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Objective: Food insecurity (FI) is a priority for government and health organizations. Over 95% of the world's population has a carious lesion or will develop one before death. This study evaluated the association between FI and oral health in two rural communities in Chiapas, Mexico. Methods: The study was conducted with patients attending an oral health campaign for dental checkups. Data were collected between April and August 2017 using the Latin-American and Caribbean Scale of Food Security (ELCSA) and the International Caries Detection and Assessment System (ICDAS). We included 209 participants from Siltepec and Huehuetan, Mexico; 67% were women. Results: The results of the ELCSA were mild FI in 43% (n = 91), moderate FI in 22% (n = 45), and severe FI (n = 6) in 3%; 32% had food security. The ICDAS results were initial decay with a mean of 6.22, moderate decay with a mean of 1.81, and extensive decay with a mean of 1.77. Conclusions: FI is associated with dental caries, and food-insecure individuals have a higher probability of severe dental caries. In this study, the FI level was lower than in other rural populations in Mexico. Identifying these individuals and addressing the factors related to FI can be useful in the rural communities.

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Abstract The COVID-19 pandemic has highlighted the economic, social, and oral care health inequities in societies, especially in the developing world. Severe restrictions have been imposed on dental practices, limiting prophylactic and routine oral care health, allowing treatment only for emergencies. Since dental care includes procedures that generate aerosols, the risk of infection for dental personnel has increased significantly. In this review, a comprehensive and updated source of information about SARS-CoV-2/COVID-19 and the impacts it is having on oral health care is presented. The ongoing repercussions in dental practice and in dental education, including the opportunities for practice innovation that are evolving, are also indicated. Also, a discussion of the psychosocial factors that affect health and the quality of life of an individual, such as stress, depression, and anxiety, is provided. This pandemic may be an opportunity to promote the inclusion of well-established prevention measures, together with the use of teledentistry in academic dental curricula, encourage the implementation of new perspectives for the effective instruction and interactions with students, and foster the transition toward e-learning strategies in dental education.

Resumo A pandemia COVID-19 destacou as desigualdades econômicas, sociais e de saúde bucal, especialmente no mundo em desenvolvimento. Severas restrições têm sido impostas para a prática odontológica, limitando a rotina de saúde bucal, permitindo o tratamento apenas em emergências. Como o atendimento odontológico inclui procedimentos que geram aerossóis, o risco de infecção para a equipe odontológica aumentou significativamente. Nesta revisão, é abordada uma fonte abrangente e atualizada de informações sobre o SARS-CoV-2/COVID-19 e os impactos que têm nos cuidados de saúde bucal. As repercussões contínuas na profissão odontológica e na educação odontológica, incluindo as oportunidades de inovação da prática. Além disso, é fornecido o efeito de fatores psicossociais que afetam a saúde e a qualidade de vida, como estresse, depressão e ansiedade. Esta pandemia pode ser uma oportunidade para promover a inclusão de medidas de prevenção bem estabelecidas, juntamente com o uso da teledontologia nos currículos acadêmicos de odontologia, trazendo novas perspectivas sobre a forma de ensinar e interagir com os alunos, com a transição para estratégias de e-learning na educação odontológica.

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The COVID-19 pandemic has highlighted the economic, social, and oral care health inequities in societies, especially in the developing world. Severe restrictions have been imposed on dental practices, limiting prophylactic and routine oral care health, allowing treatment only for emergencies. Since dental care includes procedures that generate aerosols, the risk of infection for dental personnel has increased significantly. In this review, a comprehensive and updated source of information about SARS-CoV-2/COVID-19 and the impacts it is having on oral health care is presented. The ongoing repercussions in dental practice and in dental education, including the opportunities for practice innovation that are evolving, are also indicated. Also, a discussion of the psychosocial factors that affect health and the quality of life of an individual, such as stress, depression, and anxiety, is provided. This pandemic may be an opportunity to promote the inclusion of well-established prevention measures, together with the use of teledentistry in academic dental curricula, encourage the implementation of new perspectives for the effective instruction and interactions with students, and foster the transition toward e-learning strategies in dental education.

