Mirna Minaya-Sánchez

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.

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.

Dental plaque, preventive care, and tooth brushing associated with dental caries in primary teeth in schoolchildren ages 6-9 years of Leon, Nicaragua.

Background Our study aimed to evaluate the effect of various risk indicators for dental caries on primary teeth of Nicaraguan children (from Leon, Nicaragua) ages 6 to 9, using the negative binomial regression model. Material/Methods A cross-sectional study was carried out to collect clinical, demographic, socioeconomic, and behavioral data from 794 schoolchildren ages 6 to 9 years, randomly selected from 25 schools in the city of León, Nicaragua. Clinical examinations for dental caries (dmft index) were performed by 2 trained and standardized examiners. Socio-demographic, socioeconomic, and behavioral data were self-reported using questionnaires. Multivariate negative binomial regression (NBR) analysis was used. Results Mean age was 7.49±1.12 years. Boys accounted for 50.1% of the sample. Mean dmft was 3.54±3.13 and caries prevalence (dmft >0) was 77.6%. In the NBR multivariate model (p<0.05), for each year of age, the expected mean dmft decreased by 7.5%. Brushing teeth at least once a day and having received preventive dental care in the last year before data collection were associated with declines in the expected mean dmft by 19.5% and 69.6%, respectively. Presence of dental plaque increased the expected mean dmft by 395.5%. Conclusions The proportion of students with caries in this sample was high. We found associations between dental caries in the primary dentition and dental plaque, brushing teeth at least once a day, and having received preventive dental care. To improve oral health, school programs and/or age-appropriate interventions need to be developed based on the specific profile of caries experience and the associated risk indicators.

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.

Diabetes or hypertension as risk indicators for missing teeth experience: An exploratory study in a sample of Mexican adults

Background: To determine an exploratory estimation of the strength of type 2 diabetes mellitus (T2DM) and hypertension diagnoses as risk indicators for missing teeth in a sample of Mexican adults. Materials and Methods: A comparative cross-sectional study of sixty adult patients in a health center in Mexico included as dependent variable, the number of missing teeth (and having a functional dentition) and as independent variables, diagnoses for diabetes or hypertension, age, sex, maximum level of schooling, and tobacco use. Of the 60 participants, 20 were diagnosed with T2DM, 13 with hypertension, and 27 were otherwise diagnosed as healthy in their most recent medical checkup. A negative binomial regression (NBR) model was generated. Results: Mean age was 50.7 ± 16.2 and 50.0% were women. Mean number of missing teeth was 4.98 ± 4.17. In the multivariate NBR model, we observed that individuals with T2DM had higher risk of more missing teeth (incidence rate ratios [IRRs] = 3.13; 95% confidence interval [CI] = 2.09–4.69), followed by those with hypertension (IRRs = 2.63; 95% CI = 1.77–3.90). In addition, participants with current tobacco use were significantly more likely to have suffered tooth loss (P < 0.05) than those who were never smokers or former smokers, just like older participants (P < 0.05). Conclusions: T2DM and hypertension are independently associated with higher experience of missing teeth in an open adult population in Mexico. Future studies with a more sophisticated epidemiological design and encompassing a more detailed landscape of chronic diseases, type and length of use of long-term medications, and patterns of dental care use are needed to better delineate these associations.

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.