Oral Health Literacy and Tooth Loss and Replacement in Older Adults at a University Dental Clinic in Colombia.

BACKGROUND: Oral health literacy (OHL) is the ability of individuals to obtain, process, and understand oral health information and services, allowing them to make appropriate oral health decisions. The association between OHL and tooth loss and replacement have not been well understood. OBJECTIVES: We aimed to determine the association between OHL and tooth loss and replacement in a Colombia population. METHODS: A cross-sectional study of 384 older adults age 65 to 89 years from Pasto, Colombia was carried out. The number of lost and replaced teeth was assessed intraorally; sociodemographic and prosthetic characteristics were collected, and the Health Literacy in Dentistry questionnaire was used to evaluate OHL. Generalized linear models were estimated to assess associations between independent variables (including OHL) and the number of lost and replaced teeth. KEY RESULTS: There were 224 (58.3%) men and 160 (41.7%) women. The mean (standard deviation [SD]) number of lost and replaced teeth was 27.78 (4.03) and 12.53 (9.89), respectively. One hundred fifty five (40.4%) individuals had full removable dental protheses, 122 (31.8%) partial removable dental protheses, 68 (17.7%) fixed prosthetics, and 36 (9.4%) dental implants. OHL was 33.29 (6.59) and significantly positively associated with the number of replaced teeth (ß = 0.65, 95% confidence interval [CI]: 0.52-0.78, p < .001), but not with lost teeth. CONCLUSIONS: OHL may foster individuals' capabilities to replace lost teeth, although we did not find it associated with reduced tooth loss, likely as tooth loss was highly common in this older population. [HLRP: Health Literacy Research and Practice. 2024;8(1):e21-e28.].

PLAIN LANGUAGE SUMMARY: The association between OHL and tooth loss and replacement has not been well understood. A study of 384 older adults was designed to evaluate the number of lost and replaced teeth and the association with OHL. We found that OHL may foster tooth replacement but was not associated with tooth loss itself.

Psychometric Testing of HeLD-14 in a Colombian Geriatric Population.

Introduction: The objective of this study was to test the validity and reliability of the Colombian version of the Health Literacy in Dentistry (HeLD-14) in older adults. Materials and Methods: A translation and validation study of HeLD-14 was conducted on 384 non-institutionalized older adults attending the Dental Clinic at Universidad Cooperativa from Pasto, Colombia. A cross-cultural adaptation of a multidimensional HeLD-14 was completed, and the psychometric properties of this scale were evaluated through a cross-validation method using an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA). Internal consistency was measured with Cronbach's alpha (α) and Omega's McDonald (É·). The statistical significance was set at P < 0.05. Results: The EFA demonstrated that a single-factor structure with 11 items explained a cumulative 59.86% of the overall variance. The CFA confirmed that goodness of fit indices of this questionnaire had optimal adequateness (χ2S-B = 109.047; χ2S-B/(44) = 2.478, P=0.001; non-normed fit index = 0.901; comparative fit index = 0.908; root mean square error of approximation = 0.079 (90% CI (0.075, 0.083)); standardized root mean residual = 0.080). The coefficients indicated a high internal consistency for the total scale (α = 0.94; É· = 0.96). Conclusion: The developed adaptation of HeLD-14 for the Colombian population, HeLD-Col, is a unidimensional, reliable, and valid instrument to assess oral health literacy in older adults in Colombia.

Association between psychological factors and molar-incisor hypomineralization: A cross-sectional study.

BACKGROUND: Molar-incisor hypomineralization (MIH) is a developmental enamel defect characterized by opacities from white to brownish color. A suspected multifactorial etiology has been suggested, whereas psychological factors during pregnancy have only been limitedly analyzed. AIM: We assessed the association between stress, depression, and anxiety in pregnancy and the presence of MIH in children at a later age. DESIGN: Using a cross-sectional Web-based questionnaire, we included 384 mothers who had children aged 6 and 12 years from Pasto, Colombia. Data were collected between October 2021 and March 2022. Sociodemographic variables; maternal and child factors related to prenatal, natal, or postnatal problems; and psychological factors such as stress and symptoms of anxiety and depression in pregnancy were inquired. Utilizing photographs depicting MIH lesions, mothers assessed their child's MIH status. A directed acyclic graph (DAG) analysis was performed to create causal assumptions, and logistic regression models were estimated to evaluate these assumptions. p-value was set at p < .05. RESULTS: The prevalence of MIH was 33.3%; 12.8% of the participants exhibited hypomineralization in both molars and incisors. DAG analysis and logistic regression models determined that MIH (present or not) was associated with symptoms of maternal depression (ORadj = 3.26, 95% CI: 1.92-5.52, p < .001), and MIH (both molars and incisors) was associated with symptoms of maternal anxiety (ORadj = 3.49, 95% CI: 1.80-6.76, p < .001). CONCLUSION: Psychological factors, among others, were significantly associated with the presence of MIH.

Clustering of Signs and Symptoms of Oral Diseases in a Colombian Population.

OBJECTIVE: The aim of this study was to estimate disease pattern clusters and co-occurrences of oral signs and symptoms in a Colombian population. METHODS: A cross-sectional study was carried out through a telephone survey amongst 1155 people registered in the telephone directory from Pasto, Colombia. The calls were made from July to November 2019. A 14-item self-report questionnaire about signs and symptoms related to oral diseases that included sociodemographic characteristics was employed. Descriptive and multivariable analyses such as hierarchical clustering, multidimensional scaling, and generalized linear models were used to determine co-occurrences in different sex and age strata. RESULTS: Age- and condition-specific clusters of signs and symptoms were identified, while sex differences were limited. Calculus and denture sore mouth were related in 18- to 34-year-olds; tooth loss and calculus in 35- to 54-year-olds, and teeth holes or pits (dental caries) and dental abscess in those aged 55 years and older. We found stronger associations between periodontal disease (bleeding gums) and dental caries (odds ratio [OR], 2.484; 95% confidence interval [CI], 1.812-3.405; P < .001) as well as grinding/clenching and facial tension (OR, 7.162; 95% CI, 5.227-9.814; P < .001). CONCLUSIONS: Age-specific clustering of signs and symptoms and diagnostic patterns wer present in ths Colombian cohort.