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Objetivo. Evaluar tres técnicas para el manejo de conducta: Desensibilización Sistemática (DS), Método Treament and Education of Autistic and related Communication Handi-capped Children (TEACCH) y la técnica Decir, Mostrar, Hacer (DMH), durante la atención dental a personas con trastorno del espectro autista (TEA). Métodos. Participaron 18 personas del Noreste de México con diagnóstico de TEA, con un rango de 13 a 15 años divididos en tres grupos según la técnica TEACCH, DS y DMH con seis personas por grupo. A los participantes se les realizó una profilaxis dental empleando la técnica de manejo de conducta y comunicación según el grupo, la conducta se evaluó usando las escalas Frankl ́s Behavior Rating Scale (FBRS) y Comfort Behavior Scale (CBS). Se usaron las pruebas Chi cuadrado, ANOVA y t de Student para comparar los resultados. Resultados. La conducta evaluada con la escala de Frankl, fue definitivamente positiva en los grupos TEACCH (33,3%) y DS (16,7%). Conducta positiva semejante en los tres grupos (66,7%). Conducta negativa semejante en DS y DMH (16,7%). Conducta definitivamente negativa solo en el grupo DMH (16,7%). En la escala CBS, solo el grupo DMH presentó aumento del tono muscular (p= 0,013) y tensión facial no sostenida (p= 0,001), al compararlo con TEACCH y DS. Conclusiones. Las tres tecnicas utilizadas son efectivas para el manejo de conducta de las personas con TEA durante el tratamiento dental, sin embargo en la técnica DMH se observó conducta definitivamente negativa y respuesta corporal-conductual que refleja tensión emocional.

Objective. Evaluate three behavior management techniques: Systematic Desensitization (SD), the Treament and Education of Autistic and related Communication Handicapped Children (TEACCH) and Tell, Show, Do (TSD) Method, during dental care for people with Autism Spectrum Disorder (ASD). Methods. Eighteen people from Northeast Mexico diagnosed with autism spectrum disorder participated, with a range of 13 to 15 years, divided in to three groups, according to the TEACCH, SD and TSD technique with six participants per group. A dental prophylaxis was performed on the participants, using the behavior management and communication technique according to the group, the behavior was evaluated using the Frankl's behavior rating scale (FBRS) and Comfort Behavior Scale (CBS). Chi square, ANOVA and Student's t tests were used to compare the results. Results. Behavior evaluated with Frankl scale was definitely positive in TE-ACCH (33.3%) and DS (16.7%) groups. Similar positive behavior in the three groups (66,7%). Similar negative behavior in DS and DMH (16.7%). Definitively negative behavior only in the DMH group (16.7%). With CBS scale, only the DMH group presented increased muscle tone (p= 0.013) and evident not sustained tension in some facial muscles (p= 0.001), when compared with TEACCH and DS by ANOVA analysis. Conclusions. The three techniques evaluated are effective for managing behavior of people with ASD during dental treatment, however, in DMH technique, definitely negative behavior and a corporal-behavioral response were observed, reflecting emotional stress.

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Resumen El diagnóstico adecuado del bruxismo incluye el análisis y la correlación de signos y síntomas con diferentes métodos de diagnóstico, siendo esencial la interpretación y evaluación de los síntomas que reporta el paciente. El presente es un trabajo inicial sobre las propiedades psicométricas del cuestionario de bruxismo autoinformado (CBA). Participaron 100 personas (34 hombres y 66 mujeres) del noreste de México, la muestra se dividió en dos grupos, uno con diagnóstico clínico y autoinforme de bruxismo (N = 50) y otro sin bruxismo. Se evaluó la confiablidad por consistencia interna, la estructura factorial y la validez convergente entre la escala de estrés percibido PSS-14 y el CBA. Los resultados muestran consistencia interna entre los 11 ítems (α = .88). El análisis factorial confirmatorio para un solo factor presentó índices estadísticos de bondad de ajuste adecuados (χ2/gl = 1.461; GFI = .916; AGFI = .857, CFI = .967, RMSEA = .068). La correlación entre las escalas PSS-14 y CBA fue positiva (r = .27; p = .001), y entre la escala de estrés percibido y las subescalas bruxismo de sueño r = .20 (p = .039) y bruxismo de vigilia r = .29 (p = .002), La correlación entre las subescalas BS y BV fue r = .71 (p = .001), Los resultados del CBA muestran alta confiabilidad, consistencia interna y correlación inter-ítems apropiada, y respaldan la validez convergente del cuestionario. Asimismo, contribuyen a mejorar los estándares de calidad al evaluar los datos subjetivos aportados por personas con bruxismo y se considera de interés continuar con el análisis del CBA, evaluando su comportamiento en otras poblaciones.

