Clinical, salivary, and bacterial markers for caries risk assessment in schoolchildren: a 4-year follow-up.

BACKGROUND: In Mexico, there is a high prevalence of dental caries and large groups of children still show extensive untreated dental damage. AIM: This study aims to evaluate, in a cohort of 6-year-old Mexican children, the relationship between caries increment at 4 years and the following caries risk markers: fissure morphology, caries experience, salivary flow rate, Snyder test results, and mutans and lactobacilli counts. DESIGN: To predict new caries lesions in 110 schoolchildren, clinical, salivary, and bacteriological caries risk markers were used, including fissure morphology, caries experience, salivary flow rate, Snyder test, and Streptococcus mutans and lactobacilli counts. To determine the validity of these markers, the baseline data were compared with the caries increment after 4 years. RESULTS: The risk model's capacity to predict caries was moderate (specificity 79.6% and sensitivity 78.6%). Caries experience (P = 0.0001), Snyder test (P = 0.002), and fissure morphology (P = 0.024) had the strongest association with caries increment. Salivary flow rate, lactobacilli, and S. mutans counts did not contribute significantly to the prediction of caries lesions in these children. CONCLUSION: In addition to the initial caries experience, tooth morphology and Snyder test proved to be useful predictors for caries. These three risk markers may be particularly useful in targeting caries prevention efforts in developing countries.

Prevalence of oral lesions in patients with psoriasis

Aim: To determine the prevalence of oral lesions (OL) in patients with psoriasis, and compare these findings withthe ones found in patients without this condition.Materials and methods: In the present observational and comparative study, we evaluated 207 patients, with andwithout psoriasis, attending the dermatological consulting service of a concentration hospital in Mexico City. Thepossible association between OL and psoriasis was analyzed through a logistic regression model; the Odds Ratio(OR) and its Confidence Interval (CI) was calculated to be 95%.Results: Two hundred and seven cases were examined (80 with psoriasis and 127 without psoriasis). Of these, 75(36.2%) were men and 132 (63.7%) women. Oral lesions were found in 54 (67.5%) psoriatic patients and in 63 (49.6%)of the comparative group (p <0.012). Fissured tongue (FT) was present in 47.5 % of the patients with psoriasis andin 20.4 % of the group without psoriasis, (OR=3.46, 95% CI [1.14, 10.5], p=0.001). Geographic tongue (GT) waspresent in 12.5 % of the group with psoriasis and 4.7 % in the group without this disease (OR=3.54 95 % CI [1.97,6.79], p=0.028). Likewise, six patients (7.5 %) with psoriasis and 3 (2.36 %) from the comparative group presentedsimultaneously GT and FT (p = 0.0776). The most frequent type of psoriasis was the vulgar psoriasis (90 %), inwhich a higher prevalence of FT (p <0.05) was present. There were no differences between both groups (p>0.05)regarding the use of tobacco. Alcohol consumption was greater (55.0%) among patients with psoriasis than amongthose without psoriasis (26.7%) (p<0.05), but when the association with GT and FT was analyzed, no significantdifferences were found among (..) (AU)

Prevención en salud periodontal: recomendaciones actualizadas y estatus del conocimiento directamente aplicable al entorno mexicano / Periodontal health prevention: updated recommendations and status of the knowledge directly applied to the Mexican scope

Objetivo: Establecer, a través de la revisión de la literatura, el impacto potencial de los procedimientos clínicos y de salud pública en el bienestar de los tejidos periodontales, en términos de lineamientos explícitos de evaluación y en el contexto de la investigación científica/profesional relevante a México. Métodos: Revisión estructurada de la literatura sobre prevención y salud periodontal en México (1990-2004); se cotejaron los hallazgos con esquemas de evaluación de la calidad de la evidencia científica y recomendaciones asociadas (Canadian Task Force on Preventive Health Care). Resultados: Los esquemas de evaluación arrojaron una clasificación cualitativa de la evidencia científica/profesional y de recomendaciones directamente relevantes a intervenciones preventivas en salud periodontal. Treinta y un artículos publicados entre 1990 y 2004 (inclusive) cumplieron con criterios de solidez metodológica y fueron agrupados en seis niveles de calidad de evidencia. Grosso modo, esta literatura no cubre con diversidad, ni a profundidad la multiplicidad de temas y retos pertinentes a la salud periodontal en México. Conclusiones: Este enfoque permitió identificar la necesidad de continuar documentando ciertos problemas de salud epidemiológicamente importantes. Es fundamental establecer acciones y emplear métodos definidos para extender el conocimiento actualmente disponible, así como operacionalizar esta información en las actividades clínicas y de salud pública