Association of children's toothbrushing and fine motor skills: a cross-sectional study.

Fine motor skills (FMS) allow for the control and coordination of the distal musculature of hands and fingers, a skill required to brush teeth. The objective of this study was to investigate the association between FMS and toothbrushing efficacy. This cross-sectional study included 42 low-income Latino children aged 5 to 9 years from Pasto, Colombia. Toothbrushing efficacy was determined by the children's dental plaque Quigley-Hein Index (QH-I) mean-score difference from before and after toothbrushing. FMS were evaluated using the 5-15R parent evaluation, the spiral drawing Archimedes test, and a neurodevelopmental assessment of movements and prehension patterns during toothbrushing. A descriptive analysis was performed to assess the characteristics of FMS and children's toothbrushing, and a generalized linear model was used to determine associations between these skills and toothbrushing efficacy. Eighty-six percent of the children had at least one difficulty with FMS, and in 7%, they interfered with daily activities. Fourteen percent presented a moderate pattern in the Archimedes test, and 43% had inefficient prehension patterns. Toothbrushing reduced the QH-I by a mean of 1.45 (SD = 0.78-2.12) (p < 0.001). Toothbrushing efficacy was only significantly associated with age (mean-difference = -0.315, 95%CI: -0.481 to -0.148, p < 0.001). FMS and toothbrushing efficacy were not significantly associated. Other components of fine motor control should be analyzed to understand the kinetics of toothbrushing.

Association of children's toothbrushing and fine motor skills: a cross-sectional study

Abstract Fine motor skills (FMS) allow for the control and coordination of the distal musculature of hands and fingers, a skill required to brush teeth. The objective of this study was to investigate the association between FMS and toothbrushing efficacy. This cross-sectional study included 42 low-income Latino children aged 5 to 9 years from Pasto, Colombia. Toothbrushing efficacy was determined by the children's dental plaque Quigley-Hein Index (QH-I) mean-score difference from before and after toothbrushing. FMS were evaluated using the 5-15R parent evaluation, the spiral drawing Archimedes test, and a neurodevelopmental assessment of movements and prehension patterns during toothbrushing. A descriptive analysis was performed to assess the characteristics of FMS and children's toothbrushing, and a generalized linear model was used to determine associations between these skills and toothbrushing efficacy. Eighty-six percent of the children had at least one difficulty with FMS, and in 7%, they interfered with daily activities. Fourteen percent presented a moderate pattern in the Archimedes test, and 43% had inefficient prehension patterns. Toothbrushing reduced the QH-I by a mean of 1.45 (SD = 0.78-2.12) (p < 0.001). Toothbrushing efficacy was only significantly associated with age (mean-difference = -0.315, 95%CI: -0.481 to -0.148, p < 0.001). FMS and toothbrushing efficacy were not significantly associated. Other components of fine motor control should be analyzed to understand the kinetics of toothbrushing.

Psychometric Properties of the SOC-13 Scale in Colombian Adults.

The aim of this study was to determine the psychometric properties of the Spanish version of the SOC-13 in Colombian adults. The SOC-13 questionnaire was administered to 489 individuals aged ≥18 years who were in lockdown from March to July 2020 in Nariño County, Colombia. Psychometric properties of the scale were examined using a cross-validation method via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Additionally, configural and metric invariance were tested. To determine the internal consistency of the questionnaire, McDonald's omega (ω), Cronbach's alpha (α), and composite reliability (CR) coefficients were estimated. The EFA determined that a three-factor structure best fit the data (comprehensibility, manageability, and meaningfulness) and CFA confirmed this three-factor model structure showing a good fit (χ2S-B = 188.530, χ2S-B/(62) = 3.615, p = 0.001; NNFI = 0.959; CFI = 0.968; RMSEA = 0.052 (90% CI [0.041-0.063]) and SRMR = 0.052).The invariance analysis indicated the same underlying theoretical structure between genders. Additionally, (ω), (α), and (CR) coefficients confirmed a high internal consistency of the instrument. The SOC-13 scale, reflecting comprehensibility, manageability, and meaningfulness, is a reliable and valid tool for assessing the sense of coherence in Colombian populations.

Lip print: a humanitarian forensic action / Huella labial: una acción forense humanitaria

ABSTRACT Introduction: forensic science involves diverse scientific disciplines that apply their particular expertise to the legal and judicial system. However, in the last decades this science has been linked to humanitarian actions and human rights proceedings. Forensic dentistry plays a vital role in personal identification. The lip print analysis is a relatively a simple procedure used in this discipline. It consists of patterns evaluation of cracks in the elevations and depressions on the labial mucosa. The aim of this study was to determine the lip print patterns of a southern Colombian population in order to add evidence of preconditions for forensic issues as part of a humanitarian forensic action. Methods: a total of 384 participants ≥ 35 years old were included in this study. The lip prints were analyzed through Suzuki and Tsuchihashi's classification in order to identify the predominant lip prints in males and females. Descriptive analysis was used to determine the sample characteristics and a χ2 test was performed to analyze independence according to sex variable for these categorical data. Results: the analyses showed that Type I and I' together were the most commonly lip prints seen in this sample, followed by Type II. There were not statistical differences between males and females. Conclusions: the evaluation of lip prints is a cost-effective method, and it could be an alternative in developing countries, especially in those that address massive violations of human rights.

