Genetic variation in the glucosyltransferase-B gene of Streptococcus mutans and its relationship with caries experience in children from Córdoba, Argentina, and with strains from other countries.

BACKGROUND: Caries is a worldwide distributed oral disease of multifactorial nature, with Streptococcus mutans being the most commonly isolated bacterial agent. The glycosyltransferases of this bacterium would play an essential role in the aetiology and pathogenesis of caries. AIM: We explored how the glucosyltransferase-B (gtf-B) gene variability of S. mutans from children in central Argentina correlated with their caries experience and how these strains were genetically related to those of other countries. DESIGN: Dental examinations were performed on 59 children; dmft and DMFT indexes were calculated. From stimulated saliva, S. mutans was grown and counted (CFU/mL). From bacterial DNA, the gtf-B gene was amplified and sequenced. Alleles were identified and their genealogical relationships established. Clinical, microbiological, and genetic variables were correlated with caries experience. Our sequences were included in a matrix with those from 16 countries (n = 358); genealogical relationships among alleles were obtained. Population genetic analyses were performed for countries with >20 sequences. RESULTS: The mean dmft + DMFT was 6.45. Twenty-two gtf-B alleles were identified here, which showed low genetic differentiation in the network. Caries experience was correlated with CFU/mL, but not with allele variation. Low differentiation was found among the 70 alleles recovered from the 358 sequences and among the countries analyzed. CONCLUSION: In this study, caries experience in children was correlated with the number of CFU/mL of S. mutans but not with the gtf-B gene variability. Combined genetic analyses of worldwide strains support the theory that this bacterium experienced population expansions, probably associated with agriculture development and/or food industrialization.

Una experiencia universitaria innovadora: la odontopediatría durante la pandemia de COVID-19 / An innovative university experience: pediatric dentistry during the COVID-19 pandemic

La realidad impuesta por la situación de emergencia sanitaria y el impacto que tiene el SARS-CoV-2 sobre la humanidad, tuvo como reto fundamental en la asignatura de Odontopediatría, seguir educando. Nos planteamos como objetivo, disponer de los medios necesarios para fortalecer la innovación continua en el uso de metodologías y herramientas de información y comunicación que nos permitieran cumplir los compromisos con los estudiantes. La asignatura fue estructurada en clases teóricas, clases magistrales y trabajos prácticos de aplicación de la teoría. La propuesta de enseñanza se focaliza en el niño como una unidad bio-psico-social en constante evolución que debe ser abordado de manera integral e interdisciplinaria y se debe tener en cuenta el contexto social. Todas las instancias de enseñanza desarrollaron la modalidad virtual. La situación pandémica planteó diversos desafíos, que pudimos afrontar satisfactoriamente. La continuidad educativa durante la primera fase de la pandemia fue el resultado de la creatividad, innovación y adaptación que mostraron tanto los docentes como los estudiantes

The reality imposed by the health emergency and the impact that SARS-CoV-2 has on humanity posed a fundamental challenge in the Pediatric Dentistry course to continue educating. Our objective was to have the necessary means to strengthen continuous innovation in use of methodologies and information and communication tools that would allow us to fulfill our commitments to the students. The course structure consisted of theoretical classes, lectures, and practical work applying the theory. The didactic proposal focuses on the child as a bio-psycho-social unit in constant evolution that must be approached in an integral and interdisciplinary manner, taking into account the social context. All teaching instances were developing the virtual modality. The pandemic situation posed several challenges, which we could successfully address. The educational continuity during the first phase of the pandemic was result of the creativity, innovation, and adaptation shown by both teachers and students.

Promotion of oral health in schoolchildren in the framework of a comprehensive collective intervention, conducted in the period 2013 -2015, in Córdoba, Argentina / Promoción de salud bucal de escolares en el marco de una intervención integral colectiva, desarrollada en el periodo 2013-2015, en Córdoba, Argentina

Objective: Oral health is a public health challenge that must be addressed by integrating its social and biological dimensions to adopt a dental practice with a sense of integrality that takes into account the needs and potentialities of each person and context. The objective of this study was to analyze the oral health status of schoolchildren in a socio-environmentally vulnerable urban area of the city of Córdoba, Argentina, within the framework of a comprehensive collective intervention, conducted in the period 2013-2015 at the María del Tránsito Cabanillas school. Material and Methods: The intervention was organized in 3 stages: diagnosis, collective design and implementation of oral health promotion strategies, and evaluation, applying qualitative and quantitative logics appropriate to the object of study. Diagnosis was carried out in 2013, performing a clinical-dental examination of schoolchildren aged 6 to 8 years and a participatory study of the school environment. Results: Based on the diagnostic data, the stage of collective design and implementation of promotion strategies and oral health care was carried out. The evaluation of the intervention was performed through the clinical-dental examination of schoolchildren aged 10 to 12 years who attended the school in 2015, and who, also having attended the same institution in 2013, participated in the diagnostic study and analysis of the qualitative records related to the intervention. Healthy clinical trends and positive assessments by the different actors were observed. Conclusion: The results encourage continuing conducting comprehensive intervention strategies for oral health promotion and care.

