RESUMO
This paper reviews recent data on sugar consumption in developing countries that may lead to a potential increase in caries prevalence. A search of the business, dental and nutritional literature was conducted through May 1995. There is evidence that sugar (sucrose) use was increasing in China, India, and Southeast Asia. In South and Central America (except Haiti) sugar use was either equivalent to or higher than that in most developed societies. In the Middle East, average sugar use was higher than that of other developing areas. However, it was either lower than or equivalent to the levels reported by other developed countries. Many central African countries consumed less than 15 kg of sugar/ person/year. Of particular concern is a rise in the consumption of sugar-containing carbonated beverages in a number of developing societies: China, India, Vietnam, Thailand, and other Southeast Asian countries are currently major growth markets for the soft drink industry. Consumption of high-sugar desserts and snacks may also be increasing in urban centers in some developing countries. To counteract the potential increase in the prevalence of dental caries in some developing countries, preventive and oral health promotion programs should be planned and implemented. We contend that taxation of sugar-containing products as well as efforts to reduce the level of sugar consumption to "safe" levels may be impractical, and in most countries, cannot be supported for political, economic, or health reasons. Instead, we recommend that collaboration be established between public health authorities and manufacturers/distributors of soft drinks and sweets in developing countries to establish a dental health fund that could be used to support caries preventive programs. The fund could be supported through donations from manufacturers based on the principle of the "milli-cent" (1 cent for every 1000 cents of sales). This minimal contribution would provide enough financial support for planning and implementing dental preventive and restorative programs in developing countries.
Assuntos
Países em Desenvolvimento , Sacarose Alimentar/administração & dosagem , África Central/epidemiologia , Sudeste Asiático/epidemiologia , Bebidas Gaseificadas/estatística & dados numéricos , América Central/epidemiologia , China/epidemiologia , Cárie Dentária/epidemiologia , Cárie Dentária/prevenção & controle , Serviços de Saúde Bucal , Restauração Dentária Permanente , Países Desenvolvidos/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Sacarose Alimentar/efeitos adversos , Comportamento Alimentar , Apoio Financeiro , Alimentos , Indústria de Processamento de Alimentos , Promoção da Saúde , Humanos , Índia/epidemiologia , Oriente Médio/epidemiologia , Saúde Bucal , Prevalência , Odontologia Preventiva , Saúde Pública , América do Sul/epidemiologia , Impostos , Saúde da População UrbanaRESUMO
This paper describes the prevalence of total tooth loss, dental caries, and periodontal disease in 2,226 Puerto Ricans, 1,192 Cuban Americans, and 5,983 Mexican Americans, ages five to 74 years, who were examined during the 1982-84 Hispanic Health and Nutrition Examination Survey (HHANES). The prevalence of total tooth loss was 2.60, 6.10, and 2.80 percent among Mexican Americans, Cuban Americans, and Puerto Ricans, respectively. After adjusting for the confounding effects of age, sex, income, and education status, no statistically significant differences were found in the mean number of decayed teeth among the three groups of Hispanics. Puerto Rican children had an average of 2.09 filled teeth compared with an average of 1.39 and 1.43 filled teeth for Mexican Americans and Cuban Americans, respectively. In adults, Puerto Ricans and Cuban Americans had at least 40 percent higher mean number of filled teeth than Mexican Americans. Cuban American and Puerto Rican adults had about twice as many missing teeth as Mexican Americans. The pit-and-fissure tooth surfaces in children accounted for the majority of sites affected by caries. All Hispanics had a higher prevalence of gingivitis than American adults as estimated during the 1985-86 National Institute of Dental Research (NIDR) survey of American adults. Puerto Ricans had the highest level of periodontal disease and the highest Debris Index scores among the Hispanic groups.
Assuntos
Cárie Dentária/etnologia , Inquéritos de Saúde Bucal , Hispânico ou Latino/estatística & dados numéricos , Doenças Periodontais/etnologia , Perda de Dente/etnologia , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Cuba/etnologia , Cárie Dentária/epidemiologia , Restauração Dentária Permanente/estatística & dados numéricos , Feminino , Humanos , Masculino , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Doenças Periodontais/epidemiologia , Prevalência , Porto Rico/etnologia , Fatores Sexuais , Perda de Dente/epidemiologia , Estados Unidos/epidemiologiaRESUMO
This article presents the results of a cross-sectional analysis of the prevalence of dental caries and periodontal disease, as well as the use of dental services, among 395 low acculturated dentate Mexican-Americans, 12-74 years of age, examined during the southwestern portion of the Hispanic Health and Nutrition Examination Survey (HHANES). Comparisons were carried out with 1,894 dentate Mexican-Americans who had high acculturation status. Mexican-American adolescents and adults with low acculturation status had 73 and 116 percent higher mean number of decayed and missing teeth, respectively, compared with those with high acculturation status. The differences between the two groups, however, did not remain statistically significant when the confounding effects of age, sex, education, and income status were taken into account. Gingivitis and periodontal pocketing were highly prevalent in both groups, but those with low acculturation status had significantly higher disease levels than those with high acculturation status. Despite the unmet dental needs and the higher prevalence of dental caries and periodontal disease, Mexican-Americans with low acculturation status were significantly less likely than those with high acculturation status to have dental insurance and to have visited the dentist as frequently.
