with caries) and experience in the primary and permanent dentition (dmft and DMFT) of 6 to 13-year-old schoolchildren in Campeche, Mexico, and to estimate the contributing roles of the likely risk indicators. A cross-sectional study was carried out in 1,644 children aged 6–13 years. Self-administered questionnaires obtained information on social, economic, behavioral, and demographic variables. The primary dentition of 1,309 children and the permanent dentition of 1,640 children were evaluated in the oral examinations. The main outcome measures were DMFT, dmft, and SiC indices. Data were modeled using logistic regression analysis. The overall caries prevalence was 77.4%, 73.6% in the primary dentition (61.6% in 6-year-olds), and 49.4% in the permanent dentition. The dmft and DMFT indices were 2.85±2.73 and 1.44±2.05, respectively (DMFT=3.11±2.62 in 12-year-olds). The SiC index was 6.05 at 12 years of age. Associated variables to dental caries in both dentitions were presence of enamel defects, presence of dental plaque, low socio-economic status, female sex, and older age. Mothers schooling was negatively associated (OR=0.95) with caries in primary dentition. Caries experience in the primary dentition (OR=6.02) was positively associated with caries in the permanent dentition. Dental caries status in these Mexican children was closer to the goals proposed by the WHO/FDI for 2000 than previous studies. This study has identified clinical, socio-economic, and behavioral determinants for dental caries in primary and permanent dentition on Mexican schoolchildren.

Edentulism risk indicators among Mexican elders 60-year-old and older.

The objective of this study was to determine the prevalence of edentulism in Mexican elders aged 60 years and older, and the associated risk indicators. A cross-sectional study was undertaken in 139 elders living in either of two long-term care (LTC) facilities, or attending an adult day center (ADC) in Pachuca, Mexico. A subject was edentulous when natural teeth were completely absent, determined through a clinical examination. Risk indicators were collected using questionnaires. Analyses were performed using binary logistic regression in STATA 9.0. Mean age was 79.0±9.8 years. Many subjects were women (69.1%). The prevalence of edentulism was 36.7%. In multivariate analysis, after adjusting for age and sex, the variables that were inversely associated (p<0.05) with edentulism were living with a spouse (odds ratio=OR=0.31), and lacking health insurance (OR=0.70). Variables associated with higher risk of being edentate were lower educational attainment (OR=1.61), having received radiation therapy (OR=4.49), being a smoker (OR=4.82), and having diabetes (OR=2.94) or other chronic illnesses (OR=1.82) (with hypertension approaching significance, p=0.067). In this sample of Mexican elders, diverse variables were associated with edentulism, in particular smoking and past radiotherapy. Oral health programs within and outside LTC/ADC should take into account risk factors specific to the older population.

Desigualdades socioeconómicas en la utilización de servicios de salud bucal: estudio en escolares mexicanos de 6 a 12 años de edad

El objetivo del estudio fue evaluar la asociacion entre diversos indicadores socioeconomicos y la utilizacion de servicios de salud bucal. Se realizo un estudio transversal en 3.048 escolares. La variable utilizacion de servicios de salud bucal y las variables sociodemograficas y socioeconomicas se colectaron a traves de un cuestionario dirigido a las madres. Para determinar las necesidades de salud se realizo un examen clinico bucal a los ninos. Las asociaciones ajustadas fueron evaluadas con regresion logistica politomica. Las variables asociadas a servicios preventivos y curativos fueron mayor edad, mayor frecuencia de cepillado y menor edad al inicio de cepillado dental, tener seguro publico o privado, y mejor nivel socioeconomico. Ademas, solo para los servicios preventivos, tambien se asocio estar inscrito en una escuela privada, y solo para los servicios curativos, la posesion de automovil y tener necesidades de salud bucal entre moderadas y muy altas. Los resultados sugieren la existencia de desigualdades socioeconomicas en la utilizacion de servicios de salud bucal en ninos mexicanos.

Socioeconomic, sociodemographic, and clinical variables associated with root caries in a group of persons age 60 years and older in Mexico

Aim:  To determine the prevalence of root caries and the root caries index in a population of older Mexicans, and its relationship to socioeconomic, sociodemographic and dental factors.

Enamel defects, caries in primary dentition and fluoride sources: relationship with caries in permanent teeth

OBJECTIVE To examine the relationship between the presence of enamel defects, dental caries in primary teeth, and exposure to various fluoride technologies and the presence of dental caries in permanent teeth in children with mixed dentition. MATERIALS AND METHODS A cross-sectional study was conducted in 713 children aged 6-9 years old in 4 elementary schools in Campeche, Mexico through the use of a questionnaire for the mothers and an oral examination in the children. The dependent variable was the prevalence of caries in permanent dentition. RESULTS The mean number of decay, missing or filling teeth in primary dentition (dmft) and in permanent dentition (DMFT) was 2.48 (2.82) (deft > 0 = 58.9%) and 0.40 (0.98) (DMFT > 0 = 18.2%), respectively. The significant caries index (SiC), which is calculated in deciduous dentition, was 5.85 for 6 year-olds. Multivariate logistic regression adjusted for variables related to fluoride exposure revealed that older age (OR = 2.99), a deft of > 0 (OR = 5.46), and lower maternal educational level (OR = 1.57) were significantly associated with a higher number of dental caries in permanent teeth. An interaction between sex and enamel defects was also found. CONCLUSIONS The number of dental caries in both primary and permanent dentitions was relatively smaller than that found in prior studies performed in Mexican populations. The results confirm that the presence of caries in primary dentition is strongly associated with caries in permanent dentition. No significant relationship was found between fluoride exposure and dental caries in permanent dentition.