Abstract Bruxism is defined as a repetitive jaw-muscle activity, characterized by grinding or clenching the teeth, and /or by bracing or thrusting of the mandible, which has different circadian manifestations, either during sleep (sleep bruxism) or when wakefulness (awake bruxism). For an appropriate clinical diagnosis of bruxism different techniques have been proposed; the most common technique is the usage of a self-reported questionnaire combined with a professional evaluation. While the first is a questionnaire in which the patient expresses their symptoms, the second depends on the presence of observed signs associated according to an evaluator, including tooth wear as well as identify symptoms associated to this jaw-muscle activity, to confirm a clinical diagnosis, there must be a correlation between the self-report questionnaire and clinical diagnosis. Therefore, there is no quantifiable measure that may help to evaluate, from a patient's perspective, the signs and symptoms that belongs to his/her muscle and mandibular activity while assessing both its proportion and measure. To strengthen the self-report technique as a reliable procedure for assessing the information expressed by patient with bruxism, this initial study reports the reliability and validity proprieties of the self-report bruxism questionnaire (CBA). The present study was conducted in Mexico and includes one hundred participants. Fifty percent of them presented a clinical diagnosis of bruxism (n = 50), the other half (control group) do not. In both groups the perceived stress scale (PSS) and the self-reported bruxism questionnaires (CBA) were equally completed on a self-administered way. Both a high internal consistency (α = .884) was found on the eleven items and a corrected item-total correlation ranged from .43 to .78, reflects an adequate reliability. The exploratory factor analysis was used to group the CBA variables; the extraction was made using a main component with Varimax rotation method. The sample adequacy coefficients, the Kaiser Meyer-Olkin (KMO = .826) and Bartlett's Sphericity test (χ2 = 579.866, p = .000) were assessed and expressed an appropriate intercorrelation between items. The factor analysis showed a bifactorial: the latent variables explained one factor of 47.8 % (eigenvalue = 5.26) variance and another of 11.5 % (eigenvalue = 1.27), thus its cumulative variance of this model was 59.36 %. Due to amount of explained variance and the difference between the eigenvalues of this initial solution we considered to prove a unidimensional model. A one solution factor scale was feasible, with factor weights greater than .52 on all items. This single-factor structure was verified in a confirmatory factor analysis, which presented significant values and suitable goodness of fit indexes (χ2/df = 1.461; GFI = .916; AGFI = .857, CFI = .967, RMSEA = .068). Also, a convergent analysis was performed proving a positive (r = .27; p = .001) correlation between the PSS-14 and CBA scales, the correlation with the subscales of self-reported awake bruxism, SAB was positive (r = .299, p = .002). Regarding self-reported sleep bruxism, SAB the correlation was also positive (r = .207, p = .039). The correlation between the subscales was both positive and strong (r = .713, p = .001). Based on the results obtained, we can conclude that, there are a positive, significant, and adequate correlation between PSS-14 scale and the scale of self-reported bruxism, as though as in the sub-scales SAB and SSB. These results suggested that the one factor solution of the CBA has high reliability, internal consistency, and an appropriate inter-item correlation; also, it supports the convergent validity of the questionnaire. Due to the possible contributions of the CBA to the improvement of the quality standards of the evaluation of subjective data provided by people with bruxism, it is suggested to continue with the analysis of the scale in future studies with other populations.

