Martha Mendoza-Rodríguez

Edentulism and other variables associated with self-reported health status in Mexican adults

Background To determine if edentulism, controlling for other known factors, is associated with subjective self-report health status (SRH) in Mexican adults. Material/Methods We examined the SRH of 13 966 individuals 35 years and older, using data from the National Survey of Performance Assessment, a cross-sectional study that is part of the technical collaboration between the Ministry of Health of Mexico and the World Health Organization, which used the survey instrument and sampling strategies developed by WHO for the World Health Survey. Sociodemographic, socioeconomic, medical, and behavioral variables were collected using questionnaires. Self-reported health was our dependent variable. Data on edentulism were available from 20 of the 32 Mexican states. A polynomial logistic regression model adjusted for complex sampling was generated. Results In the SRH, 58.2% reported their health status as very good/good, 33.8% said they had a moderate health status, and 8.0% reported that their health was bad/very bad. The association between edentulism and SRH was modified by age and was significant only for bad/very bad SRH. Higher odds of reporting moderate health or poor/very poor health were found in women, people with lower socio-economic status and with physical disabilities, those who were not physically active, or those who were underweight or obese, those who had any chronic disease, and those who used alcohol. Conclusions The association of edentulism with a self-report of a poor health status (poor/very poor) was higher in young people than in adults. The results suggest socioeconomic inequalities in SRH. Inequality was further confirmed among people who had a general health condition or a disability.

Relationship of hyposalivation and xerostomia in Mexican elderly with socioeconomic, sociodemographic and dental factors.

We determined the prevalence of hyposalivation and xerostomia in older Mexicans (≥60 years), and its relationship with diverse factors. A cross-sectional study was realized in elderly subjects from Pachuca, Mexico. Chewing-stimulated saliva was collected under standardized conditions and salivary flow was measured; subjects were considered to have hyposalivation if their stimulated salivary flow was less than 0.7 mL per minute. Xerostomia was evaluated by asking subjects ‘Does your mouth feel dry?’. Hyposalivation was present in 59.7%, and xerostomia in 25.2% of subjects. 16.5% of subjects had both conditions. Xerostomia was present in 27.7% of subjects with hyposalivation and 21.4% of subjects without hyposalivation, but the difference was not significant (p > 0.05). Thus, 68.3% of older Mexicans had xerostomia and/or hyposalivation. Factors associated with hyposalivation were: using fewer devices in oral hygiene, lacking social benefits for retirement/pension, living in a public retirement home, brushing teeth less than twice a day and lacking teeth without dentures. None of the factors included in this study were associated with xerostomia. We concluded that several variables studied were associated with hyposalivation, but none for xerostomia. Additional research should examine the amount of hyposalivation and factors associated with hyposalivation especially in elderly with increased risk for hyposalivation.

Reasons Why Erupted Third Molars Are Extracted in a Public University in Mexico

PURPOSE The aim of this study was to determine the reasons for which erupted third molars (3M) are extracted in a sample of Mexican patients. SUBJECTS AND METHODS A retrospective cross-sectional study was performed on a sample of 83 patients attending exodontia (minor oral surgery) clinics of a public university in Mexico (Autonomous University of Hidalgo State). The outcome variable was the reason for extractions using Kay and Blinkhorns classification. The independent variables were age, gender, arch and tooth number according to the World Health Organization (WHO). For statistical analysis, we used the Chi-squared test in Stata 9.0. RESULTS Eighty-three patients underwent 150 3M extractions. Mean age was 38.67 ± 13.96 years, and 71.1% were female. The four reasons for 3M extraction were prosthetic (44.0%), followed by orthodontic (24.7%), dental caries (20.0%) and periodontal disease (11.3%). Differences were observed in the reasons for 3M extractions across age groups (p < 0.05). No significant differences existed between men and women (p > 0.05), or the WHO tooth number (p > 0.05). CONCLUSION Women and patients 18 to 34 years of age had erupted 3M extracted more frequently, primarily for prosthetic reasons. The age profile indicated a trend in demand for services that differ from those of overall tooth extractions, but not for the trend across gender.

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.

