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.     

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.

     

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.     

Socioeconomic and sociodemographic variables associated with oral hygiene status in Mexican schoolchildren aged 6 to 12 years

BACKGROUND: The purpose of this study was to identify the socioeconomic and sociodemographic variables associated with oral hygiene status in schoolchildren aged 6 to 12 years in Navolato, Sinaloa, Mexico. METHODS: A cross-sectional study was carried out in 3,048 schoolchildren. A questionnaire was used to determine socioeconomic and sociodemographic variables, and a clinical oral examination was carried out to establish oral hygiene status. The "plaque" component of the simplified oral hygiene index (S-OHI) was the criterion used to determine oral hygiene status in children. Using principal component analysis, five socioeconomic factors were streamlined to one principal component to determine the individual socioeconomic level. Data were analyzed with non-parametric tests and multivariable logistic regression. RESULTS: The population included 1,456 boys and 1,592 girls. The mean value for S-OHI was 1.10 +/- 0.34. The largest percentage (50.8%) of the S-OHI scores ranged between 0 and 1. In the multivariate model, younger age, male gender, and lower toothbrushing frequency (P <0.05) were associated with poor oral hygiene. Children with better socioeconomic status had better oral hygiene (P <0.05). CONCLUSIONS: Most children ( approximately 60%) had an acceptable level of oral hygiene. Diverse variables were associated with oral hygiene in these Mexican children, highlighting a gradient distribution throughout the socioeconomic spectrum. It is necessary to implement strategies that would help to diminish the disparities observed across diverse socioeconomic groups.     

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