Dental caries in 12-Year-Old schoolchildren who participate in a preventive and restorative dentistry program / Caries dental en escolares de 12 años que participan en un programa de odontología preventiva y rehabilitación oral

Abstract Since 2013, the Faculty of Dentistry of the University of Costa Rica has provided a preventive and restorative oral health program at Carmen Lyra Public School. The first generation of students that received dental care from this project were examined in 2019 for caries status. A total of 62 twelve-year-old schoolchildren were examined (31 boys and 31 girls). First, all teeth surfaces were cleaned with a brush and then rinsed. Subsequently, examination was performed in each person by a calibrated examiner using the International Caries Detection and Assessment System (ICDAS). Prevalence of dental caries was 59.7%. ICDAS code 2 was the most prevalent (68.8%), followed by 1 (19.3%), 5 (4.5%), 3 (3.5%), 6 (2.5%), and 4 (1.4%). Regarding number of carious surfaces, the highest prevalence was observed in the occlusal surfaces (77.3%), followed by the vestibular (13.9%), mesial (4.2%), palatal/ lingual (4,1%) and distal (0.5%). Of these carious surfaces, 7% were caries associated with restorations and were present only on the occlusal surfaces. Boys had more cavities than girls (54.1% compared to 45.9%), however, this difference was not significant. Regarding the condition of restorations in teeth, 92 dental restorations (resin or amalgam) were found in the population studied and were well adjusted. Most of these restorations were found on the occlusal surfaces (82.6%), followed by vestibular surfaces (8.7%,) palatal/lingual (5.4%) surfaces, mesial surfaces (3.3%), and no restorations were detected on the distal surfaces. Sealants were identified in 11.3% schoolchildren; 98% were identified on the occlusal surfaces and the other 2% were found on the palatal/lingual surfaces. DMFT Index was 1.6±0.71. The prevalence of dental caries in this sample was low compared to other studies in twelve-year-old schoolchildren in Costa Rica. This may suggest that the oral health program had a positive impact in the studied population.

Resumen Desde el año 2013, la Facultad de Odontología de la Universidad de Costa Rica ha brindado un programa de prevención y rehabilitación oral en la Escuela Carmen Lyra. La primera generación de estudiantes que recibieron atención dental por parte de este programa, fueron examinados en el año 2019 para determinar la prevalencia de caries. Se examinó a 62 escolares de 12 años (31 niños y 31 niñas). Primero, todas las superficies de los dientes se limpiaron con un cepillo y luego se enjuagaron. Posteriormente, el examen fue realizado en cada participante por un examinador calibrado utilizando el Sistema Internacional de Detección y Evaluación de Caries (ICDAS). La prevalencia de caries dental fue del 59,7%. El código ICDAS 2 fue el más prevalente (68,8%), seguido de 1 (19,3%), 5 (4,5%), 3 (3,5%), 6 (2,5%) y 4 (1,4%). En cuanto al número de superficies cariadas, la mayor prevalencia se observó en las superficies oclusales (77,3%), seguidas de las vestibulares (13,9%), mesiales (4,2%), palatinas/linguales (4,1%) y distales (0,5%). De estas superficies cariadas, el 7% eran caries asociadas con restauraciones y estaban presentes solo en las superficies oclusales. Los niños tenían más caries que las niñas (54,1% en comparación con el 45,9%), sin embargo, esta diferencia no fue significativa. En cuanto al estado de las restauraciones dentales, se encontraron 92 restauraciones dentales (resina o amalgama) en la población estudiada y se encontraban bien ajustadas. La mayoría de estas restauraciones se encontraron en las superficies oclusales (82,6%), seguidas de las superficies vestibulares (8,7%), superficies palatinas/linguales (5,4%), superficies mesiales (3,3%) y no se detectaron restauraciones en las superficies distales. Se identificaron sellantes de fosas y fisuras en el 11,3% de los escolares. El 98% de estos sellantes se identificó en las superficies oclusales y el otro 2% se encontró en las superficies palatino/lingual. El índice CPOD fue de 1,6±0.71. La prevalencia de caries dental en esta muestra fue baja en comparación con otros estudios en escolares de doce años en Costa Rica. Esto sugiere que el programa de salud bucal tuvo un impacto positivo en la población estudiada.