Objetivo: La salud bucal constituye un desafío de la salud pública que demanda ser abordado integrando su dimensión social y biológica, para desarrollar una práctica odontológica con sentido de integralidad que respete las necesidades y potencialidades del contexto. El objetivo de este estudio es analizar la salud bucal de escolares de un área urbana socio-ambientalmente vulnerabilizada de la ciudad de Córdoba, Argentina, en el marco de una intervención integral colectiva, desarrollada durante el periodo 2013-2015 en la escuela María del Tránsito Cabanillas.Material y Métodos: La intervención se desarrolló en 3 etapas: diagnóstico, diseño colectivo e implementación de estrategias de promoción de salud bucal y evaluación, aplicando lógicas cualitativa y cuantitativa según correspondiera al objeto de estudio. En el año 2013 se llevó a cabo el diagnóstico realizándose exámen clínico-odontológico a los escolares de 6 a 8 años y estudio participativo del entorno escolar.Resultados: A partir de los datos diagnósticos se realizó la etapa de Diseño colectivo e implementación de estrategias de promoción y atención de salud bucal. La evaluación de la intervención se realizó a través del examen clínico-odontológico a los escolares de 10 a 12 años asistentes a la institución escolar en el año 2015, que habiendo asistido en el año 2013 a la misma institución participaron del estudio diagnóstico y del análisis de los registros cualitativos relativos a la intervención desarrollada. Se observaron tendencias clínicas saludables y valoraciones positivas por parte de los diferentes actores.Conclusión: Los resultados estimulan a continuar desarrollando estrategias de intervención integrales de promoción y atención de salud bucal.

Caries and genetic variability of streptococcus mutans / Caries y variabilidad genética de streptococcus mutans

In the last two decades, the increase in population genetics studies has contributed to elucidating important questions about the evolution of the pathogenesis of bacteria of clinical interest. The objective of this study is to revise and update the knowledge of the last fifteen years regarding the genetic variability of Streptococcus mutans and their association with dental caries. Streptococcus mutans, one of the most widely distributed bacteria in the world, are heavily associated with this condition. This research shows the results of numerous studies carried out in various countries that, using molecular and biochemical methods, revealed associations between different serotypes and caries activity. In addition, it is reported that the population genetics structure of Streptococcus mutans in Argentina is highly recombinant, which reflects the largest waves of human immigration that occurred in the 19th and 20th centuries. On the other hand, demographic analysis suggests that these bacteria experienced a population expansion that coincided with the beginning of agricultural development.

En las últimas dos décadas el incremento de los estudios de genética de poblaciones ha contribuido a dilucidar cuestiones importantes sobre la evolución de la patogénesis de bacterias de interés clínico. El objetivo de este trabajo es realizar una actualización sobre los conocimientos de los últimos quince años referidos a la variabilidad genética de Streptococcus mutans y su relación con la caries dental. Streptococcus mutans, de amplia distribución mundial, es una de las bacterias más fuertemente asociada a dicha enfermedad. En este trabajo se muestran resultados de numerosos estudios realizados en diferentes países que utilizando métodos moleculares y bioquímicos revelaron asociaciones entre diferentes serotipos y la actividad de caries. Además, se reporta que la estructura genética poblacional de Streptococcus mutans de Argentina es de alto nivel recombinante, lo que reflejaría las grandes oleadas inmigratorias humanas ocurridas en los siglos 19thy 20th. Por otra parte, los análisis demográficos sugieren que esta bacteria experimentó una expansión poblacional coincidente con el comienzo del desarrollo de la agricultura

Cárie dentária na América do Sul: realidade entre escolares do Brasil e Argentina / Dental caries in South America: reality among schoolchildren from Brazil and Argentina

Objetivo: este estudo transversal multicêntrico objetivou determinar a proporção de cárie dentária, sua gravidade e atividade em escolares brasileiros e argentinos. Métodos: a amostra foi composta por escolares selecionados por conveniência, 406 do Brasil (Belo Horizonte - MG) e 241 da Argentina (Córdoba-Cba). Os dados foram coletados por seis dentistas previamente treinados e calibrados (kappaintra≥0,63; kappainter≥0,67). A proporção e gravidade da cárie foram medidas pelos índices ceod e CPOD. A alta experiência de cárie foi identificada pelo Significant Caries Index (SiC). A atividade de cárie foi avaliada segundo a reflexão e a textura da superfície (Nyvad et al., 1999) e o Índice de Cuidados (O/CPO*100) foi mensurado. Resultados: a proporção de livres de cárie (ceod e CPOD = 0) no Brasil foi de 45,7% e 19,9% na Argentina. O ceod foi de 1,48 (IC95%: 1,26-1,71) e 2,38 (IC95%: 2,0-2,72) entre escolares do Brasil e da Argentina, respectivamente. Nos dois países, o componente cariado foi o mais frequente. Entre os indivíduos com experiência de cárie (ceod > 1 e/ou CPOD > 1), a atividade de cárie esteve presente em 77,5% das crianças examinadas no Brasil e em 26,4% na Argentina. No grupo SiC, o CPOD foi de 2,20 (IC95%: 1,95-2,20) no Brasil e 2,17 (IC95%: 1,91-2,43) na Argentina, e o ceod no Brasil foi de 3,37 (3,01-3,72) e na Argentina 5,56 (5,04-6,07). O Índice de Cuidados foi baixo. Conclusão: em ambos os países, a proporção de crianças com experiência de cárie foi alta. Concentração de carga e atividade de cárie foi encontrada em grupos de polarização. Cabe ressaltar que a cárie dentária na dentição decídua é um problema relevante que necessita de esforços direcionados em ambos os países.