RESUMEN Introducción: la ciencia forense involucra diversas disciplinas científicas que aplican su experiencia particular al ámbito legal y judicial. Sin embargo, en las últimas décadas esta ciencia se ha relacionado con acciones humanitarias y procesos de derechos humanos. La odontología forense juega un papel vital en la identificación personal. El análisis de la huella labial es un procedimiento relativamente sencillo utilizado en esta disciplina. Éste consiste en la evaluación de patrones de fisuras en elevaciones y depresiones de la mucosa labial. El objetivo de este estudio fue determinar patrones de huella labial en una población del sur de Colombia, con el fin de agregar evidencia de precondiciones para problemas forenses como parte de una acción forense humanitaria. Métodos: en este estudio se incluyó un total de 384 participantes ≥ 35 años. Las huellas labiales se analizaron mediante la clasificación de Suzuki y Tsuchihashi para identificar el predominio en hombres y mujeres. Se utilizó un análisis descriptivo para identificar las características de la muestra y se realizó una prueba de χ2 para analizar la independencia en la variable sexo para estos datos categóricos. Resultados: los análisis mostraron que los Tipos I y I' en conjunto fueron las huellas labiales más comunes que se observaron, seguidas del Tipo II. No existieron diferencias estadísticas entre hombres y mujeres. Conclusiones: la evaluación de las huellas labiales es un método económico y podría ser una alternativa en países en desarrollo, especialmente en aquellos que sustentan violaciones masivas de derechos humanos.

Propiedades psicométricas de la versión española de la Abeer Children Dental Anxiety Scale (ACDAS) para la medición de ansiedad dental en niños / Psychometric properties of the Spanish version of the Abeer Children Dental Anxiety Scale (ACDAS) to dental anxiety in children

El proceso de validez y fiabilidad de las escalas de ansiedad dental en español para niños ha sido escasa. El objetivo de esta investigación fue evaluar las propiedades psicométricas de la adaptación española de la Abeer Children Dental Anxiety Scale (ACDAS) como una medida de auto-reporte de ansiedad dental en niños. El ACDAS incluye 13 ítems sobre las reacciones de ansiedad a estímulos de la atención odontológica y un componente cognitivo evaluado a los niños, padres y operadores. Se adaptó la ACDAS al idioma Español, luego se determinaron las propiedades psicométricas en una muestra de 200 pacientes niños de la Clínica Odontológica de la Universidad Cooperativa de Colombia, Pasto, Colombia. La validez estructural de la escala fue estimada con un Análisis Factorial Exploratorio (AFE) y su fiabilidad fue establecida a través de la consistencia interna (a de Cronbach). La muestra consecutiva fue comprendida de 112 hombres y 88 mujeres y sus edades estuvieron entre 5 a 10 años. El AFE determinó una estructura de cuatro factores que representó el 72,12 % de la varianza explicada. Se nombró a los factores de acuerdo con las reacciones de ansiedad a estímulos potencialmente nocivos como "estímulos pre-intervención", "estímulos restrictivos/invasivos", "estímulos inocuos (tacto, gusto)" y "estímulos inocuos (olfato, oído)". La consistencia interna de las sub-escalas fue 0,88; 0,71; 0,84 y 0,76 respectivamente. Las sub-escalas mostraron una buena convergencia, ser discriminantes y validez de constructo. Los resultados sugieren que la ACDAS es un instrumento válido y fiable, y clínicamente útil para la evaluación de la ansiedad dental en niños.

The validity and reliability process of dental anxiety scales for children in Spanish has been scarce. The aim of this research was to determine the psychometric properties of a Spanish adaptation of the Abeer Children Dental Anxiety Scale (ACDAS) as a self-report measure of dental anxiety in children. The ACDAS includes 13 items about the anxiety reactions of receiving dental care and a cognitive component assessed to children, parents and operators. We adapted the Abeer Children Dental Anxiety Scale to Spanish language, and then determined its psychometric properties in a sample of 200 children patients from the Dental Clinic at Universidad Cooperativa de Colombia, Pasto, Colombia. The scale's structural validity was estimated through an Exploratory Factor Analysis (EFA) and the reliability was established by examining its internal consistency (Cronbach's a). The consecutive sample was comprised of 112 men and 88 women and their ages ranged from 5 to 10 years. The EFA loaded a four-factor structure which accounted for 72.12 % of the variance. We labeled to those factors according to anxiety reactions to potential harmful stimuli as "pre-intervention stimuli", "invasive/restrictive stimuli", "innocuous stimuli (touch, taste)" and innocuous stimuli (smell, hearing)". The internal consistencies of the sub-scales were 0.88, 0.71, 0.84 and 0.76, respectively. The sub-scales showed good convergent, discriminant and construct validity. The results suggest the ACDAS is a valid, reliable, and clinically useful instrument for assessing dental anxiety in children.

Occlusal and cephalometric characteristics of anterior open-bite among Colombian 5-10 years old school children / Características oclusales y esqueléticas de mordida abierta anterior en escolares colombianos de 5 a 10 años

Abstract: objetive. The aim of this study was to determine oclussal and skeletal characteristics of anterior open bite (AOB) according to sex and socioeconomic status (SES) in school children in the municipality of Pasto, Colombia. Methodology. A cross-sectional study was carried out involving 384 children between 5 and 10 years of age. A clinical assessment was performed to evaluate AOB, and information regarding socio-demographic variables, such as sex and SES according to Colombian standards, was obtained. Standardized lateral cephalograms and cast models were taken from participating subjects. A statistical analysis was performed using frequencies, percentages, t-student, ANOVA, Mann-Whitney and Kruskal-Wallis tests. Results. Prevalence of AOB was 8.1 percent, showing a significant difference according to SES. The most common Angle’s classification was Class II with 70.6 percent in the right molars, and 58.8 percent in the left molars, according to occlusal characteristics. Statistically significant differences were observed in the ratio of posterior and anterior facial height (PFH:AFH) (p=0.050) according to sex. The distance between the upper first molar and palatal plane (U6-PP) (p=0.028), the Overbite (p=0.032) and Gonial° (p=0.033) values showed statistically significant differences according to SES in vertical skeletal measures. The 64.7 percent of AOB were of dental origin. Conclusion. Results suggest variations in some vertical skeletal measures according to sex and SES in children with AOB. Since a high percentage of AOB is caused by dental factors, preventive programs are required to control this condition.

