National survey on edentulism and its geographic distribution, among Mexicans 18 years of age and older (with emphasis in WHO age groups)

To determine the prevalence of edentulism in adults aged 18 years and older in Mexico and to describe its distribution in 20 of the 32 States in Mexico, highlighting the experience in the WHO age groups. A secondary analysis of the National Performance Evaluation Survey 2002-2003 (representative at the state level and part of the Word Health Survey) was undertaken. The sample design was probabilistic, stratified and through conglomerates. Data on dental conditions were available only for 20 of the 32 states of Mexico, leading to a total of 24 159 households (N = 54 638 654). The percentage of edentulism was determined as the proportion of subjects that self-reported complete loss of teeth. Data were analyzed using the SVY module for complex surveys in STATA 8.2. The mean age was 41.3 +/- 17.0 years (range 18-99). An estimated 6.3% (N = 3 437 816) of the population > or =18 years was edentulous. Lowest prevalences were observed in the states of Tlaxcala, Puebla and the Estado de Mexico with 3.4%, 3.8% and 4.5%, respectively. Highest prevalences were observed in San Luis Potosí, Colima, and Michoacán with 10.3%, 10.2% and 10.1%, respectively. Following the WHO age groups, the prevalence ranged from 2.4% in the 35-44 group through 25.5% in the 65-74 group. No obvious association between socio-economic and socio-demographic indicators at the state level and prevalence of edentulism was found. The prevalence of complete tooth loss observed in the present study varied greatly across states, although no straightforward association was found with socio-economic and socio-demographic indicators at the state level. This study could serve as a baseline to enable future evaluations of the oral status of Mexican adults and elders, following WHO age groups.     

Impact of socio-demographic,socioeconomic, and water variables on dental fluorosis in adolescents growing up during the implementation of a fluoridated domestic salt program

The objective of this study is to determine the impact of socio-demographic, socioeconomic, and other risk indicators on dental fluorosis (DF) among Mexican adolescents. A cross-sectional study was carried out in 1,538 adolescents 12 and 15 years of age in semi-rural communities located at high altitude (>2,000 m) and with high concentration of fluoride in water (1.38–3.07 ppm) in Hidalgo, Mexico. DF was determined by means of Dean’s Index and all teeth were examined. Remaining variables were collected using a questionnaire. The adjusted final model was performed using ordered logistic regression. After adjusting for sex, the variables associated with DF were (p < 0.05): being 12 years old (OR = 1.10) versus 15 years old; having lived the first 6 years of life in El Llano (3.07 F ppm) (OR = 3.19) or San Marcos (1.38 F ppm) (OR = 1.63) versus Tula (1.42 F ppm); having public (OR = 1.35) or private health insurance (OR = 1.36) versus those without insurance; belonging to the lower quartiles of socioeconomic position (SEP) [1st quartile (OR = 2.48), 2nd quartile (OR = 1.81), 3rd quartile (OR = 1.49)] versus the highest quartile; having drunk tap water (OR = 1.83) or from a well or spring (OR = 2.30) versus those who drank water purchased in large containers or bottles. Demographic and socioeconomic variables were associated with DF. While better SEP appeared to play an important role in DF, a pattern of water intake associated with water purchased in large containers or bottles (which have different connotations to the use of bottled water in industrialized Western countries) did reduce DF risk in these high fluoride content, high altitude communities.     

Characterizing Socioeconomic Inequalities in Professionally Applied Topical Fluoride Treatment Courses in Schoolchildren from a Developing Country