Prevalence of multimorbidity in subjects aged ≥60 years in a developing country

Background Aging is one of the most prominent features in recent population dynamics around the world. As populations age, the prevalence of simultaneous chronic diseases increases, which is known as multimorbidity. Objective The aim of the present study was to determine the prevalence of multimorbidity and associated factors in a sample of elderly Mexican subjects. Materials and methods A cross-sectional descriptive study was performed on a convenience sample of 139 subjects aged ≥60 years. The dependent variable was the multimorbidity diagnosis performed by a physician, which was categorized as 0 for subjects with no chronic disease or only 1 disease and 1 for subjects with 2 or more chronic diseases. Questionnaires were used to collect the information on the different variables. A statistical analysis was performed in Stata 11.0. Results The mean age was 79.06±9.78 years, and 69.1% of the subjects were women. A total of 69.1% (95% confidence interval =61.3–76.8) reported at least 1 morbidity. The mean morbidity by subject was 1.04±1.90. Cardiovascular diseases (25.9%), hypertension (20.1%), musculoskeletal disorders (19.4%), and diabetes (13.7%) were the most frequently reported conditions. The prevalence of multimorbidity (2 or more diseases) was 27.3% (95% confidence interval =19.8–34.8). No significant differences were observed in the independent variables. Conclusion In conclusion, the prevalence of multimorbidity in this sample of elderly Mexican subjects was relatively low. The distribution across the included variables was not significantly different. Interventions focused on the health care of older adults with multimorbidity should pay special attention to cardiovascular diseases, hypertension, and musculoskeletal disorders.

Factors Associated with Dental Pain in Mexican Schoolchildren Aged 6 to 12 Years

Objective To identify dental pain prevalence and associated factors in Mexican schoolchildren. Methods This cross-sectional study included 1,404 schoolchildren aged 6 to 12 years from public schools in the city of Pachuca de Soto, Hidalgo, Mexico. Data were collected through a questionnaire that addressed sociodemographic and socioeconomic factors, eating and dental hygiene habits, and behavior variables. The dependent variable was self-reported dental pain in the 12 months prior to the survey. Data were analyzed using nonparametric statistics and a binary logistical regression model. Results Dental pain prevalence among the studied children was 49.9%. The variables associated in the final model (p < 0.05) were younger mothers age, higher socioeconomic level, absence of an automobile in the home, fried food, fruit intake, lower tooth brushing frequency, never having used mouthwash or not knowing about it, and parents/guardians with regular to high levels of knowledge about oral health and a regular or good/very good perception of their childs oral health. Conclusions One in two children in the study had experienced dental pain in the twelve months prior to the survey. The association of socioeconomic variables with dental pain suggested inequalities among the children in terms of oral health.

Contribution of prosthetic treatment considerations for dental extractions of permanent teeth

Background. Tooth loss is an easily identifiable outcome that summarizes a complex suite of factors in an individual’s history of dental disease and its treatment by dental services over a lifetime. Assessment of overall tooth loss data is essential for epidemiologically evaluating the adequacy of dental care provided at a systems level, as well as for placing in context tooth loss for non-disease causes. For example, when derived from prosthetic treatment planning, the latter may unfortunately lead to some teeth being extracted (pulled) for the sake of better comprehensive clinical results. The objective of the present manuscript was to identify the contribution to overall tooth loss, by extraction of permanent teeth because of prosthetic treatment reasons. Material and Methods. A cross-sectional study included sex, age, total number of extractions performed by subject, sextant (anterior vs. posterior), group of teeth (incisors, canines, premolars and molars), upper or lower arch, and the main reason underlying extraction (extraction for any reason vs. prosthetic treatment), in patients 18 years of age and older seeking care at a dental school clinic in Mexico. A multivariate logistic regression model was generated. Results. A total of 749 teeth were extracted in 331 patients; 161 teeth (21.5% of total) were extracted for explicit prosthetic treatment indications. As age increased, the likelihood of having an extraction for prosthetic reasons increased 3% (OR = 1.03, p < 0.001). Women (OR = 1.57, p < 0.05) were more likely to be in this situation, and molars (OR = 2.70, p < 0.001) were most at risk. As the total number of extractions increased, the risk of having an extraction for prosthetic reasons decreased (OR = 0.94, p < 0.05). Conclusions. A significant amount (21.5%) of the extractions of permanent teeth were performed for prosthetic reasons in this dental school clinical environment; age, sex, type of tooth, and the total number of extractions moderated such pattern.