Resumen: el objetivo de este estudio fue determinar las características oclusales y esqueléticas de mordida abierta anterior (MAA) según sexo y nivel socioeconómico en escolares de Pasto, Colombia. Metodología. Se diseñó un estudio transversal con la participación de 384 niños entre 5 y 10 años. Se realizó una valoración clínica para evaluar la MAA y se obtuvo información sobre variables socio-demográficas como edad, sexo y estrato socioeconómico (ESE) basado en los parámetros de Colombia. A los participantes se les tomó cefalometrías laterales estandarizadas y modelos de estudio de yeso. Se hizo un análisis estadístico usando frecuencias, porcentajes, t-student, ANOVA, Mann- Whitney y Kruskal-Wallis. Resultados. La prevalencia de MAA fue 8,1 por ciento y existió una diferencia significativa según ESE. La clasificación de Angle más común fue la Clase II para el molar derecho en 70,6 por ciento e izquierdo: en 58,8 por ciento de acuerdo a las características oclusales. Diferencias estadísticamente significativas fueron observadas en la razón entre la altura facial posterior y anterior (PFH: AFH) según sexo (p=0,05). Los valores de la distancia entre el primer molar superior y el plano palatino (U6-PP) (p=0,028), el Overbite (p=0,032) y Gonial° (p=0,033) tuvieron una diferencia estadísticamente significativa con respecto al ESE en las medidas esqueléticas verticales. El 64,7 por ciento de MAA fueron de origen dental. Conclusión. Los resultados sugieren variaciones en algunas medidas esqueléticas verticales según sexo y ESE. Debido a que existe un alto porcentaje de MAA dental, se requieren programas preventivos para controlar esta condición.

Factors associated with dentine hypersensitivity severity in Colombian dental patients / Factores asociados a la severidad de la hipersensibilidad dentinal en pacientes de odontología colombianos

Abstract: Introduction: the aim of this study was to determine the pre¬valence of dentine hypersensitivity (DH) and examine associated etiological factors related to the severity of DH in dental clinic patients treated at the School of Dentistry at Universidad Cooperativa de Colombia, Pasto, Colom¬bia. Materials and Methods: A cross-sectional study was designed in which three hundred and thirty three patients aged 15 to 44 years old were assessed for the presence and severity of DH. The dentine hypersensitivity diagnosis was based on self-reported sensitivity and a clinical examination. The ques¬tionnaire included socio-demographic information, data about oral health habits and acidic dietary intake. A descriptive analysis was performed and the association between DH severity and risk factors was determined using an ordinal logistic regression model. Results: Dentine hypersensitivity was detected in 88 out of 333 (26.4 percent) subjects (95 percent CI: 21.83-31.56). The pH of natural juices (OR=6.013; 95 percent CI: 0.995-36.319, p=0.051) and pH of alcohol beverages (OR= 7.800; 95 percent CI: 2.282-26.658, p=0.001) were signi¬ficantly associated with the severity of dentine hypersensitivity. Conclusions: The results indicated that the prevalence of dentine hypersensitivity in these patients was consistent with previous reports. Furthermore, the severity of DH was influenced by acidic diet. These results suggest that dental coun¬seling should be provided to all patients as well as to those with dentine hypersensitivity to prevent the occurrence of this oral health problem and the severity of symptoms.

Resumen: Introducción: el objetivo de este estudio fue determinar la prevalencia de hipersensibilidad dentina (HD) y examinar los factores etiológicos asociados relacionados a la severidad de la HD en pacientes de la clínica de la Facultad de Odontología de la Universidad Cooperativa de Colombia, Pasto, Colombia. Materiales y Métodos: Se diseñó un estudio transversal donde trescientos treinta y tres pacientes de edades entre 15-44 años de edad fueron evaluados para la presencia y severidad de HD. El diagnóstico de la hipersensibilidad dentinal fue basado en sensibilidad auto-reportada y un examen clínico. El cuestionario incluía información socio-demográfica, datos acerca de hábitos de salud oral e ingesta de dieta ácida. Un análisis descriptivo fue realizado y la asociación entre la severidad de la HD y los factores fue determinada usando un modelo de regresión logística ordinal. Resultados: La hipersensibilidad dentinal fue detectada en 88 de 333 (26,4 por ciento) sujetos (IC 95 por ciento: 21,83-31,56). El pH de los jugos naturales (OR=6,013; IC 95 por ciento: 0,995-36,319, p=0,051) y el pH de las bebidas alcohólicas (OR=7,800; IC 95 por ciento: 2,282- 26,658, p=0,001) fueron asociadas significativamente con la severidad de la hipersensibilidad dentinal. Conclusiones: Los resultados indican que la prevalencia de HD en estos pacientes fue concordante con previos reportes. Además, la severidad de la HD fue influenciada por la dieta acida. Estos resultados sugieren que el consejo odontológico debería ser provisto a todos los pacientes, al igual a aquellos con HD tanto para prevenir la ocurrencia de este problema de salud oral como la severidad de los síntomas.

Dentine sensitivity risk factors: A case-control study.

