Ana Alicia Vallejos-Sánchez

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.

Dental fluorosis in cohorts born before, during, and after the national salt fluoridation program in a community in Mexico

Objective. To determine the prevalence and severity of dental fluorosis, as well as factors associated with its occurrence, in seven cohorts of children before and after the implementation of a fluoridated salt program in 1991. Material and methods. A cross-sectional study was carried out in 1,373 children aged from 6 to 12 years in Campeche, Mexico. Data were collected by means of a questionnaire administered to mothers and a dental examination of the children. Modified Deans criteria were used to diagnose dental fluorosis. A multivariate logistic regression model was used to evaluate the relationship between dental fluorosis and independent variables. Results. The prevalence of dental fluorosis was 51.9%. The most common degree of dental fluorosis was very mild, with 84.7%, followed by mild, moderate, and severe with 13.1%, 1.7%, and 0.6%, respectively. The multivariate model adjusted by number of additional sources of fluoride, age at the beginning of use of toothpaste, and level of schooling of the mother, showed that children born in 1990 (OR = 1.74; CI 95% = 1.36–2.22), 1991 (OR = 4.03; CI 95% = 2.58–6.28), and 1992 (OR = 10.41; CI 95% = 5.77–18.78) were more likely to have dental fluorosis than those born in the period 1986–1989. The frequency of toothbrushing (OR = 1.63; CI 95% = 1.37–1.95) was also associated with dental fluorosis. Conclusions. A close relationship was found between exposure to toothpaste and dental fluorosis. Implementation of the fluoridated salt program greatly increased the risk of fluorosis.

Prevalence of and risk indicators for chronic periodontitis in males from Campeche, Mexico

OBJECTIVE Determining the prevalence, severity and extension of chronic periodontitis and identifying risk indicators amongst policemen in Campeche, Mexico, using an electron probe. MATERIALS AND METHODS A cross-sectional study of a convenience sample of 161 men was conducted. A case of periodontitis was defined as a participant having clinical attachment loss in at least one (3) 4 mm site. Every periodontal site in the mouth was measured by a standardized periodontist using a Florida Probe System. STATA 8.2 was used for bivariate and multivariate statistical analysis, using logistic binary regression. RESULTS Mean age was 38.36+/-10.99 years. 23,622 periodontal sites were available for examination. Mean (SD) teeth and sites examined per person were 24.45+/-4.63 and 146.72+/-27.80, respectively. Periodontitis prevalence was 62.7%. Periodontitis severity was 2.9 mm and extent was 53.7%. Adjusted for alcohol intake, factors associated with periodontitis prevalence were being older ((3)35 years; OR=2.08; CI95%=1.05-4.10), smoking (current/former; OR=2.22; CI95%=1.06-4.77) and gingivitis (presence; OR=3.35; CI95%=1.34-8.42). CONCLUSIONS Many study participants had poor periodontal conditions, with substantial overall prevalence of periodontitis. Older age, tobacco use and the presence of gingivitis were factors associated with periodontitis prevalence.

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.

Gingival recession and associated factors in a homogeneous Mexican adult male population: A cross-sectional study

Background: Diverse variables are implicated in the pathogenesis of gingival recession; more detailed knowledge about the relationship between the clinical presentation of gingival recession and assorted risk indicators may lead to improved patient monitoring, early intervention, and subsequent prevention. The objective was to evaluate clinically gingival recession in a homogeneous Mexican adult male population and to determine the strength of association with related factors. Method: A cross-sectional study was carried out in a largely homogeneous group in terms of ethnic background, socioeconomic status, gender, occupation, and medical/dental insurance, in Campeche, Mexico. Periodontal examinations were undertaken to determine diverse clinical dental variables. All periodontal clinical examinations were assessed using the Florida Probe System, a dental chair and one examiner. Questionnaires were used to collect diverse risk indicators. Statistical analyses were undertaken with negative binomial regression models. Results: The mean number of sites with gingival recession per subject was 6.73±5.81; the prevalence was 87.6%. In the negative binomial regression model we observed that for (i) each year of age, and (ii) each percentage unit of increase in sites with plaque, and (iii) with suppuration, mean sites with gingival recession increased 2.9%, 1.0% and 13.0%, respectively. Having a spouse was associated with gingival recession. Conclusions: We observed association between gingival recession, and sociodemographic and clinical parameters. Patients need to be educated about risk indicators for gingival recession as well as the preventive maneuvers that may be implemented to minimize its occurrence. The potential of improved oral self-care to prevent a largely benign condition such as gingival recession is important, given the associated disorders that may ensue root exposure, such as root caries and root hypersensitivity. Key words:Oral health, periodontal health, gingival recession, adults, Mexico.

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.

Relationship between premature loss of primary teeth with oral hygiene, consumption of soft drinks, dental care, and previous caries experience

We determine the relationship between premature loss of primary teeth and oral hygiene, consumption of soft drinks, dental care and previous caries experience. This study focused on 833 Mexican schoolchildren aged 6–7. We performed an oral examination to determine caries experience and the simplified oral hygiene index. The dependent variable was the prevalence of at least one missing tooth (or indicated for extraction) of the primary dentition; this variable was coded as 0 = no loss of teeth and 1 = at least one lost primary tooth. The prevalence of at least one missing tooth was 24.7% (n = 206) (95% CI = 21.8–27.7). The variables that were associated with the prevalence of tooth loss (p < 0.05) included: the largest number of decayed teeth (OR = 1.11), the largest number of filled teeth (OR = 1.23), the worst oral hygiene (OR = 3.24), a lower frequency of brushing (OR = 1.60), an increased consumption of soda (OR = 1.89) and use of dental care (curative: OR = 2.83, preventive: OR = 1.93). This study suggests that the premature loss of teeth in the primary dentition is associated with oral hygiene, consumption of soft drinks, dental care and previous caries experience in Mexican schoolchildren. These data provide relevant information for the design of preventive dentistry programs.

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.