Assuntos
Aculturação , Assistência Odontológica/estatística & dados numéricos , Cárie Dentária/epidemiologia , Hispânico ou Latino , Doenças Periodontais/epidemiologia , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Índice CPO , Cárie Dentária/etnologia , Humanos , México/etnologia , Pessoa de Meia-Idade , Índice de Higiene Oral , Doenças Periodontais/etnologia , Índice Periodontal , Prevalência , Sudoeste dos Estados Unidos/epidemiologiaRESUMO
Analysis of Southwestern HHANES data showed that the prevalence of dental caries among Mexican-American children is similar to that of children of the same age examined during the NIDR survey (1979-1980), despite a lower level of restorative treatment. Approximately 50% of Mexican-American children 17 years of age, however, had five or more teeth that were either decayed or filled. Occlusal surfaces of molars were the most susceptible teeth to decay; few anterior teeth were affected. This distribution of dental caries strongly supports the use of fissure sealants on molar teeth. Children from low-income families had two times more decayed teeth than children from high-income families. Mild gingivitis and poor oral hygiene were more prevalent in the Mexican-American children than in the child population for the region examined during NHANES I in 1971-1974. Children from high-income families had better periodontal health than those from low-income families.
Assuntos
Cárie Dentária/epidemiologia , Hispânico ou Latino , Doenças Periodontais/epidemiologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Índice CPO , Métodos Epidemiológicos , Feminino , Gengivite/epidemiologia , Humanos , Masculino , México/etnologia , Distribuição Aleatória , Fatores Sexuais , Fatores Socioeconômicos , Estados UnidosRESUMO
The Southwestern portion of the Hispanic Health and Nutrition Examination Survey (HHANES) was conducted by the National Center for Health Statistics (NCHS) in 1982 and 1983. The survey population was Mexican-Americans residing in five Southwestern states. This report presents data on the prevalence of total tooth loss, dental caries, and periodontal diseases in 3860 Mexican-American adults aged from 18 to 74. Results show that 4.3% of this group was edentulous. Among the dentate, Mexican-Americans had lower overall DMF scores but higher numbers of untreated decayed teeth than did residents of the same region seen in the NHANES I survey in 1971-1974. Caries of the smooth surfaces in both posterior and anterior teeth was more pronounced in the older than in the younger age groups. Mexican-Americans had more gingivitis but fewer periodontal pockets than did the general population in the Western states during NHANES I. The caries pattern in the Mexican-Americans suggests that caries among adults may remain a problem in the future, with the possibility of increased involvement with the aging, although modest, of smooth tooth surfaces.
Assuntos
Cárie Dentária/epidemiologia , Hispânico ou Latino , Arcada Edêntula/epidemiologia , Doenças Periodontais/epidemiologia , Adolescente , Adulto , Idoso , Índice CPO , Feminino , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Índice de Higiene Oral , Pobreza , Estados UnidosAssuntos
Doenças Periodontais/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Depósitos Dentários/epidemiologia , Educação , Inserção Epitelial/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New Mexico , Índice de Higiene Oral , Doenças Periodontais/etnologia , Doenças Periodontais/patologia , Fatores SexuaisRESUMO
The purpose of this study was to describe the distribution of advanced periodontal destruction (pocket depth equal to or deeper than six mm) in continuous residents, aged 27 to 74 years, of Lordsburg and Deming, New Mexico. The distance from the free gingival margin to the base of the gingival crevice or pocket was measured on the facial and mesiofacial sides of six index teeth. The presence of supragingival calculus, subgingival calculus, and plaque, as well as gingival bleeding around the index teeth, also were evaluated. Of the 372 examinees, only 46 individuals (12.4 percent) had at least one deep pocket equal to or deeper than six mm on at least one site on the six index teeth. Age was significantly associated with prevalence of deep pockets, although about 80 percent of those aged 47 to 74 years did not have deep pockets. Of those with deep pockets, 89.1 percent had fewer than four tooth sites (out of 12) affected. The only significant risk factor of the presence of deep pockets, other than age, was the number of teeth with plaque accumulations. Age and the number of teeth with plaque explained only 10.5 percent of the variability in the prevalence of deep pocketing, suggesting that risk factors other than those included in this study may be important. The results of this study indicate that destructive periodontal disease occurs at selected sites within the mouth, and that about 87 percent of the adults over age 27, in this population, do not have deep pockets in the six index teeth examined.