OBJECTIVE: To identify the clinical and psychological risk factors associated with dentine hypersensitivity (DH) in order to provide an early diagnosis and preventive therapy. MATERIALS AND METHODS: A nested case-control study was design between 2011 and 2012. A total of 61 DH cases and 122 controls participated in this investigation. Cases and controls were matched for sex, group of age and socioeconomic status in a ratio of 1:2. DH to different stimuli such as cold, heat, acid, and sweet was asked in patient interviews, and dental examinations were used to detect DH. Clinical and psychological risk factors such as dental hygiene, periodontal disease, acid diet, alcohol consumption, psychological stress, and psychopathological symptoms were inquired. Psychological stress was measured through the PSS-10 and psychopathological symptoms were evaluated by SCL-90-R in Spanish. Descriptive and univariate binary logistic regression analysis were performed to estimate the association between clinical and psychological risk factors and the presence of DH. RESULTS: Toothpaste abrasivity (odds ratio [OR] 1.881, 95% confidence interval [CI] 1.010-3.502, P = 0.045), gingival recession (OR 2.196, 95% CI 1.020-4.728, P = 0.041), and periodontal therapy (OR 5.357, 95% CI 2.051-13.993, P < 0.001) were associated with DH. Subjects with perceived stress (OR 1.211, 95%, CI 0.518-2.833, P = 0.658), obsessive-compulsive (OR 1.266, 95%, CI 0.494-3.240, P = 0.623) and hostility (OR 1.235, 95%, CI 0.507-3.007, P = 0.642) symptoms had a clinical greater odd of DH. CONCLUSION: Oral hygiene products and periodontal conditions are important risk factors for DH. Individuals with perceived stress, obsessive-compulsive, and hostility symptoms may increase a clinical risk for this entity. Targeting to dental counseling focused on oral hygiene products, periodontal therapy and a psychological evaluation may be promising in DH prevention.

Alcohol consumption among college medical students in Pasto (Colombia) / Consumo de alcohol en estudiantes de medicina en Pasto (Colombia)

Objective: To evaluate the reliability of the Spanish version of the AUDIT and assess the rate of problematic alcohol consumers and associated risk factors among medical students in Pasto (Colombia). Materials and Methods: A cross-sectional study was carried out in a random sample of 340 medical school students. All subjects were interviewed by two trained researchers. According to socio-demographic characteristics, variables such as age, sex, residence, socioeconomic status (SES), marital status, and study year were included. The 10-item Alcohol Disorder Identification Test (AUDIT) was used for assessing alcohol consumption. The inter-item correlations and Cronbach's α coefficient were calculated as measures of the internal consistency of the AUDIT. Results: Factor analysis for the AUDIT items supported a single factor solution, with an eigenvalue of 4.8. Using a cut-off score of 8 for the AUDIT analysis indicated 39.1 % had problematic drinking (52.4 % men and 28.2 % women). There were significant statistical differences according to socio-demographics variables such as age, sex and study year. Conclusion: The AUDIT principal component analysis resulted in a single-factor solution. The estimated occurrence of problematic drinking was high in these medical students. In terms of risk factors, variables such as age, sex and study year were related to higher scores. Preventive programs are needed to educate students about the risks associated to alcohol use.

Objetivo: Evaluar la fiabilidad de la versión española del AUDIT y valorar el porcentaje de consumidores problemáticos de alcohol y factores de riesgo asociados en estudiantes de Medicina en Pasto (Colombia). Materiales y métodos: Se realizó un estudio transversal en una muestra aleatoria de 340 estudiantes de Medicina. Todos los sujetos fueron entrevistados por dos investigadores entrenados. De acuerdo a las características sociodemográficas, se incluyó variables como la edad, sexo, residencia, nivel socioeconómico (SES), estado civil y año de estudio. La prueba de identificación de trastornos por alcohol (AUDIT) de 10 ítems fue usada para evaluar el consumo de alcohol. Las correlaciones inter-ítem y el coeficiente α de Cronbach se calcularon como medidas de consistencia interna del AUDIT. Resultados: El análisis para los ítems del AUDIT mostró una estructura uni-factorial, con un eigenvalue de 4,8. Utilizando un punto de corte de 8 en el análisis del AUDIT indicó que 39,1 % tenía un consumo problemático (52,4 % hombres y 28,2 % mujeres). Existieron diferencias estadísticas significativas según variables sociodemográficas como edad, sexo y año de estudio. Conclusión: El análisis de componentes principales del AUDIT mostró una estructura unifactorial. La ocurrencia estimada de consumo problemático fue alta en estos estudiantes de Medicina. En términos de factores de riesgo, variables como la edad, el sexo y el año de estudio se relacionaron con puntuaciones más altas. Son necesarios programas de prevención para educar a los estudiantes acerca de los riesgos del uso del alcohol.

Color dental en diferentes grupos etarios de Pasto, Colombia / Teeth shade in different age groups from Pasto, Colombia

Resumen Introducción y objetivo: La percepción del color de los dientes con instrumentos de coincidencia de sombra visuales es un problema en los procedimientos restauradores estéticos. Los objetivos del presente estudio fueron determinar la prevalencia de color de los dientes y evaluar los factores sociodemográficos, clínicos y comportamentales relacionados con el color dental en diferentes grupos de edad en Pasto, Colombia. Materiales y métodos: Un estudio transversal se llevó a cabo en una muestra probabilística aleatoria de 384 individuos. Se diseñó una encuesta para obtener información sobre las características sociodemográficas, clínicas y comportamentales. El color dental se midió visualmente en los centrales, incisivos y caninos maxilares utilizando los criterios de evaluación de la guía de dientes VITA Master 3D (Vita-Zahnfabrik). Los datos fueron codificados y analizados con el programa SPSS versión 19. Resultados: Las sombras más comunes para los incisivos centrales y los incisivos laterales maxilares fueron 2M2 con 32% y 37,8%, respectivamente, y alrededor de 30% presentaron 2M3 en caninos. La claridad, intensidad y tonalidad cambiaron según la edad. En sujetos del grupo de 45 y =54 hubo una diferencia significativa de acuerdo al sexo en relación con las dimensiones del color. La erosión/ abrasión dental estuvieron significativamente relacionadas con las tres dimensiones de color y fumar con la claridad y tonalidad. Conclusión: Existe una coincidencia de sombra utilizando una guía visual para comparar los patrones de color dental entre diferentes muestras de edades. Las variables demográficas, clínicas y comportamentales se relacionaron significativamente con las dimensiones del color dental.