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Animal-assisted therapy aimed at improving individuals' mental or physical health has been widely reported. However, the data on how a therapy dog could help control anxiety during dental procedures is scarce. The objective of this work was to evaluate the effect of dog-assisted therapy on people with a history of dental anxiety while receiving preventive dental treatment. Twelve adults participated (women: n = 11 (91.7%) and men: n = 1 (8.3%), mean age = 31.25 years, D.E. = 5.78). The Corah Dental Anxiety Scale was applied, the patient's mood was assessed with a Likert scale before and after receiving the dental treatment, and their blood pressure was recorded for each of the three stages of treatment. A therapy dog accompanied the participants during the dental procedure. The main results indicated that a decrease in discomfort was perceived during the intervention, and there was also an improvement in the patient's evaluation of the experience. The results are based on the decrease in patients' blood pressure when taken in the middle of the dental treatment.

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Diabetes mellitus (DM) is a frequent worldwide disease. There are currently more than 46 million people who suffer this disease in North America and the Caribbean. The objective of this study was to determine if there is an association between DM and the presence of iron precipitates (Fe2+) in dental structure. The third molar was extracted for reasons that merit extraction from 40 individuals with and without DM to analyze dentin tissue. Horizontal and longitudinal slices of tooth samples were made and later stained with 10% potassium cyanoferrate. The samples were observed by optical microscope to identify basophilic elements. A nonparametric Spearman correlation was performed to find an association between the quantitative (gender, group, and dentinal tissue) and qualitative variables (gender). The Mann-Whitney U test was used to find differences in the means of the nonparametric variables in two different groups in relation to the P value (<0.05). Iron elements were found in the predentin and circumpulpal dentin areas, and the results obtained showed a statistically significant difference between dentin tissue from patients with diabetes and those without. Individuals with Type 2 DM are prone to present iron precipitates in predentin and circumpulpal dentin tissue. Few iron elements were found in dental organs of individuals without DM.

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Con la finalidad de explicar la influencia de los factores psicosociales en las personas con bruxismo autoinformado, el presente trabajo evalúa un modelo explicativo, analizando el proceso estrés-emoción-manejo, basado en la teoría transaccional del estrés. Participaron 128 personas que autoinformaron síntomas de bruxismo. Las variables psicológicas estrés percibido, ansiedad, afrontamiento de autocrítica inadecuado y retirada social, y el rasgo neuroticismo se evaluaron usando cuestionarios autoadministrados de adecuada validez y fiabilidad. Los resultados del modelo estructural final muestran adecuados índices de bondad de ajuste y sugieren que, en este grupo de personas, el afrontamiento como recurso cognitivo y conductual influye en la evaluación cognitiva del estresor y en la manera en la que se interpreta, dando como respuesta física al estrés psicológico la actividad músculo-mandibular de bruxismo

In order to explain the influence of psychosocial factors in people with self-reported bruxism, an explanatory model was evaluated by analyzing the stress-emotion-handling process based on the transactional stress theory. One hundred and twenty eight people, who self-reported symptoms of bruxism, participated in this study. The following psychological variables were evaluated using self-administered questionnaires of adequate validity and reliability: perceived stress, anxiety, inadequate self-critical coping and social withdrawal, and trait neuroticism. The results of the final structural model show adequate Goodness-of-fit indexes and suggest that, within this group of people, coping as a cognitive and behavioral resource has an influence on the cognitive appraisal of the stressor. In addition, the muscle-mandibular activity of bruxism is interpreted as a physical response to psychological stress

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Apexification procedures have been widely used to treat teeth with incomplete root development and pulp necrosis. The middle mesial canal (MMC) is an anatomical variation and in most cases represents a challenge during endodontic treatments. In this article, a favorable outcome is reported after apexification in a molar with MMC.