Dantha Bhagya Scheme-A Way Forward for People with Edentulism in India

Oral health problems are emerging as one of the major public health concerns. Elderly people have to face many difficulties in utilizing oral health services, especially the below-the-poverty-line population. Taking into Consideration Dantha Bhagya Yojana was launched in Karnataka, for the Below poverty line population as dental services are highly-priced. Databases, media articles, and government official websites providing information regarding Dantha Bhagya Yojana were considered. The scheme aims to provide complete and partial dentures to the senior citizens of Karnataka, belonging to the below poverty line category. The program works under public-private partnership lines and is proving to be helpful to the beneficiaries in Karnataka province. These services are made available in public as well as private dental colleges of Karnataka. The community healthcare workers' role is to identify the edentulous patients and refer them to the nearby dental college for treatment.

Oral health-related quality of life in women participating in the "More Smiles for Chile" dental program / Calidad de vida relacionada con la salud oral en mujeres participantes del programa odontológico "Más sonrisas para Chile"

ABSTRACT Introduction: oral health problems are not only a manifestation of physical problems, but they also affect psychosocial aspects. The "More Smiles for Chile" program was created to make a change on the quality of life of participating women; however, the assessments usually focus on goals achieved. The aim of the present study was to determine the oral health-related quality of life (OHRQoL) in women who participated in the "More Smiles for Chile" program at the San Pedro Family Health Center. Method: a quantitative, descriptive-correlational, cross-sectional study was conducted with a non-probabilistic sample of 120 women. The Oral Health Impact Profile (OHIP) scale and a questionnaire about demographic and dental variables were used to measure OHRQoL. The interviews were conducted at the Family Health Center. Results: the most affected components of OHRQoL are psychological discomfort and physical pain. The dimensions with significant changes in OHRQoL were: functional limitation, psychological discomfort, psychological disability, and global perception. Conclusions: the More Smiles for Chile program positively impacts the OHRQoL perception in participating women, with significant differences in post-participation averages.

RESUMEN Introducción: los problemas de salud bucal no solo manifiestan problemas físicos, sino que además afectan aspectos psicosociales. El programa "Más Sonrisas para Chile" fue creado para generar un impacto en la calidad de vida de las mujeres participantes, sin embargo, las evaluaciones han estado centradas en el cumplimiento de metas. El objetivo del estudio fue determinar la calidad de vida relacionada con la salud oral (CVRSO) en mujeres que participaron en el programa "Más Sonrisas para Chile" en el Centro de Salud Familiar San Pedro (CESFAM). Método: se realizó un estudio cuantitativo, descriptivo-correlacional, transversal, con una muestra no probabilística de 120 mujeres. Para medir la CVRSO se utilizó la escala Oral Health Impact Profile (OHIP) y un cuestionario de preguntas sobre variables demográficas y odontológicas. Las entrevistas se realizaron en el propio CESFAM. Resultados: los componentes de la CVRSO más afectados son malestar psicológico y dolor físico. Las dimensiones que experimentan cambios significativos en la CVRSO fueron: limitación funcional, malestar psicológico, discapacidad psicológica y percepción global. Conclusiones: el programa Más Sonrisas para Chile impacta positivamente en la percepción de la CVRSO de las mujeres participantes, con diferencias significativas en los promedios posparticipación.