Objective: This multicentric cross-sectional study aimed to determine the proportion of dental caries, its' severity and activity among Brazilian and Argentines schoolchildren. Methods: The sample was selected by convenience and comprised of 406 schoolchildren from Brazil (Belo Horizonte-MG) and 241 in Argentina (Córdoba-Cba). Data were collected by six previously trained and calibrated dentists (kappaintra≥0.63; kappainter≥0.67). The proportion and severity of dental caries were measured by dmft and DMFT index. The high caries experiences was identified using Significant Caries Index (SiC). The caries activity was evaluated according to the reflection and texture of the surface (Nyvad et al., 1999) and the Care Index (O/CPO * 100) was measured. Results: The caries free (dmft and DMFT = 0) in Brazil was 45.7% and 19.9% in Argentina. The dmft was 1.48 (95% CI: 1.26-1.71) and 2.38 (95% CI: 2.0-2.72) among schoolchildren in Brazil and Argentina, respectively. In both countries, decayed component was the most frequent observed. Among subjects with caries experience (dmft > 1 and / or DMFT > 1) the caries activity was present in 77.5% of the children examined in Brazil and 26.4% in Argentina. In SiC group, DMFT was 2.20 (95% CI: 1.95-2.20) in Brazil and 2.17 (95% CI: 1.91-2.43) in Argentina and dmft in Brazil was 3.37 (3.01-3.72) and in Argentina was 5.56 (5.04-6.07). The Care Index was low. Conclusions: In both countries, the proportion of children with caries experience was high. Concentration of burden and caries activity was found in polarization' groups. It is noteworthy that caries in the primary dentition is a relevant problem that needs targeted efforts in both countries.

El componente bucal en las representaciones del proceso salud-enfermedad-atención construidas por jóvenes en situación de encierro de la ciudad de Córdoba, Argentina / The oral component in the representations of the health-disease-care process built by institutionalized youth in the city of Córdoba, Argentina

ABSTRACT: Health is a social construction built from different interacting dimensions: biological, environmental and social, which interact with people's lifestyles, understood in a broader sense, as a result of decisions taken both individually and collectively. Objective: The aim of this research was to know the representations of the health-disease-care process in general and of the oral component in particular held by institutionalized youth housed in socio-educational centers of the Juvenile Criminal Area of the Province of Córdoba, Argentina. Methodology: A qualitative study was conducted and the grounded theory methodology applied. Results and conclusion: The representations of the health-disease-care process of these youth in confinement include the oral component as part of general health, from experiences of suffering, mainly through physical pain and self-care, but also given its aesthetic importance.

La salud es una construcción social elaborada desde diferentes dimensiones interactuantes: biológica, ambiental y social en interacción, con los estilos de vida de las personas; entendida en un sentido más amplio como resultante de decisiones tomadas tanto en el plano individual como colectivo. Objetivo: El propósito de esta investigación fue conocer las representaciones del proceso salud enfermedad atención en general y del componente bucal en particular que poseen los jóvenes en situación de encierro alojados en centros socioeducativos del Área Penal Juvenil de la Provincia de Córdoba, Argentina. Metodología: Se realizó un estudio cualitativo siguiendo la metodología de la teoría fundamentada. Resultados y conclusión: Las representaciones del PSEA de estos jóvenes en situación de encierro, incluyen al componente bucal como parte de la salud general, a partir de situaciones de padecimientos, principalmente por el dolor físico y su autoatención, pero también por la importancia estética.

Knowledge, attitudes, practices and oral health status in adolescents of the city of Córdoba, Argentina

Adolescence is a critical period in the appropriation of knowledge, attitudes and health practices. objective: to analyze the experience of caries in relation to the level of knowledge, to attitudes and oral health practices in adolescents. materials and methods: an analytical cross-sectional study was carried out in 52 adolescents attending the provincial dental Institute in the city of Córdoba, Argentina. the study included a clinical dental examination and a self-administered survey. all participating subjects provided an informed consent signed by their parents or guardians. the DMFT index and relative frequency of responses were calculated. Indices of "knowledge", "attitudes" and "practices" were created. Spearman's rank correlation coefficient between indices and a linear regression model with respect to the DMFT index were applied. results: mean age was 16.57±2.27 years. female subjects accounted for 57.7 percent of participants. between 92 percent and 96 percent of adolescents acknowledged that the presence of bacteria and a lack of oral hygiene could promote tooth decay. ninety-six per cent reported using toothbrush and toothpaste, 32 percent reported using fluoride toothpaste, and only 19 percent used dental floss. the DMFT index was 4.7±4.0; component C 4.4±2.9. there was a significant correlation between the indices of knowledge and attitudes about oral health (p<0.05). the linear regression analysis showed as main predictors the questions: "does brushing teeth prevent cavities?" and "how important is it for you to clean your teeth?" conclusion: although participants have information on some oral health care practices, it is necessary to design strategies that involve the participation of young people, with contents that take into account the interests and characteristics of the target population.

Impact of oral health on the quality of life of young people in confinement, Córdoba, Argentina: a mixed methods study

Introduction: quality of life can be understood as the perception subjects have of their position in life in relation to their goals, expectations and concerns. Measuring and understanding the impact of oral health on the quality of life of people may contribute to the promotion of health and prevention of disease. The aim of this study was to evaluate the impact of oral health on the quality of life of young people in confinement. Methodology: Cross-sectional study with mixed approach. Adolescents between 14 and 18 years of age, confined in socio-educational juvenile detention centers in the Province of Córdoba, Argentina, were included in the study. After signing of informed consent, the OHIP-49 questionnaire was applied to 70 youngsters and 32 semi-structured interviews were conducted. Results: The OHIP-49 had a mean of 53.37 +/- 28.77, the dimensions with more impact were: functional limitation, physical pain and psychological discomfort. Confinement emerges as an amplifier of sensations and as a barrier for accessing palliative care. Regarding aesthetic aspects, subjects reported specific discomfort that does not always interfere with their self-esteem or relationship with peers. Conclusions: Young people perceive the impact of oral health on their quality of life from episodes of suffering, although not only because of pain, but also for aesthetic reasons. Confinement creates a particular context for sensations and resolutions on health-disease-care processes regarding oral health.

Oral health of youth housed in socio-educational centers of the Juvenile Penal Area of the Province of Córdoba, Argentina.