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Bruxism is a jaw muscle activity that involves physio-pathological, psycho-social, hereditary and genetic factors. The purpose of this study was to determine the associations between self-reported bruxism, anxiety, and neuroticism personality trait with the rs6313 polymorphism in the gene HTR2A. A sample of 171 subjects of both sexes (14-53 years of age) was included. The control group (group 1, n=60) exhibited no signs or symptoms of bruxism. The case group had signs and symptoms of bruxism (n=112) and was subdivided into group 2, bruxism during sleep (n=22); group 3, awake bruxism (n=44); and group 4 combined bruxism (n=46). As diagnostic tools, the Self-Reported Bruxism Questionnaire (SBQ), the Beck Anxiety Inventory (BAI) and the Eysenck Personality Questionnaire Revised-Abbreviated (EPQR-A) were used. HTR2A (rs6313) SNPs were determined by qPCR for all the participants. The packages SPSS, maxLik and EPI-INFO were used for data analysis. The combined bruxism group reported higher scores in bruxism symptoms, mean = 32.21; anxiety symptoms, mean = 14.80; and neuroticism, mean = 3.26. Combined bruxism was associated with a higher degree of neuroticism (OR=15.0; CI 1.52-148.32) and anxiety in grade 3-moderate (OR=3.56; CI 1.27-10.03), and grade 4-severe (OR=8.40; CI 1.45-48.61), as determined using EPISODE computer software. Genotypic homogeneity analysis revealed no significant differences in allele frequency (P=0.612) among the four groups. The population was in Hardy-Weinberg equilibrium (maxLik package). In conclusion, the three instruments confirm traits of bruxism, anxiety and neuroticism in individuals with bruxism. These data were ratified when the sample was divided by genotypic homogeneity. On the other hand, there was no significant difference between the groups in the SNPs rs6313 from the HTR2A gene.

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El objetivo de este trabajo es evaluar la relación entre la ansiedad y el manejo inadecuado de las emociones negativas en personas con síntomas de bruxismo, en una muestra de 192 participantes, separados en grupos sin bruxismo (n = 64) y bruxismo (n = 128), dividido este en los subgrupos bruxismo de sueño (n = 26), bruxismo en vigilia (n = 52) y bruxismo combinado (n = 50). Se utilizó un método descriptivo, no experimental y transversal. Se aplicó el Cuestionario de autoinforme de bruxismo (SBQ), el Inventario de ansiedad de Beck (BAI) y el Inventario de estrategias de afrontamiento (CSI). El análisis estadístico se realizó mediante un modelo de ecuaciones estructurales, con estadísticos de bondad de ajuste de valores adecuados. Los resultados muestran una asociación fuerte y positiva entre el afrontamiento inadecuado, los síntomas de ansiedad y el bruxismo autoinformado. Las estrategias autocritica y retirada social tienen efecto directo sobre los síntomas de ansiedad afectivo-cognitivos y somáticos, y estos síntomas predicen los síntomas clínicos de bruxismo

The aim of this paper was to assess the relationship between anxiety and the mismanagement of negative emotions in people with bruxism symptoms. A total of 192 participants were included and divided into non-bruxism (n = 64) and bruxism (n = 128) groups. The bruxism group was subdivided into sleep bruxism (n = 26), awake bruxism (n = 52), and combined bruxism (n = 50). A non-experimental and cross-sectional descriptive method was used. The self-reported bruxism questionnaire (SBQ), the Beck Anxiety Inventory (BAI) and Coping Strategies Inventory (CSI) were used. Statistical analysis was performed using structural equation modelling and the goodness of fit figures presented adequate values. Results showed a strong positive association between inadequate coping, anxiety symptoms and self-reported bruxism. The model showed that self-criticism and social withdrawal strategies have a direct effect on affective-cognitive and somatic anxiety symptoms; these symptoms predicted the clinical symptoms of bruxism