Abstract Introduction and objective: The perception of teeth color with visual shade matching instruments is a problem in aesthetic restorative procedures. The aims of the present study were to determine the prevalence of teeth color and evaluate the sociodemographic, clinical and behavioral factors related to teeth color in different age groups in Pasto, Colombia. Materials and methods: A cross-sectional study was performed in a random probabilistic sample of 384 individuals. A survey was designed to obtain information about sociodemographic, clinical, and behavioral features. Tooth color was measured visually on the maxillary central incisors, incisives and canines using a VITA tooth guide 3D Master (Vita-Zahnfabrik) evaluation. Data were coded and analyzed using SPSS software version 19. Results: The most common shades for the maxillary central incisors and lateral incisors were 2M2 with 32% and 37.8% respectively and around 30% presented 2M3 for canines. Lightness, chroma and hue varied by age. In subjects group between 45 and ≤54 there was a significant difference according to sex in relation to color dimensions. Dental erosion/abrasion were significantly related to the three dimensions of color and smoking to lightness and hue. Conclusion:There was a shade matching using a visual guide to compare of the dental color patterns among different ages' samples. Demographic, clinical and behavioral variables were significantly related to dental color dimensions.

Prevalencia de defectos del esmalte dental en niños y adolescentes colombianos / Prevalence of dental enamel defects in children and adolescents from Pasto, Colombia

Introducción: el objetivo de esta investigación fue establecer la prevalencia de defectos del esmalte dental (DE) en niños y adolescentes de Pasto, Colombia. Métodos: quinientos noventa y nueve niños y adolescentes entre 6 y 15 años de edad, de tres corregimientos de Pasto, Colombia, fueron examinados clínicamente para determinar la presencia de opacidad por flúor e hipoplasia del esmalte. Literatura científica y fotografías en color de la cavidad oral fueron estudiadas previamente por dos examinadores, con el propósito de diagnosticar DE en estos corregimientos. La severidad de la opacidad por flúor fue valorada de acuerdo al índice de Dean y la hipoplasia del esmalte al índice de Silberman. Resultados: la prevalencia de DE en niños y adolescentes fue de 49,9% (IC al 95%: 45,8%-53,9%). La mayoría de ellos, 85,3%, presentaron opacidades por flúor (OPF) y 14,7% hipoplasias del esmalte. El tipo de severidad predominante de OPF fue moderada (73,7%). Las OPF fueron más prevalentes en mujeres (86,3%) que en hombres (84,2%) (p > 0,05); mientras que la hipoplasia del esmalte fue más frecuente en hombres (15,8%) que en mujeres (13,7%) (p>0,05). Las hipoplasias del esmalte fueron observadas blancas-cremosas y cafés, y fueron encontradas más frecuentemente en dientes permanentes incisivos centrales superiores. Conclusiones: la prevalencia de DE fue elevada en estos corregimientos. Las opacidades por flúor fueron las más frecuentes y se mostraron moderadas de acuerdo con el índice de Dean. Nuevos diseños de investigación son requeridos para establecer la exposición a diferentes niveles de flúor en estas comunidades. Estos resultados ciertamente representan un problema de salud pública.

Introduction: the objective of this study was to estimate the prevalence of dental enamel defects (ED) in children and adolescents from Pasto, Colombia. Methods: five hundred and ninety-nine children and adolescents aged 6 to 15 years from three municipalities of Pasto, Colombia were clinically examined for fluoride opacity and enamel hypoplasia. Scientific literature and color photographs of the oral cavity were previously studied by two examiners in order to diagnose ED in these municipalities. Severity of fluoride opacity was assessed with Dean’s index and enamel hypoplasia with Silberman’s index. Results: ED prevalence in children and adolescents was 49.9% (95% CI: 45.8% - 53.9%). Most of them, 85.3%, had fluoride opacities (FOP) and 14.7% enamel hypoplasia. The predominant type of FOP severity was the moderate level (73.7%). FOP were more prevalent in females (86.3%) than in males (84.2%) (p > 0.05), while enamel hypoplasia was more frequent in males (15.8%) than in females (13.7%) (p > 0.05). Enamel hypoplasia appeared as creamy-white and brown lesions and were most frequently found in permanent upper central incisors. Conclusions. ED prevalence was high in these municipalities. Fluoride opacities were the most frequent and were classified as moderate according to Dean’s index. New studies are required to establish levels of fluoride exposure in these communities. Certainly, these findings represent a public health problem.

Complicaciones asociadas y análisis de supervivencia de niños con leucemias agudas tratados con el protocolo BFM-95 / Associated complications and survival analysis in children with acute leukemia treated with BFM-95 protocol