The purpose of this research was to analyze the oral health status of youth housed in socio-educational centers of the Juvenile Penal Area of the Province of Córdoba, Argentina of corrections by considering clinical evaluation and the main sociodemographic data. Socio-demographics, healthy and unhealthy habits of self-care, and dental clinical profile were assessed for this purpose. An exploratory cross-sectional study was carried out on 70 14- to 18-year-olds who had been institutionalized for at least six months. A clinical examination was conducted and the WHO Oral Health Survey was applied. Centralization and dispersion measurements, relative frequency, multiple correspondence analysis and generalized linear models were used to describe the data. The results showed: males 94%, mean age 16.91 ± 1.11, complete primary schooling 34%, from Córdoba City 69% and belonging to nuclear families 29%. Regarding healthy habits, 71% had frequent sugar intake, and 46% brushed teeth daily; while among unhealthy habits, 80% smoked tobacco, 63% drankalcohol and 73% used psychoactive substances. Sixty-three percent had visited a dentist once, and in 80% of the cases reason for the visit was pain. Clinical examination showed high prevalence of deterioration of the oral health component (DMFT = 8.94 ± 4.75, SiC = 14.26 ± 2.15, IPC3 = 56%, MO = 53%). Clinical profile showed marked prevalence of a very high level of caries severity, gingival disease and malocclusion, but not of initial stages of caries, alterations of enamel or temporomandibular dysfunction. The socio-demographic characteristics revealed conditions of social, educational and health vulnerability, a situation which interferes with the inclusion of these youths in the productive system and their access to better living conditions.

El propósito de esta investigación fue analizar la situación de salud bucal de jóvenes alojados en centros socioeducativos del Area Penal Juvenil de la Provincia de Córdoba, a través de la evaluación clínica teniendo en cuenta los principales datos sociodemográficos. Para tal fin se valoraron las características sociodemográfica; los hábitos saludables, no saludables, de autocuidado y el perfil clínico odontológico. Se desarrolló un estudio transversal exploratorio en 70 jóvenes, de 14 a 18 años de edad, alojados por un período no menor a seis meses. Se realizó examen clínico y se aplicó la Encuesta de Salud Bucal de la OMS. Para la descripción de los datos se aplicaron medidas de centralización y de dispersión, frecuencia relativa, análisis de correspondencia múltiples y modelos lineales generalizados. Los resultados mostraron el siguiente perfil sociodemográfico: 94% son varones con una edad media de 16,91 ±1.11 que tienen primario completo 34%, son procedentes de la Ciudad de Córdoba 69% y pertenecen a familias nucleares 29%. Respecto a los hábitos saludables el 71% de los jóvenes tienen una alta frecuencia de consumo de azucares, el 46% presenta frecuencia diaria de cepillado dental; entre los hábitos no saludables el 80% consume tabaco, 63% bebidas alcohólicas, y 73% SPA, el 63% concurrió al odontólogo alguna vez por dolor (80%). El exámen clínico mostró una alta prevalencia del deterioro del componente bucal de la salud (CPOD= 8,94 ± 4,75; SIC=14,26 ± 2,15; IPC3 56%; MO 53). El perfil clínico mostró una marcada prevalencia del nivel muy alto de severidad de caries, enfermedad gingival y maloclusión, no así de los estadios iniciales de caries, alteraciones de esmalte y disfunción temporomandibular. Las características sociode-mográficas halladas ponen de manifiesto condiciones de vulnerabilidad social, educativa y sanitaria, las cuales interfieren en su incorporación al sistema de producción y acceso a mejores condiciones de vida.

Experiencia de formación docente para la Clinica Ampliada en salud bucal, una agenda necesaria / Experiência de formação de professores para a Clínica Ampliada em saúde bucal, uma agenda necessária / Teacher training experience for the Clinic Enlarged in oral health, a necessary agenda

El presente trabajo relata una experiencia de formación docente en el contexto de atención clínica de la salud bucal a niños de 8 a 10 años de edad en escuelas de enseñanza general básica 1. Se realiza en el marco del proyecto de investigación Innovación en la producción del cuidado y en la atención integral de salud bucal, un aporte para la equidad (2015-2016), desarrollado en acuerdo de cooperación internacional entre Facultades Públicas de Argentina y Brasil, para fortalecer estrategias de investigación y formación en salud colectiva. A modo de encaminar la transformación de las prácticas clínicas nos propusimos, reconocer a partir de la reflexión, las fortalezas y debilidades de las propias prácticas docentes en situación clínica en contexto escolar, identificando en ella significados y valoraciones, prácticas naturalizadas, para poder deconstruir y posteriormente diseñar la clínica ampliada en dicho contexto. Se aplicaron técnicas de observación participante de situaciones clínicas; entrevistas y diario de campo del profesional observado y dibujo a tema realizado por los niños que recibieron atención clínica-odontológica. Para el análisis y socialización de la información producida se trabajó con la modalidad de taller. La experiencia se desarrolló en 4 momentos: Conformación de equipo de operadores clínicos y observadores; práctica clínica en el contexto escolar; análisis individual y grupal de la información y diseño de la innovación. Los docentes connotaron positivamente el escuchar al otro como sujeto revalorizando la palabra y la actitud de flexibilidad ante emergentes no previstos; demandaron mayor cooperación en el equipo interdisciplinario; identifican tensiones y fortalezas las que serán ejes orientadores para la resignificación de prácticas clínicas en escenarios escolares en el marco de la clínica ampliada para el cuidado de la salud (AU).