Programa de Promoción y Educación para la Salud Bucal, Destinado a Niños y Adolescentes Hospitalizados / Oral Health Education and Promotion Program for Hospitalized Children and Adolescents

La enfermedad sistémica es uno de los riesgos asociados al desarrollo de enfermedades bucales. Este programa fue orientado a promover la salud bucal de niños y adolescentes internados en la clínica de la cátedra de Pediatría del Hospital de Clínicas "José de San Martín". Se realizó un estudio descriptivo transversal sobre una muestra de 1140 individuos registrados entre los años 2008 y 2018. El objetivo fue analizar las variables que afectan su salud bucal. Para ello, cursantes de la Carrera de especialización en Odontopediatría de la UBA implementaron semanalmente un Programa de Promoción y Educación para la salud bucal, destinado a niños internados y sus acompañantes. Para el registro de caries se utilizó el Índice de Necesidad de Tratamiento comunitario (INTc), se analizó la dieta, el riesgo social y la presencia o no de cepillo dental. Se realizó prueba de Chi cuadrado para la comparación de las variables cualitativas, cálculo de medias, rangos, porcentajes y desvíos. Como resultado se observaron diferencias significativas del INTc en los pacientes con dieta cariogénica entre los distintos grupos de edad. El coeficiente asociado a la dieta es aproximadamente 5 veces mayor que el asociado al uso de cepillo. El INTc evidenció una media en preescolares de 2.45 con DS 2.47, en escolares de 4.59 con DS de 3.33 y en adolescentes fue de 4.02 con DS de 3.15. En conclusión, la salud bucal no está separada de la salud general, por lo que se destaca la necesidad de incorporar al odontólogo dentro del grupo interdisciplinario que atiende a niños hospitalizados. La dieta cariogénica fue la covariables con mayor efecto y luego el uso de cepillo dental (AU)

Changes in the amount of pit and fissure sealants supplied in Korea after inclusion in the National Health Insurance coverage / 대한구강보건학회지

OBJECTIVES: The purposes of this study were to review changes in the amount of pit and fissure sealant (PFS) provided after the inclusion of PFS in treatments covered by the National Health Insurance (NHI) and to assess differences in the supplied amount between geographical areas where accessibility to dental care differs. METHODS: The years for comparison were selected based on data availability and the time of inclusion of PFS into NHI coverage. The selected pre-inclusion year was 2008, and the post-inclusion year was 2012. Data regarding the amount of PFS supplied were collected from the oral health program, NHI, and Medical care. To dichotomize areas by high and low dental care accessibility, we standardized the population size, number of dental institutions, and number of dentists in each group. RESULTS: We considered metropolitan areas and Gyeonggi Province as high dental care accessibility areas, while other provinces were considered as low dental care accessibility areas. Regardless of the transforming constant, the amount of PFS supplied increased in high dental care accessibility areas and decreased in low dental care accessibility areas after inclusion of PFS in NHI. CONCLUSIONS: To increase the amount of PFS provided in low dental care accessibility areas, promotion of PFS should be strengthened and support from oral health programs should be increased. Additionally, waiving out-of-pocket money for PFS in NHI should be considered to remove barriers of supply.

Reforma de Salud en Chile: Evaluación Garantía Explícita en Salud Oral en Población de 60 Años / Evaluation of Explicit Guarantees in Oral Health in 60-year-old Population

La reforma chilena creó el Programa de Garantías Explícitas en Salud (GES) para salvaguardar la atención bajo condiciones garantizadas de acceso, oportunidad, protección financiera y calidad para situaciones prioritarias como la salud oral del adulto de 60 años. Objetivo: Comparar la salud bucodental y satisfacción entre pacientes beneficiarios del GES salud oral integral 60 años y no beneficiarios. Estudio caso-control. Los participantes se dividieron en casos (n=48) y grupo control (n=28). Examen clínico recogiendo las variables: sexo, edad, enfermedades sistémicas declaradas, nivel educacional, uso de prótesis, índices COPD, CPITN y O'Leary. Para medir satisfacción se utilizó la escala multidimensional SERVPERF no ponderado. Análisis inferencial mediante test de significancia (pruebas de Pearson, Exacto de Fisher, Mann-Whitney, Medianas de Mood y Kolmogorov-Smirnov con un nivel de confianza del 95%) en los software SPSS19, Stata-SE 10.1 y Minitab 15. En las mediciones bucodentales se encontraron diferencias significativas sólo en cariados y COPD. No hubo diferencias en las necesidades de tratamiento periodontal entre los grupos (p-valor=0.615). La presencia de prótesis removible es estadísticamente mayor en el grupo de casos (OR=4,4 [1,6­12,5]); p-valor=0,006). La reforma en salud a través del GES Salud Oral Integral de 60 años, demuestra variar los parámetros clínicos de los pacientes beneficiarios, enfocado a la restauración con un aumento significativo de prótesis y una disminución de las caries, pero no logra mantener la salud periodontal ni el manejo de los factores de riesgo. La satisfacción del usuario es buena en los beneficiarios del GES.