Objetivo: Determinar las complicaciones y porcentaje de supervivencia de niños con leucemia linfoide y mieloide aguda tratados con el protocolo Berlin-Frankfurt-Münster 95 (BFM-95) de Enero de 2008 a Diciembre de 2010 en el Hospital Infantil "Los Ángeles". Materiales y métodos: Una cohorte retrospectiva fue diseñada para evaluar a niños tratados con el protocolo BFM-95 durante tres años en el Hospital Infantil "Los Ángeles". La información fue obtenida de los datos demográficos del paciente, complicaciones asociadas con el protocolo BFM-95 y supervivencia. Los datos fueron recolectados de las historias médicas y los reportes de fallecimiento del hospital. Las variables nominales fueron presentadas como proporciones y las variables continuas fueron expresadas como medias y desviaciones estándares. El análisis de supervivencia fue realizado por el método Kaplan-Meier. Los datos fueron analizados usando el programa Statistical Package for Social Sciences, versión 17,0 (SPSS Inc., Chicago, Illinois, USA). Resultados: Cincuenta y dos niños fueron incluidos en este estudio. De todo el grupo, 47 (90,4%) tuvieron leucemia linfoide aguda y 5 (9,6%) leucemia mieloide aguda. Treinta y cinco (67,3%) presentaron complicaciones. Veintitres niños (65,7%) mostraron complicaciones infecciosas siendo las más frecuentes. El análisis de supervivencia de Kaplan-Meier mostró que los pacientes con complicaciones tuvieron un tiempo más corto de supervivencia comparado a los pacientes sin complicaciones. Conclusiones: La incidencia de complicaciones fue elevada. El análisis Kaplan-Meier reveló diferencias entre la leucemia linfoide aguda y leucemia mieloide aguda de acuerdo a las complicaciones.

Objective: To determine complications and survival percentage in children suffering from acute lymphoid and myeloid leukemia treated with Berlin-Frankfurt-Münster 95 (BFM-95) protocol from January 2008 to December 2010 at Los Ángeles Children Hospital. Materials and methods: A retrospective cohort was designed to evaluate children treated with BFM-95 protocol during three years at Los Ángeles Children Hospital. The Information was obtained from the patient demographics, complications associated with BFM-95 protocol and survival. Data were collected from medical records and hospital decease reports. Nominal variables were presented as proportions and the continuous variables were presented as means and standard deviations. The survival analysis was performed using Kaplan-Meier method. Data were analyzed using the Statistical Package for Social Sciences, 17.0 version software (SPSS Inc., Chicago, Illinois, USA). Results: Fifty two children were included in this study. From the whole group, 47 (90.4%) had acute lymphoid leukemia and 5 (9.6%) had acute myeloid leukemia. Thirty five (67.3%) presented complications. Twenty three children (65.7%) had infectious complications, being the most frequent ones. Kaplan-Meier survival analysis showed that patients with complications have shorter survival time compared to patients with no complications. Conclusions: The incidence of complications was high in children treated with BFM-95 protocol. Kaplan-Meier analysis revealed differences between acute lymphoid leukemia and acute myeloid leukemia according to complications.

Extracurricular factors influence perceived stress in a large cohort of Colombian dental students.

The aim of this study was to investigate the association of extracurricular factors including socioeconomic status and career choice with perceived stress in dental school in a large cohort of Colombian dental students. Participants in the study were 5,700 students enrolled in seventeen Colombian dental schools. The study employed a Spanish adaptation of the Dental Environment Stressors (DES30-Sp) questionnaire and recorded an array of demographic, socioeconomic, career choice, and dental studies-related information. Data analyses relied on descriptive, bivariate, and multivariate methods based on multi-level mixed-effects linear regression and post hoc estimation of predictive margins. "Fear of failing a course or year" emerged as the highest ranked item. Male students consistently reported less perceived stress than females, and stress scores were higher among seniors. Independent of gender, age, and study year, having dentistry as one's first career choice, relying on financial support, and belonging to higher socioeconomic strata were associated with lower stress levels. Academic environment interventions aimed to improve students' educational well-being will need to account for the individual heterogeneity among them. These data from a robust cohort of predoctoral dental students underscore the importance of considering students' educational experiences in a broader social and economic context.

Determinantes de adherencia al tratamiento antihipertensivo de adultos ≥ 35 años de edad / Determinants of adherence to antihypertensive treatment in adults ≥ 35 years of age

Introducción: La hipertensión es una condición prevalente y un factor de riesgo que conduce a morbi-mortalidad alrededor del mundo. El objetivo de este estudio es establecer los determinantes de adherencia al tratamiento hipertensivo en adultos sobre 35 años de edad de Pasto, Colombia. Método: Un estudio transversal fue llevado a cabo para establecer los determinantes de adherencia a la terapia farmacológica antihipertensiva en 128 adultos del "Centro de Salud Lorenzo de Aldana". La evaluación de la adherenci��0ue hecha a través del test de Morisky-Green versión en Español. Un análisis descriptivo fue usado para variables demográficas y una regresión logística fue ejecutada para calcular un resultado dicotómico para los determinantes de adherencia. Resultados: La muestra de estudio consistió en 40 (31,3%) hombres y 88 (68,8%) mujeres pacientes hipertensos. El porcentaje de adherencia a la medicación fue 41.4%. Los pacientes hombres tenían mayor probabilidad de estar adheridos al tratamiento hipertensivo cuando ellos usaban más de un medicamento antihipertensivo, tal como inhibidores de la enzima convertidora de angiotensina, bloqueadores de los canales de calcio y diuréticos (OR:4,16; IC al 95%:0,34-5,61), ellos estaban casados (OR:2,97; IC al 95%: 0,72- 11,73) y ellos estaban hospitalizados (OR:1,92; IC al 95%: 0,11- 33,30). Sin embargo, las pacientes mujeres cuando ellas no tenían comorbilidad (OR:4,27; IC al 95%: 0,81-22,49), ellas estaban entre 35 y 45 años (OR:4.0; IC al 95%:0,39-40,05) y ellas eran solteras (OR:2,56; IC al 95%:1,03-6,38) fueron más adherentes. Conclusiones: Estos hallazgos sugieren que los determinantes de la adherencia a tratamientos antihipertensivos podrían depender del género.