O presente trabalho relaciona uma experiência de formação de professores no contexto da atenção clínica à saúde bucal para crianças de 8 a 10 anos nas escolas de educação básica 1. É realizada no âmbito do projeto de pesquisa Inovação na produção do cuidado e na atenção integral de saúde bucal, uma contribuição para a equidade (2015-2016), desenvolvido em um acordo de cooperação internacional entre escolas públicas da Argentina e do Brasil, para fortalecer estratégias de pesquisa e treinamento em saúde coletiva. Para direcionar a transformação das práticas clínicas que propusemos, reconhecer a partir da reflexão, os pontos fortes e fracos das próprias práticas docentes em uma situação clínica no contexto escolar, identificando significados e avaliações, práticas naturalizadas, para desconstruir e depois, projetar a clínica estendida nesse contexto. Foram aplicadas técnicas de observação participativa de situações clínicas; entrevistas e diário de campo do profissional observado e desenho para o tema feito pelas crianças que receberam atenção clínico-odontológica. Para a análise e socialização da informação produzida, trabalhamos com a modalidade da oficina. A experiência foi desenvolvida em 4 momentos: Conformação de uma equipe de clínicos e observadores; prática clínica no contexto escolar; Análise individual e grupal de informação e design de inovação. Os professores reconheceram positivamente a escuta do outro como sujeito, revalorizando a palavra e a atitude de flexibilidade diante de emergências inesperadas; exigiram maior cooperação na equipe interdisciplinar; eles identificam tensões e pontos fortes que irão orientar os eixos para a ressignificação das práticas clínicas em contextos escolares no âmbito da Clínica Ampliada para o cuidado da saúde (AU).

Oral health of youth housed in socio-educational centers of the Juvenile Penal Area of the Province of Cordoba, Argentina

The purpose of this research was to analyze the oral health status of youth housed in socioeducational centers of the Juvenile Penal Area of the Province of Córdoba, Argentina of corrections by considering clinical evaluation and the main sociodemographic data. Sociodemographics, healthy and unhealthy habits of selfcare, and dental clinical profile were assessed for this purpose. An exploratory crosssectional study was carried out on 70 14to 18yearolds who had been institutionalized for at least six months. A clinical examination was conducted and the WHO Oral Health Survey was applied. Centralization and dispersion measurements, relative frequency, multiple correspondence analysis and generalized linear models were used to describe the data. The results showed: males 94%, mean age 16.91 ± 1.11, complete primary schooling 34%, from Córdoba City 69% and belonging to nuclear families 29%. Regarding healthy habits, 71% had frequent sugar intake, and 46% brushed teeth daily; while among unhealthy habits, 80% smoked tobacco, 63% drankalcohol and 73% used psychoactive substances. Sixtythree percent had visited a dentist once, and in 80% of the cases reason for the visit was pain. Clinical examination showed high prevalence of deterioration of the oral health component (DMFT = 8.94 ± 4.75, SiC = 14.26 ± 2.15, IPC3 = 56%, MO = 53%). Clinical profile showed marked prevalence of a very high level of caries severity, gingival disease and malocclusion, but not of initial stages of caries, alterations of enamel or temporo mandibular dysfunction. The sociodemographic characteristics revealed conditions of social, educational and health vulnerability, a situation which interferes with the inclusion of these youths in the productive system and their access to better living conditions (AU)

El propósito de esta investigación fue analizar la situación de salud bucal de jóvenes alojados en centros socioeducativos del Área Penal Juvenil de la Provincia de Córdoba, a través de la evaluación clínica teniendo en cuenta los principales datos sociodemográficos. Para tal fin se valoraron las características sociodemográfica; los hábitos saludables, no saludables, de autocuidado y el perfil clínico odontológico. Se desarrolló un estudio transversal exploratorio en 70 jóvenes, de 14 a 18 años de edad, alojados por un período no menor a seis meses. Se realizó examen clínico y se aplicó la Encuesta de Salud Bucal de la OMS. Para la descripción de los datos se aplicaron medidas de centralización y de dispersión, frecuencia relativa, análisis de correspondencia múltiples y modelos lineales generalizados. Los resultados mostraron el siguiente perfil sociodemográfico: 94% son varones con una edad media de 16,91 ±1.11 que tienen primario completo 34%, son procedentes de la Ciudad de Córdoba 69% y pertenecen a familias nucleares 29%. Respecto a los hábitos saludables el 71% de los jóvenes tienen una alta frecuencia de consumo de azucares, el 46% presenta frecuencia diaria de cepillado dental; entre los hábitos no saludables el 80% consume tabaco, 63% bebidas alcohólicas, y 73% SPA, el 63% concurrió al odontólogo alguna vez por dolor (80%). El exámen clínico mostró una alta prevalencia del deterioro del componente bucal de la salud (CPOD= 8,94 ± 4,75; SIC=14,26 ± 2,15; IPC3 56%; MO 53). El perfil clínico mostró una marcada prevalencia del nivel muy alto de severidad de caries, enfermedad gingival y maloclusión, no así de los estadios iniciales de caries, alteraciones de esmalte y disfunción temporomandibular. Las características sociode mo gráficas halladas ponen de manifiesto condiciones de vulnerabilidad social, educativa y sanitaria, las cuales inter fieren en su incorporación al sistema de producción y acceso a mejores condiciones de vida (AU)

Consumo de alimentos durante el recreo escolar. Diseño y validación de un instrumento de relevamiento / Food consumption during the school playtime. Design and validation of a survey instrument

Objetivo: Construir y validar un instrumento diagnóstico de pautas de consumo alimentario infantil en el recreo escolar para contextualizar estrategias promotoras de salud. Método: Participaron en el estudio 240 escolares de ambos géneros de 6 a 13 años de edad Los contenidos se elaboraron a partir de información obtenida previamente en ese mismo contexto a través de entrevistas a los maestros , observación de recreos y registro de residuos en basureros. En las opciones se priorizó el formato iconográfico. Para la validación se aplicó panel de expertos, validez de campo, prueba piloto y Coeficiente alfa Cronbach. Resultados: Se modificó el instrumento eliminándose una pregunta por sesgo de deseabilidad y la distribución espacial de íconos y palabras para evitar sesgo de reiteración; se incorporaron nuevos productos, sugeridos por el panel de expertos, conformado por pedagogos, biólogos, psicólogos, odontólogos, nutricionista y maestros de de nivel primario. Los niños del primer ciclo escolar mostraron dificultad en la lectura comprensiva de consignas, la que fue superada modificando tipo de letra y forma de administración. Conclusión: La aplicación de un instrumento de relevamiento de hábitos alimenticios adaptado a las potencialidades psico-cognitivas-culturales (edad y nivel educativo ) de los destinatarios, permitió un diagnóstico válido para contextualizar estrategias promotoras de salud.