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Despite being a commonly studied topic, it is difficult to find studies which explain the problem of dental erosion. For this article, literature was analyzed to find information on the agents which trigger dental erosion, the main diagnosis methods, the most common treatments used nowadays and the interrelationship with dental materials. The etiology of dental erosion is multifactorial, including acids, eating disorders and gastro-esophageal reflux. However, biological factors such as saliva or habits also play a part in the establishment of this condition. In order to establish a reliable diagnosis, clinical appearance becomes decisive. The Basic Index Erosive Wear Exami¬nation (BEWE), created in 2008, is an auxiliary diagnosis tool for assessing the status and progress of the erosion. Treatment should be linked to the eradication of the causative agent and it can range from simple observational monitoring of slightly affected teeth to the placement of total crowns in the most severe cases, but this will depend entirely on the extent, severity, symptoms and type of dentition. Regarding dental materials used in the treatment of eroded parts, there are glass ionomer and composite; the latter presents the greatest resistance to biodegradation when interacting with acids. Glass ionomers are the most vulnerable material while resin is seen as the most resistant. In conclusion, dental erosion has become an issue of great importance in the dental practice because of its serious impact on dental structures. Consequently, it is ranked among the most important dental disorders in the present day.

A pesar de ser un tópico altamente examinado, es difícil encontrar estudios que esclarezcan la problemática de la erosión dental. En este trabajo se analizó en la literatura los agentes que desencadenan la erosión dental, los principales métodos de diagnosis, los tratamientos más empleados en la actualidad y la interrelación con los materiales dentales. La etiología de la erosión es multifactorial incluyendo elementos ácidos, desórdenes alimenticios y reflujo gastroesofágico. Sin embargo, los factores biológicos como la saliva o los hábitos también intervienen en el establecimiento de la afección. Para establecer un diagnóstico fiable, la apariencia clínica se vuelve decisiva. Un auxiliar diagnóstico para evaluar el estado y progreso de la erosión es el índice Basic Erosive Wear Examination (BEWE) establecido en el 2008. La terapéutica deberá estar ligada a la erradicación del agente causal y consistirá desde simple observación hasta coronas totales en los casos más severos, pero esta dependerá totalmente de la extensión, severidad, sintomatología y tipo de dentición presente. Dentro de los materiales dentales empleados en el tratamiento de piezas erosionadas, se encuentran el ionómero de vidrio y el composite; siendo este último quien presenta mayor resistencia a la biodegradación al interactuar con elementos ácidos. El ionómero de vidrio constituye el material más vulnerable mientras que la resina se posiciona como la más resisten¬te. La erosión dental se ha vuelto una cuestión de gran importancia en el ámbito odontológico por las graves re¬percusiones que se producen en las estructuras dentales, posicionándola como uno de los desordenes dentales con mayor trascendencia en la actualidad.

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It comes to consulting the Faculty of Dentistry at the University of Nuevo León pediatric male patient of 9 years 10 months, who was admitted with a presumptive diagnosis of hemophilia due to a subsequent persistent bleeding to treatment with steel crowns made in an earlier appointment. Interconsultation is performed with the hematologist who by laboratory examinations notice decreased coagulation factor VIII confirming the diagnosis of hemophilia A. It plans and conducts comprehensive treatment dental team with the hematologist who said that patients in hospitals with the replacement of missing clotting factor is prepared by cryo precipitates or with concentrated factor VIII intravenously before and after his dental intervention. The aim of the article is to highlight that hemophilia can be a disease detected during dental surgery in some patients and for it to be successfully treated with multidisciplinary management protocol is required between hematologists and dentists.

Se presenta a consulta en la Facultad de Odontología de la Universidad Autónoma de Nuevo León paciente masculino pediátrico de 9 años 10 meses, el cual ingresa con un diagnóstico de presunción de hemofilia debido a un sangrado persistente posterior al tratamiento con coronas de acero realizadas en una cita anterior. Se efectúa interconsulta con el hematólogo quien mediante exámenes de laboratorio observa una disminución del factor VIII de coagulación lo que confirma el diagnóstico de hemofilia tipo A. Se planea y realiza el tratamiento integral odontológico en equipo con el hematólogo quien indica que se prepare al paciente a nivel hospitalario con la reposición del factor de coagulación faltante a través de crio precipitados o mediante concentrado del factor VIII por vía intravenosa previo y posterior a su intervención dental. El objetivo del artículo es destacar que la hemofilia puede ser una enfermedad detectada durante la consulta dental en algunos pacientes y que para que éstos sean tratados con éxito se requiere un protocolo del manejo multidisciplinario entre hematólogos y odontólogos.

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