Defectos del esmalte, caries en dentición primaria, fuentes de fluoruro y su relación con caries en dientes permanentes

Objetivo: Explorar la relacion entre la presencia de defectos del esmalte (DE), la experiencia de caries en la denticion temporal, y la exposicion a diversas fuentes de fluoruros, con la presencia de caries en la denticion permanente de ninos con denticion mixta. Material y metodos: Se realizo un estudio transversal en 713 sujetos de 6-9 anos de edad de 4 escuelas de Campeche, Mexico, mediante un cuestionario dirigido a las madres, y un examen clinico bucal a los ninos. La variable dependiente fue la prevalencia de caries en la denticion permanente. Resultados: El promedio de dientes temporales cariados, extraidos y obturados (ceod) y dientes permanentes cariados, perdidos y obturados (CPOD) fue de 2,48 (2,82) (ceod > 0 = 58,9%) y 0,40 (0,98) (CPOD > 0 = 18,2%), respectivamente. El indice SiC (indice de caries significativa, calculado en la denticion temporal) fue de 5,85 para los ninos de 6 anos de edad. En el analisis de regresion logistica multivariado permanecieron significativas, despues de ajustar por variables de exposicion a fluoruros, la mayor edad (odds ratio [OR] = 2,99), el ceod > 0 (OR = 5,46), la menor escolaridad de la madre (OR = 1,57) y una interaccion entre sexo y defectos del esmalte. Conclusiones: Las caries en la denticion temporal y permanente fueron relativamente menores que las observaciones publicadas por otros estudios en Mexico. Los resultados confirmaron que la caries en la denticion temporal se asocio fuertemente con la caries en la denticion permanente. No hubo una relacion significativa entre las fuentes de fluoruro y la caries dental en la denticion permanente.

Confirmation of symmetrical distributions of clinical attachment loss and tooth loss in a homogeneous Mexican adult male population

Background/purpose To ascertain whether or not clinical attachment loss and tooth loss are present with similar severity and prevalence across the two sides of the mouth in a homogeneous sample of urban male adults. Materials and methods A cross-sectional study was carried out on 161 policemen (a largely homogeneous group in terms of ethnic background, socioeconomic status, sex, occupation, and medical/dental insurance) in Campeche, Mexico. Periodontal examinations were undertaken using the Florida Probe System in a dental chair by one trained and standardized examiner (kappa ≥ 0.60) to determine clinical attachment loss and tooth loss. We examined six sites in all teeth present in the mouth (a maximum of 168 sites, no third molars). Because of correlated data between observations, McNemar (for tooth loss) and Wilcoxon (for attachment loss) signed-rank tests were used to compare right and left sites within the same patient. Results The mean age was 38.4 ± 11.0 years. The mean number of teeth present was 24.4 ± 4.6; the mean number of periodontal sites/person was 146.7 ± 27.8. All P values were ≥ 0.05 (except for attachment loss in the upper first premolars), suggesting that there were no statistically significant differences between the right and left sides for the frequency of presentation of these two conditions. Conclusion Tooth loss and attachment loss measurements largely resemble each other on both sides of the mouth.

Introducing a Clinical-behavioural Scoring System for Children's Oral Hygiene

OBJECTIVES Developing and testing a clinical-behavioural scoring system for assessing childrens oral hygiene. MATERIALS AND METHODS One clinical variable (the presence of dental plaque, measured using Silness and Loes index) and one behavioural variable (self-reported tooth brushing frequency) were combined into secondary data analysis of research databases for 3-6-year-olds and 6-13-year-olds in a Mexican community. The combined scoring is an ordinal scale that depicts suitable, moderate and inadequate hygiene. Blinded dental examiners also collected dmft/DMFT data in standardised conditions. Data was analysed with Spearmans rho, Kruskall-Wallis, non-parametric tests for trends and Pearsons chi2 tests. RESULTS 1303 children aged 3-6 years old and 1644 children aged 6-13 years old participated in the study. Clear relationships existed between the combined scoring system and dmft (p < 0.01) and between the scoring system and DMFT (p < 0.01), suggesting that the combined clinical-behavioural scoring system is a reasonably accurate measurement of the relationship between caries experience and oral hygiene in children in the given setting. CONCLUSIONS The combined clinical-behavioural scoring system is a simple, easy-to-use tool that incorporates clinical and behavioural data commonly found in dental systems. Whether the clinical-behavioural scoring system can be generalised remains to be established.

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/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.

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.