Introduction: Hypertension is a prevalent condition and a risk factor for morbidity and mortality around the world. The aim of this study is to establish the adherence determinants to antihypertensive treatment in adults over 35 from Pasto, Colombia. Methods: A cross-sectional study was conducted to establish the adherence determinants to antihypertensive pharmacotherapy in 128 adults at "Centro de Salud Lorenzo de Aldana". The adherence evaluation was made through the Morisky-Green test in its Spanish version. A descriptive analysis was used for demographic variables, and a logistic regression was performed to calculate a dichotomous outcome by adherence determinants. Results: The study sample consisted of 40 (31.3%) men and 88 (68.8%) women who are hypertensive patients. The percentage of adherence to medication was 41.4%. Male patients were more likely to be adherent to hypertensive treatment when they used more than one antihypertensive drugs such as angiotensin converting enzyme inhibitors, calcium channel blockers and diuretics (OR:4.16; 95% CI:0.34, 5.61), when they were married (OR:2.97; 95% CI:0.72, 11.73), and when they were hospitalized (OR:1.92; 95 % CI:0.11, 33.30). However, female patients were adherent when they did not have comorbidity (OR: 4.27; 95% CI: 0.81, 22.49), when they were 35 to 45 years old (OR:4.0; 95% CI:0.39, 40.05), and when they were single (OR:2.56; 95% CI:1.03, 6.38). Conclusions: These findings suggest that adherence determinants to antihypertensive treatment may depend on gender.

Psychological distress and its correlates among dental students: a survey of 17 Colombian dental schools.

BACKGROUND: Links between the demanding nature of studies in the health sciences, students' personality traits and psychological distress have been well-established. While considerable amount of work has been done in medicine, evidence from the dental education arena is sparse and data from Latin America are lacking. The authors conducted a large-scale investigation of psychological distress among dental students in Colombia and sought to determine its curriculum and student-level correlates. METHODS: The Spanish version of the Derogatis' Symptoms Checklist Revised (SCL-90-R) was administered to all students officially registered and attending classes or clinics in 17 dental schools in 4 geographic districts of Colombia between January and April 2012. Additional information was collected on participants' socio-demographic information and first career choice, as well as school's characteristics such as class size. The Global Severity Index (GSI) score, a measure of overall psychological distress, served as the primary analytical endpoint. Analyses relied on multilevel mixed-effects linear and log-binomial regression, accounting for study design and sample characteristics. RESULTS: A total of 5700 dental students completed the survey, a response rate of 67%. Pronounced gradients were noted in the association between socio-economic status and psychological distress, with students in higher strata reporting fewer problems. After adjustment for all important covariates, there was an evident pattern of increasing psychological distress corresponding to the transition from the didactic, to the preclinical and clinical phases of training, with few differences between male and female students. Independent of other factors, reliance on own funds for education and having dentistry as the first career choice were associated with lower psychological distress. CONCLUSIONS: Levels of psychological distress correlated with students' socio-economic and study-level characteristics. Above and beyond the influence of person-level factors, variations in levels of distress paralleled specific transitional stages of the 5-year dental curriculum, providing opportunities for targeted interventions.

Dental aesthetics and self-esteem in adolescents / Estética dental y autoestima en adolescentes

Objective: The aim of this study was to investigate the relationship between dental aesthetics and self-esteem in adolescents. Methods: The sample was 387 randomly selected high school adolescents between 13 and 16 years of age. A clinical examination to evaluate dental aesthetics was conducted using the Dental Aesthetic Index (DAI). Self-esteem was assessed with the Rosenberg's Self-esteem Scale. The statistical analysis included a descriptive analysis and means comparison, which was made through t-Student and ANOVA tests. DAI was correlated to Rosenberg's Self-esteem Scale with Spearman's rank correlation coefficient. The data collected was analyzed by using the SPSS program version 17. Results: The mean DAI score was 34.2 (SD=14.2) and self-esteem was 22.6 (SD=4.6). The low socioeconomic status (SES) group had the highest levels of DAI and the lowest levels of self-esteem. A weak, but statistically significant, negative correlation was found between DAI scores and Rosenberg's self-esteem scale (r=-0.1, p<0.05). According to age, in adolescents aged sixteen there was a slight correlation with both variables (p>0.05). Regarding gender, in female individuals a negative weak correlation (r=-0.14, p<0.05) was observed. No statistically significant difference was shown among SES groups. Nevertheless, there was a positive slight correlation in the middle SES group (p>0.05). Conclusions: The outcomes generated by this investigation can improve our understanding of how the correlation between dental aesthetics and self-esteem may fluctuate because of the SES variability.

Objetivo: Investigar la relación entre estética dental y autoestima en adolescentes. Métodos: La muestra de 387 adolescentes entre 13 y 16 años seleccionados aleatoriamente de los colegios de educación secundaria. Se realizó un examen clínico para evaluar la estética dental a través del Dental Aesthetic Index (DAI). La autoestima se valoró usando la Rosenberg's Self-esteem Scale. El análisis estadístico incluyó medidas descriptivas y una comparación de medias realizadas a través de las pruebas t-Student y ANOVA. El DAI se correlacionó con la Rosenberg Self-esteem Scale por medio del coeficiente de correlación de Spearman. Los datos recolectados se analizaron en el programa SPSS versión 17. Resultados: La media de DAI fue 34.2 (DE=14.2) y de autoestima de 22.6 (DE=4.6). El grupo de estrato socio-económico (SES) bajo tuvo los niveles más altos de DAI y los más bajos de autoestima. Una pequeña pero significativa correlación negativa se encontró entre los niveles del DAI y la Rosenberg's Self-esteem Scale (r=-0.1; p<0.05). De acuerdo con la edad, los adolescentes de 16 años tuvieron una leve correlación en las dos variables (p>0.05). En relación con género, en mujeres se encontró una pequeña correlación negativa (r=-0.14; p<0.05). Ninguna correlación estadísticamente significativa se observó entre los grupos según estrato socioeconómico. Sin embargo, existió una leve correlación positiva en estrato socio-económico medio (p>0.05). Conclusiones: Los resultados obtenidos por esta investigación pueden mejorar el entendimiento de cómo la correlación de estética dental y autoestima podría fluctuar debido a la variabilidad del SES.