Cigarette smoking and dental caries among professional truck drivers in Mexico.

BACKGROUND: Professional truck drivers are at high risk of chronic diseases. Further examination of tobacco use and its impact on oral health is warranted - both in terms of the direct association between tobacco use and poor oral health, and in terms of tobacco use being an indicator of poor health behaviors. OBJECTIVE: To estimate the possible association between smoking and dental caries experience in a population with high tobacco use. METHODS: Drivers' licenses are periodically re-issued by the Mexican government and as part of the licensing process a physical exam takes place. We administered a free, standardized questionnaire together with an oral examination (WHO criteria) included in the physical exam, targeting a random sample of applicants in Mexico City. RESULTS: A total of 824 dentate males (mean age 35.5 +/- 10 years) took part in the study, of whom 49.2% were current smokers and 23.2% were former smokers. Caries experience was mean DMFT 8.95 (+/- 6.05). Only 18.0% of participants had 'excellent' or 'good' oral hygiene. The prevalence of 'large' cavities increased as the number of cigarettes/day increased from 14.6% (1-3 cigarettes/day) to 33.3% (> or =10 cigarettes/day). Using multiple linear regressions, we found that older age, poorer oral hygiene, higher education, and greater tobacco exposure were significantly associated with higher caries experience (DMFT). An interaction was observed with oral hygiene and tobacco: drivers that smoked and had 'poor' oral hygiene showed the highest number of large cavities and missing teeth. Health promotion interventions are needed in this at-risk population group.

Anthropometric measurements of a sixty-year and older Mexican urban group.

In the Third World Countries, little attention has been paid to health and nutrition aspects of the elderly population. In Mexico, there are no data that provides anthropometric parameters of this group. The purpose of this study was to obtain anthropometric measurements of 60-year-old-and older Mexican men and women in Mexico City. A cross sectional study was carried out. The sample was selected from men and women registered as retired or pensioned by the Mexican Social Security Institute (IMSS) and from those requesting identification cards from the Elderly National Institute (INSEN). Standardized protocols were used to register anthropometric measurements. The group examined included 1091 people, 484 males and 607 females. The mean age of the population was 66.1 (s.d. 6.1). The values in the male group were higher than in the female group in height, weight and waist circumference; women showed higher values in body mass index (BMI), arm circumference, triceps skinfold and hip circumference (p < 0.01). The data gathered up were divided in five age groups; each one in a five-year interval. Percentiles of the anthropometric measurements according to the age group and gender are presented. Regression analysis indicated that the measurements of weight, body mass index, arm circumference and arm muscle area, showed lower values in the older groups. An important segment of the population studied had a BMI higher to the normal values. Additional studies covering other communities in Mexico with a different socioeconomic and ethnic composition, would be necessary to obtain a better characterization of the Mexican elderly.

Overweight in elderly Mexican women of a marginal community.

Obesity is a main risk factor in the development of diseases, which are causes of death in elderly population. Socio-economic characteristics had an impact in the prevalence of obesity. The purpose of this study was to estimate the prevalence of obesity in elderly Mexican women living in a marginal community and compare their results with those of women of urban and rural areas in Mexico. The study has a cross sectional design. Standardised nutritionist carried out the measurements. The international techniques recommended were used to measure weight and height. To estimate the proportion of overweight and obesity, the body mass index (BMI) was used following the WHO categories. A total of 249 elderly women were examined. The mean age was 71.6 (sd 7.8). No difference in age was found in the three communities visited (p>0.05). The mean BMI in the urban women was 26.7 (sd 4.6), in the rural 24.5 (sd 3.9), and in the marginal group 28.6 (sd 5.5) (p<0.0001). The proportion of overweight and obese women was in the urban group 60.7%, in the rural 36.2%, and in the marginal women 76.5% (p<0.001). The results of this study indicated the presence of a high prevalence of overweight and obesity in elderly women of urban and particularly in the marginal areas. Marginality seams to be a risk marker of obesity in elderly women in Mexico. Intervention programs aimed to decrease the prevalence of obesity and improve nutritional condition in this group are urgent.

Dental caries experience in Mexican schoolchildren from rural and urban communities.

OBJECTIVE: To compare dental caries experience in Mexican rural and urban settings. DESIGN: Cross-sectional samples of schoolchildren. SETTING: A school in Mexico City and a rural school in a remote area of the Oaxaca State in Southern Mexico. SAMPLE AND METHODS: A total of 347, 9- to 10-year-old schoolchildren (rural area, 131 children; urban, 216) was examined by two standardised dentists using the WHO 1987 criteria. OUTCOME MEASURES: Data were analysed in terms of central tendency measures and 95 per cent confidence intervals. RESULTS: Caries prevalence was 91.6 per cent in the urban area, and 54.4 per cent in the rural area (P < 0.05). DMFT in 10-year olds was 1.93 (sd 1.72) and 0.40 (sd 0.76) in urban and rural areas respectively (95 per cent CI 1.16-1.89). The entire DMFT/dmft indices in the rural group were made up of the decayed component. CONCLUSIONS: There is a large difference in the prevalence and distribution of dental caries between rural and urban Mexican children. Dental treatment background also differs markedly. Findings highlight the need to establish distinct preventative and rehabilitative treatment strategies tailored to meet the specific needs of different population groups.