Objective: To develop and validate a diagnostic tool for food consumption patterns in children’s school playtime to contextualize health-promotion strategies. Method: The content was developed according to information obtained with other instruments in this context. The iconographic format was prioritized in the options. Validation included a panel of experts, a validity of field test and Cronbach alpha coefficient.Results: The instrument was modified by removing a question of desirability bias and the spatial distribution of icons and words to avoid reiteration bias; we added new products, suggested by the panel of experts. The children of the first school cycle showed difficulty in the reading comprehension of slogans, which they overcame by modifying the font and the way the test was applied, thus giving greater viability to the test.Conclusion: The application of an instrument to survey food habits adapted to the psycho-cultural-cognitive potential of respondents provided a valid diagnosis to design contextualized health-promoting strategies.Adapted to the age and educational level of respondents.

Experiencia de caries y calidad de vida de jóvenes en situación de encierro / Caries experience and quality of life of confined teenagers

RESUMEN Objetivo Evaluar el impacto de la experiencia de caries en la calidad de vida de jóvenes institucionalizados del Área correccional de Córdoba, Argentina. Método Se realizó examen clínico a 70 jóvenes, se determinó el índice de experiencia de caries CPOD y tipo de tratamiento necesario. Y se aplicó el cuestionario del perfil de impacto de salud oral OHIP 49. Resultados El estudio de los 70 jóvenes de la muestra presentó la media de elementos presentes en boca fue 28,1 ± 1,53; índice CPOD fue de 8,9±4.75; Cariados: 7,4±4,26; Perdidos: 0,6 ± 0,91 y Obturados: 0,9±1,97; y el 67,14 % necesita tratamiento de rehabilitación. El OHIP49 mostró mayor impacto en las dimensiones de: disconfort psicológico 52,86 %, limitación funcional 47,14 %, dolor físico 40 %, incapacidad física 41,43 %. Menor impacto tuvieron las dimensiones incapacidad psicológica 28,57 %, incapacidad social 21,43 %; y en desventaja 22,86 %. Conclusión La experiencia de caries produce un impacto medio en la calidad de vida de estos jóvenes, siendo el dolor físico su principal responsable.(AU)

ABSTRACT Objective To evaluate the impact of caries on the quality of life of teenagers confined in the Correctional Center of Córdoba, Argentina. Method A clinical examination was conducted to 70 teenagers in order to determine DMFT and the necessary treatment. The Oral Health Impact Profile (OHIP-49) was used. Results The study conducted on a sample of 70 teenagers reported that the average of elements found in the mouth was 28.1±1.53, the DMFT index was 8.9±4.75, decayed teeth were 7.4±4.26, missed teeth were 0.6±0.91, filled teeth were 0,9 ± 1.97, and that 67.14 % of patients needed rehabilitation treatment. OHIP-49 showed greater impact on psychological discomfort (52.86 %), functional limitation (47.14 %), physical pain (40 %), physical disability (41.43 %), and less impact on psychological disability (28.57 %), social disability (21.43 %), and disadvantage (22.86 %). Conclusion Dental caries experience produces an average impact on the quality of life of these teenagers, being physical pain the most critical factor.(AU)

[Caries experience and quality of life of confined teenagers]. / Experiencia de caries y calidad de vida de jóvenes en situación de encierro.

OBJECTIVE: To evaluate the impact of caries on the quality of life of teenagers confined in the Correctional Center of Córdoba, Argentina. METHOD: A clinical examination was conducted to 70 teenagers in order to determine DMFT and the necessary treatment. The Oral Health Impact Profile (OHIP-49) was used. RESULTS: The study conducted on a sample of 70 teenagers reported that the average of elements found in the mouth was 28.1±1.53, the DMFT index was 8.9±4.75, decayed teeth were 7.4±4.26, missed teeth were 0.6±0.91, filled teeth were 0,9 ± 1.97, and that 67.14 % of patients needed rehabilitation treatment. OHIP-49 showed greater impact on psychological discomfort (52.86 %), functional limitation (47.14 %), physical pain (40 %), physical disability (41.43 %), and less impact on psychological disability (28.57 %), social disability (21.43 %), and disadvantage (22.86 %). CONCLUSION: Dental caries experience produces an average impact on the quality of life of these teenagers, being physical pain the most critical factor.

Oral health in drug addict adolescents and non psychoactive substance users.