The objective of the present study was to characterize socioeconomic inequalities in the patterns of professionally applied topical fluoride (PATF) in Mexican schoolchildren. A cross-sectional study was carried out on 3029 Mexican schoolchildren. A questionnaire was administered to caregivers to determine sociodemographic, socioeconomic, and behavioral variables. The dependent variable was prevalence of PATF, coded as 0?=?without PATF and 1?=?with PATF, at any point in life, and separately, in the previous year. Various indicators of socioeconomic position were included. Logistic regression was used in the final multivariate analysis. The prevalence of PATF any time in life was 33.8%, while in the previous year it was 11.4%. The variables associated (p?<?0.05) with PATF any time in life were child's older age (OR?=?1.12), older age when tooth brushing started (OR?=?1.57), higher brushing frequency (OR?=?1.60), having health insurance [public (OR?=?1.61) or private (OR?=?1.45)], if family owned a car (OR?=?1.29) and better socioeconomic position [parents' education, second (OR?=?1.48) and third (OR?=?1.75) tertile]. For PATF in the previous year, the variables associated were older age of mother (OR?=?1.03), older age when tooth brushing started (OR?=?1.99), higher brushing frequency (OR?=?1.68), having health insurance [public (OR?=?1.62)] and better socioeconomic position (parents' education, second (OR?=?1.57) and third (OR?=?1.97) tertile). This study suggests the existence of socioeconomic inequalities in PATF, manifested through socioeconomic position, access to health insurance and household having a car. Identifying and addressing PATF inequalities would improve oral health in the child population.

     

Influence of predisposing, enabling, and health care need variables on the use of dental health services among Mexican adolescents from a semi-rural location

Objective: The purpose of this study was to quantify the influence of some of the predisposing, enabling, and healthcare need variables on dental health services utilization (DHSU) among Mexican adolescents. Material and methods: This is a cross-sectional analytical study including 1,538 Mexican teenagers 12 and 15 years of age. The dependent variable was DHSU in the previous 12 months. Data were collected through a questionnaire and included demographic, socioeconomic, and behavioral factors. The study included an oral examination. The analysis included nonparametric statistics and a logistic regression model. Results: Of the 1,538 adolescents, 688 were 12 years old and 850 were 15 years old. Girls accounted for 49.9%. The prevalence of DHSU was 15%. In the final model we found that having moved at least once from the community in which the child was born was associated with DHSU (OR: 1.24; 95% CI: 1.10-1.40; p > 0.05), just as it was observed for purchasing purified water for home consumption instead of relying on piped water supplies (OR: 1.52; 95% CI: 1.03-2.25), higher educational attainment of the mother (OR: 1.39; 95% CI: 1.02-1.91) and of the father (OR: 1.87; 95% CI: 1.09-3.19). Having more sound teeth (OR: 0.96; 95% CI: 0.94-0.98), and having at least one tooth with caries (OR: 1.10; 95% CI: 1.01-1.18) were also associated with DHSU (p > 0.05). Conclusion: The percentage of subjects with DHSU in the prior 12 months was low compared with other studies. Our identification of the variables associated with DHSU (often surrogates of socioeconomic position) indicated the existence of oral health inequalities and the need to develop strategies to reduce the gaps identified.     

Dental fluorosis prevalence and severity using Dean’s index based on six teeth and on 28 teeth

To contrast the sensitivity, specificity, and positive-negative predictive values between dental fluorosis prevalence scored on 28 (DF28) and on six permanent teeth (DF6), we undertook a cross-sectional study on 1,538 adolescents (12 and 15 years old) residing in Hidalgo State, Mexico, a naturally fluoridated (>0.7 ppm) area at an elevated altitude (>2,500 m above sea level). Dental fluorosis was scored using Deans modified index. Using the scores obtained for all teeth present (DF28) as a gold standard, we calculated the sensitivity, specificity, positive-negative predictive values, and receiver operating characteristic and concordance index pertaining to the scores based on six teeth (upper incisors and canines). DF28 fluorosis prevalence was 81.7%; based on DF6, it was 58.7% (23% difference). Among 12 year olds, the difference between DF28 and DF6 was 20.1% (84.5 vs. 64.4%); among 15 year olds, it was 25.4% (79.4 vs. 54%). Among girls, it was 23.2% (81.1 vs. 57.9%) and among boys, 22.8% (82.2 vs. 59.4%). The fluorosis community indices were 1.75 (DF28) and 1.11 (DF6). All positive predictive values reached 100% while negative predictive values were below 45%. Concordance between DF28 and DF6 was 53.9%, and kappa coefficient was 0.40. Partial scoring of fluorosis based on esthetically important permanent teeth underestimated prevalence, compared to full-mouth scoring. The decision to use an abridged Dean's index protocol must take into account the number of teeth examined, and which specific teeth are examined, to appraise the benefit of reduced data collection effort against possible information loss.     