Changes in dental caries prevalence in 12-year-old students in the State of Mexico after 9 years of salt fluoridation.

The purpose of this study was to describe the dental caries experience in 12-year-old students in the State of Mexico and to detect changes after 9 years of salt fluoridation (1988-1997). The 1987 WHO dental caries criteria were used in both surveys. The population studied encompassed 2,275 12-year-old students in 1988, and 1,138 in 1997. The proportion of 'caries-free' children was 10. 3% in the first survey and 27.7% in the second one. The mean DMFT index was 4.39 (SD 2.9) in 1988 and 2.47 (SD 2.4) in 1997, the confidence interval of the differences between DMFT means was [95% CI 1.73, 2.11]; the caries reduction detected was 43.7%. The Unmet Restorative Index was 82.3% in 1988 and 72.8% in 1997. The results of the present study indicate that the oral health status of State of Mexico students has improved during the last decade; however, there is still a need for further caries reduction and an increment in access to dental treatment.

Caries experience and treatment needs in a 6- to 12-year-old urban population in relation to socio-economic status.

OBJECTIVE: To report caries experience in the permanent dentition among Mexico City elementary school children and undertakes a comparative analysis of dental caries experience and treatment needs of children of different socio-economic status (SES). RESEARCH DESIGN: SES was established according to an official measure of economic well-being, that of the family income being high enough to allow the child to attend school in a private institution as opposed to a public school. PARTICIPANTS: A probabilistic sample of 4,048 6- to 12-year-old children (47.2% females) was examined using the 1987 WHO caries criteria (546 attended private schools and 3,502 were public school children). RESULTS: The proportion of caries-free 12-year-old children was 28.6% and 9.5% in the private and public schools, respectively (P < 0.01). In 12-year-old children, DMFT was 2.78 (SD 2.9) and 4.64 (SD 3.2) in the private and public school groups, respectively (P < 0.001). Higher treatment needs were found among public schoolchildren (TN = 83.0%) compared with private schoolchildren (TN = 27.6%) (P < 0.001). CONCLUSIONS: Dental caries and treatment needs were considerably higher in children of lower SES. Differences in dietary patterns and toothpaste use could be the more likely explanations for these findings, indicating markedly unequal burdens of disease according to socio-economic status. Special efforts should be developed to improve the oral health status in Mexico City children by implementing preventive health promotion and treatment programmes.

Prevalence and severity of dental fluorosis in a Mexican community with above-optimal fluoride concentration in drinking water.

The purpose of this study was to determine the prevalence and severity of dental fluorosis in children living in a community at 2066 m above sea level. The water fluoride concentration of this community was 2.8 ppm. The population selected encompassed 10-12-yr-old schoolchildren who were life-long residents of the area. The modified Dean Index was used to estimate the severity of fluorosis. A total of 93 children participated in the study. They all showed evidence of dental fluorosis. Fifty-seven percent had moderate fluorosis, and 19% severe fluorosis. The high prevalence and severity of fluorosis in the population examined emphasized the need to study the factors determining dental fluorosis in Mexican communities.

Use of fissure sealants by dentists in private practice in Mexico City.

This paper presents findings on the use of pit and fissure sealants by dentists working in private practice in Mexico City. A total of 386 dentists participated in the study. Dentists working in high, middle, and low socioeconomic areas of the city were personally interviewed and their patients' records of the last 5 working days were reviewed. 45% of the dentists indicated that they used sealants and 10% used them during the 5 days studied. A greater proportion of recent dental graduates used sealants compared with older graduates. The dentists who utilized sealants were more likely to apply fluoride treatments in their practice than dentists who did not utilize sealants. The proportion of sealants in relation to all treatments provided was low (0.8%), and even lower in the low socioeconomic areas (0.02%). Considering the high dental caries experience of Mexican children, the use of dental sealants should be promoted by Mexico City dentists. In addition, school-based sealant programmes should be established, particularly in low socioeconomic areas.

[Incipient carious lesions and their histological characteristics, in teeth of Mexico city residents]. / Lesiones cariosas incipientes y sus características histológicas, en dientes de personas de la ciudad de México.

Twelve tooth sections from young Mexico City patients with incipient caries-like lesions, were examined through polarized light microscope and lightening media. According to size, lesions under study were classified as "late" in occurrence. Their median depth was 450 microns: their surface area measured an average breadth of 63 microns; the body of the lesion was 310 microns, and the dark zone, 73 microns. The translucid area was detected in 83% of the sections. In 41% of the teeth, well-mineralized laminations were observed within the body of the lesion. Further studies on a larger number of cases is vehemently recommended, in order to understand better the characteristics and variations of incipient and latent lesions in our general population.