The purpose of this study was to compare oral health between adolescents who are recovering drug addicts and adolescents who report not having used psychoactive substances. A retrospective observational Case-Control study was conducted on 60 subjects per group, aged 15 to 25 years, paired according to sex, age and educational vulnerability. Dental and sialochemical examinations were used to determine oral health/disease/care indicators. Psychoactive substance use habits were obtained from clinical records. DMFT index for Case adolescents was 8.58}4.34, doubling the mean value for the Control group, which was 4.33}4.30. CPI was compatible with gingival-periodontal health in 45% of the Control subjects, but only 20% in the Case group. CPI categories 2 and 3 had different distributions according to the study group, with CPI2=33%, CPI3=0% for the case group and CPI2=57%; CPI3=5% for the control group. Mean values for stimulated saliva for Case and Control groups, respectively, were: salivary flow (ml/min) 1.42}1.08; 0.98}0.41, salivary pH 6.96}0.33 6.86}0.27, and buffer capacity expressed as final pH, 6.73}0.29, 6.61}0.28. Wilcoxon's test for independent samples showed significant differences (p<0.05) between Case and Control for the variables White Spot, Non-Cavitated Carious Lesions, Cavitated Carious Lesions, DMFT, Components D and M, Salivary Flow and Buffer Capacity. There was significant association between the D component in DMFT and use of psychoactive substances, both in single drug and polydrug users. Oral component status was worse in recovering drug addicts than in non-users of psychoactive substances.

Oral health in drug addict adolescents and non psychoactive substance users

The purpose of this study was to compare oral health between adolescents who are recovering drug addicts and adolescents who report not having used psychoactive substances. A retrospective observational Case-Control study was conducted on 60 subjects per group, aged 15 to 25 years, paired according to sex, age and educational vulnerability. Dental and sialochemical examinations were used to determine oral health/disease/care indicators. Psychoactive substance use habits were obtained from clinical records. DMFT index for Case adolescents was 8.58}4.34, doubling the mean value for the Control group, which was 4.33}4.30. CPI was compatible with gingival-periodontal health in 45% of the Control subjects, but only 20% in the Case group. CPI categories 2 and 3 had different distributions according to the study group, with CPI2=33%, CPI3=0% for the case group and CPI2=57%; CPI3=5% for the control group. Mean values for stimulated saliva for Case and Control groups, respectively, were: salivary flow (ml/min) 1.42}1.08; 0.98}0.41, salivary pH 6.96}0.33 6.86}0.27, and buffer capacity expressed as final pH, 6.73}0.29, 6.61}0.28. Wilcoxon's test for independent samples showed significant differences (p<0.05) between Case and Control for the variables White Spot, Non-Cavitated Carious Lesions, Cavitated Carious Lesions, DMFT, Components D and M, Salivary Flow and Buffer Capacity. There was significant association between the D component in DMFT and use of psychoactive substances, both in single drug and polydrug users. Oral component status was worse in recovering drug addicts than in non-users of psychoactive substances.

El proposito de esta investigacion fue comparar el estado de salud bucodental en adolescentes drogodependientes en recuperacion y los que no refieren consumo de sustancias psicoactivas. Se realizo un estudio observacional tipo Caso y Control, retrospectivo de 60 adolescentes de 15 a 25 anos para cada grupo, apareados segun: sexo, edad y vulnerabilidad educativa. A traves de examen clinico odontologico y sialoquimico se relevaron indicadores de saludenfermedad- atencion del componente bucal. Los habitos de consumo de sustancias psicoactivas se obtuvieron de historias clinicas. El indice CPOD en los adolescentes Casos resulto 8,58}4,34 valor que dobla la media que presenta el grupo Control 4,33}4,30. El Indice IPC presento una situacion compatible con salud gingivo-periodontal en el 45% de los sujetos Control, mientras que solo alcanzo al 20% en el grupo Caso. Las categorias 2 y 3 del IPC mostraron distribucion diferente segun el grupo de estudio siendo IPC2=33%; IPC3=0% y IPC2=57%; IPC3=5%, respectivamente para casos y controles. Los valores medios de los regis tros de saliva estimulada fueron para flujo salival (ml/min) 1,42}1,08; 0,98}0,41, pH de saliva 6,96}0,33 6,86}0,27, y la capacidad amortiguadora o buffer expresada como pH final 6,73}0,29, 6,61}0,28 para el grupo Caso y Control respectivamente. La prueba de Wilcoxon para muestras independientes puso en evidencia diferencias significativas (p<0,05) entre Caso y Control para las variables Mancha Blanca, Caries no Cavitada, Caries Penetrante, CPOD, Componentes C y P, Flujo salival y Capacidad buffer. Se observo asociacion significativa entre el componente C del CPOD y el consumo de sustancias psicoactivas tanto para la modalidad de monoconsumo como para la de policonsumo. La situacion del componente bucal de los sujetos drogodependientes en recuperacion, presenta mayor deterioro, respecto a los no consumidores de sustancias psicoactivas.

Maestros rurales como mediadores de pautas saludables / Rural teachers as mediators of healthy behaviors

Se analizan las concepciones de salud de maestros como potenciales mediadores de pautas saludables en comunidades rurales desprotegidas. Se realizó un estudio de campo en 71 escuelas rurales del Departamento de Cruz del Eje, Córdoba, Argentina. Se aplicó una entrevista por cuestionario a la totalidad de los docentes y se realizaron entrevistas en profundidad a los docentes de una muestra de 8 escuelas, recuperándose las expresiones más significativas de los discursos. Se detectó que las concepciones de salud de los maestros están ligadas a lo curativo e intervienen como condicionantes, tanto de las conductas con que los maestros enfrentan sus propios procesos de salud-enfermedad, como en las acciones que realizan en sus roles de animadores socioculturales, lo que afecta la construcción de la escuela como centro promotor de salud. Los datos evidenciaron la necesidad de que los maestros reconceptualicen sus propias concepciones de salud y enfermedad, de modo que puedan contribuir a que las comunidades excluidas superen el aislamiento sociocultural al que se encuentran sometidas (AU)

Maestros rurales como mediadores de pautas saludables / Rural teachers as mediators of healthy behaviors