The Chilean reform created the Program of Explicit Guarantees in Health to safeguard the attention under guaranteed conditions of access, opportunity, financial protection and quality for prioritized situations such as oral health of the 60-year-old adult. Objective: To compare oral health and satisfaction between patient beneficiaries of the program of guaranteed oral health for 60 year-olds and non-beneficiaries. Methods: Case ­ control study. The participants were divided in cases (n=48) and control group (n=28). Clinical examination gathering the variables: sex, age, systemic declared diseases, educational level, use of prosthesis, indexes COPD, CPITN and O'Leary. To measure satisfaction, SERVPERF (the multidimensional scale not weighted) was used. Inference analysis by means of test of significance (c2 Pearson, Fisher´s, Mann-Whitney, Mood´s Medians and Kolmogorov-Smirnov with a confidence level of 95%) in the software SPSS19, Stata 10.1 and Minitab 15. In the oral measurements significant differences were found only in decay and COPD. There were no differences in the needs ofperiodontal treatment between the groups (p-value=0.615). The presence of removable prosthesis was statistically greater in the group of cases (OR=4.4 [1.6-12.5]); p-value=0.006). The health reform known as GES Complete Oral Health for 60-year-old adults, demonstrates to change the clinical parameters of the patient beneficiaries, focused on restoration with a significant increase of prosthesis and a decrease of cavities, but it does not achieve maintenance of periodontal health and management of risk factors. User satisfaction was good among the beneficiaries of the program.

Caries preventive effect of permanent teeth using pit and fissure sealant program and community water fluoridation program / 대한구강보건학회지

OBJECTIVES: The aim of this study was to evaluate the caries preventive effects of oral health programs composed of pit and fissure sealant and community water fluoridation in Hapcheon-Up, Hapcheon-Gun, the Republic of Korea. METHODS: Dental surveys were conducted on 6 to 14 year old children at Hapcheon-Up, Hapcheon-Gun in 2000 and 2009, respectively. The number of the subjects was 1,957 and 1,535 children in 2000 and 2009, respectively. The percentage of samples among total population aged 6 to 14 years in 2000 and 2009 was 90.6% and 92.3%, respectively. The obtained data from these surveys were analyzed with the PASW statistical package version 18.0 (SPSS Inc., Chicago, IL, USA). The 2009 dental health data including the prevalence of dental caries and fissure sealants on children's permanent teeth was compared to the 2000 dental health data, and assessed using chi-square test and independent-sample t-test. RESULTS: DMF rate of 12-year olds was 76.9% in 2000, and it significantly decreased to 42.5% in 2009. DMFT index of 12-year olds was 3.03 in 2000, and it significantly decreased to 1.07 in 2009. The prevalence rate of sealed permanent teeth among the 12-year olds was 15.4% in 2000, and it significantly increased to 97.2% in 2009. The caries reduction rate from pit and fissure sealant added by community water fluoridation program was calculated as 44.7% in 12-year olds by the difference of DMFT index between 2000 and 2009 year. Logistic regression analysis revealed that both programs were associated with an increasing likelihood of experiencing no dental caries (OR=4.00, 95% CI; 3.23-4.95). CONCLUSIONS: These results suggest that the oral health program composed of pit and fissure sealant and community water fluoridation in Hapcheon was very effective in caries prevention. The program should be expanded to other area to prevent dental caries among children.