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 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.     

Ecologic study in Mexico (2003-2009) on cleft lip and/or palate and associated sociodemographic, socioeconomic and pollution factors

ObjectiveTo analyze the rates of cleft lip and/or cleft palate (CLP) in Mexico between 2003 and 2009 and assess their association with variables at ecological level, sociodemographic, socioeconomic, and pollution.Material and methodsAn ecological study was conducted with data from the 32 states of Mexico for incidence of CLP, obtained from the Ministry of Health. We included sociodemographic, socioeconomic, and pollution information, obtained from governmental agencies. CLP incidence rates were used as dependent variable; independent variables were socioeconomic, demographic and pollution indicators. Statistical analysis was performed using Spearman correlation and chi² tests.ResultsDuring the study period 10573 new cases presented (mean 1510.43 per year). The States with the highest rate (per 1000 births) were: in 2003 the Federal District (Mexico City) (1.76), in 2004 Jalisco (2.62), in 2005 Oaxaca (1.66), in 2006 the State of Mexico (1.29), in 2007, 2008 and 2009 Jalisco (2.17, 2.92, and 1.99). For all the years men were more likely affected than women (P < .05). Variables found positively correlated to LPH rates were total population, solid waste, life expectancy, urban solid waste. The variables negatively correlated were population percentages of high alcohol users, and of alcohol abuse or addiction.ConclusionsThe State of Jalisco was one of the most affected locations over the years. Ecologic positive correlations existed between cleft lip and/or palate and sociodemographic, socioeconomic, and pollution factors. Incidence rate was negatively correlated with alcohol use and abuse. More detailed epidemiological studies are needed to fully characterize risk factors in Mexican populations.     

Dental fluorosis in 12- and 15-year-olds at high altitudes in above-optimal fluoridated communities in Mexico

OBJECTIVE: The purpose of this study was to determine the prevalence and severity of dental fluorosis in Mexican adolescents. MATERIALS AND METHODS: A cross-sectional epidemiological study was carried out in 1,024 adolescents 12 and 15-years-old residing in three naturally fluoridated locales at high altitudes above sea level (> 2,000 m or > 6,560 ft) in Tula de Allende, Hidalgo, Mexico. Participants had lived in those communities from birth to their sixth birthday. Both the Modified Dean Index and the Community Fluorosis Index were calculated. RESULTS: The overall fluorosis prevalence was 83.8 percent. Fluorosis prevalence in El Llano (3.07 ppmF), San Marcos (1.38 ppmF), and Tula Centro (1.42 ppmF) was 94.7, 89.8, and 81.9 percent, respectively. Overall, the Community Fluorosis Index was 1.85. We observed a high prevalence of dental fluorosis--mostly very mild (35.9 percent), but also uncommonly severe (20.6 percent). CONCLUSIONS: At least 8 out of 10 adolescents had some level of fluorosis, and such prevalence is considered to be a dental public health problem. A relationship between fluoride concentration in water in each community and fluorosis was observed. The high fluorosis prevalence and severity might possibly be associated with the high altitude of the communities.     

Sociobehavioral factors influencing toothbrushing frequency among schoolchildren

BACKGROUND: Toothbrushing may help prevent some oral health diseases considered to be public health problems--in particular, certain presentations of chronic periodontal diseases and dental caries. The authors conducted a study to identify variables associated with frequency of toothbrushing with toothpaste among schoolchildren aged 6 to 12 years. METHODS: The authors collected data regarding sociodemographic, socioeconomic, oral hygiene and attitudinal variables through a cross-sectional questionnaire administered to 1,373 schoolchildren from Campeche, Mexico. They categorized toothbrushing frequency as "two times a day or fewer" and "three times a day or more." The authors used logistic regression to analyze the data. RESULTS: Multivariate analyses showed that girls (odds ratio [OR]=1.41), older children (OR=1.07) and offspring of mothers with higher levels of schooling (OR=1.07) were more likely to brush more frequently. The results showed an interaction between the attitude of the mother toward oral health and the use of dental care in the previous 12 months. When mothers had a positive attitude, the likelihood of their children's brushing more frequently was higher among those who received dental care in the previous 12 months (OR=2.43; P 相似文献