Se analizan las concepciones de salud de maestros como potenciales mediadores de pautas saludables en comunidades rurales desprotegidas. Se realizó un estudio de campo en 71 escuelas rurales del Departamento de Cruz del Eje, Córdoba, Argentina. Se aplicó una entrevista por cuestionario a la totalidad de los docentes y se realizaron entrevistas en profundidad a los docentes de una muestra de 8 escuelas, recuperándose las expresiones más significativas de los discursos. Se detectó que las concepciones de salud de los maestros están ligadas a lo curativo e intervienen como condicionantes, tanto de las conductas con que los maestros enfrentan sus propios procesos de salud-enfermedad, como en las acciones que realizan en sus roles de animadores socioculturales, lo que afecta la construcción de la escuela como centro promotor de salud. Los datos evidenciaron la necesidad de que los maestros reconceptualicen sus propias concepciones de salud y enfermedad, de modo que puedan contribuir a que las comunidades excluidas superen el aislamiento sociocultural al que se encuentran sometidas

Oral health promotion intervention in rural contexts: impact assessment: Córdoba, Argentina / Intervención para la promoción de salud bucal en contextos rurales: evaluación de impacto: Córdoba, Argentina

Introduction: The study was carried out in Cruz del Eje Department, Cordoba Province, Argentina. It was based on diagnosis of conceptions of health, concentration of fluoride in drinking water and accessibility to dental coverage in 71 rural schools. Additionally, parents and teachers’ conceptions of general and oral health, dental clinical status and sialochemistry of students from eight schools were considered. Objective: To evaluate a community intervention strategy for promoting oral health in rural contexts. Through the participation of the teacher as a mediator of healthy pattern, this strategy was developed. Methods: In order to elaborate oral health promoting strategies, educational workshops, epistolary communication and on site tutorials meetings were implemented. Specific health projects to be added to the Educational Institutional Programs, as a contextualized mediating strategy for promoting oral health were designed by teachers. The strategy was evaluated comparing dental caries increase (CI) detected the previous year and the one following the implementation of the educational plans. Mac Nemar's test was applied, and p<0.05 was set to indicate statistical differences between both periods. Results: A 30.43 percent CI (p<0.0001) was observed the year before implementing the educational programs as well as a CI reduction to 17.39 percent (p=0.0002) a year after their application. Conclusion: The drop off in 57.14 percent of the CI in rural areas, confirms the intervention strategy of designed for this particular context.

Introducción: El trabajo se desarrolló en el Departamento Cruz del Eje, Córdoba, Argentina, en base a diagnósticos sobre concepciones de salud, tenor de fluoruro en el agua de bebida y accesibilidad a la cobertura odontológica realizado en 71 escuelas rurales, y sobre concepciones de salud general y bucal de padres y maestros, estado clínico odontológico y condiciones sialoquímicas de escolares de 8 escuelas. Objetivo: Evaluar una estrategia de intervención comunitaria, para la promoción de salud bucal en contextos rurales, desarrollada a través de la participación del docente como mediador de pautas saludables. Material y método: Para el desarrollo de las estrategias de promoción de la salud bucal se implementaron talleres docentes, comunicación epistolar y encuentros tutoriales en terreno. Los maestros diseñaron proyectos específicos de salud integrados en los Programas Educativos Institucionales, como estrategia mediadora contextualizada de promoción de salud bucal. Se evaluó la estrategia comparando el incremento de caries (IC) detectado en el año previo y en el siguiente a la implementación de los planes educativos. Se aplicó la prueba de Mac Nemar, fijando p<0.05 para indicar diferencias estadísticas entre ambos períodos. Resultados: Se observó 30,43 por ciento de IC (p<0.0001) en el año previo a la implementación de los planes educativos y una reducción del IC al 17,39 por ciento (p =0.0002) al año de comenzada la aplicación de los mismos. Conclusión: La disminución en un 57,14 por ciento del IC en los escolares rurales, valida la estrategia de intervención construida para estos contextos particulares.

Salud bucal y hábitos de consumo de sustancias psicoactivas en adolescentes y jóvenes drogodependientes en recuperación / Oral health and psychoactive substance consumer habits in adolescents and young addicts in recovery

Objetivo: analizar la situación clínica-odontológica en relación al consumo de sustancias psicoactivas (PSA), en adolescentes y jóvenes drogodependientes en recuperación, en Córdoba, Argentina. Métodos: participaron 61 adolescentes y jóvenes de 15 a 30 años de edad. Se realizó examen clínico odontológico y se tomaron muestras de saliva total. Las variables consideradas relativas a los hábitos de consumo de SPA, se obtuvieron de historias clínicas. Se aplicó Coeficiente de Spearman y Análisis de Correspondencia para estudiar la relación entre variables. Resultados: se observó asociación (CS≥0,50) entre tiempo de exposición a SPA, Lesión-Estomatológica y componente C del CPOD. El Análisis de Correspondencia, en sujetos con exposición a SPA >7años mostró asociación entre Mancha blanca, C, IPC grado 4 y policonsumo diario. Conclusión: policonsumo, la frecuencia y el tiempo de exposición SPA, fueron los factores de mayor impacto negativo en la salud del componente bucal, en este estudio

Objective: analyze the clinical status and their relation with consumer habits of (PSA) in adolescents and young drug addicts in recovery, in Córdoba, Argentina. Methods: 61 people from 15 to 30 years of age participated. Dental clinical examination was carried out and whole saliva samples were taken. SPA consumer habits were obtained from the records. The coefficient of Sperman and correspondence analysis was applied to the study of the relationship between variables. Results: Association (CS≥0, 50) between exposure to SPA, stomatology injury and D component of DMFT was observed. The correspondence analysis in subjects with exposure to SPA > 7 showed the association between white spot, C, IPC grade 4 and polydrug use with history of daily consumption. Conclusion: polydrug use, frequency and time of exposure SPA, would be the factors of greater negative impact on the oral component health