Factores de riesgo de caries en escolares mediante el Sistema Internacional de Clasificación y Manejo de Caries (ICCMS tm)

Abstract

La caries es una enfermedad multifactorial y un problema de salud pública, 60-90% de escolares en todo el mundo la padecen. Diversas variables denominadas factores de riesgo han sido propuestas y evaluadas para su predicción. Objetivo: Identificar los factores de riesgo de caries a nivel de paciente (extraoral) e intraoral en escolares de 12 años, aplicando el Sistema Internacional de Clasificación y Manejo de Caries (ICCMSTM). Método: Se realizó un estudio transversal, universo de estudio (60 escolares 12 años y 60 padres), ambos sexos de una escuela primaria pública. La muestra fue por conveniencia, 30 escolares y 30 cuidadores. Se realizó entrevista y examen clínico, se evaluó: higiene bucal de los escolares mediante IHOS-S, flujo salival (prueba saliva en reposo), detección PUFA, CPOD (escolares y padres), nivel socioeconómico (NSE) por AMAI, barreras de acceso a servicios de salud bucal, frecuencia y consumo de azúcares. Se calculó el nivel de riesgo de caries CAMBRA, se evaluó la actividad cariogénica y se categorizó según ICDAS-ICCMSTM. Mediante un análisis estadístico descriptivo, prueba de Chi cuadrada y uso de la matriz ICCMSTM se determinó la probabilidad de nuevas lesiones de caries. Resultados: La prevalencia de caries en escolares 60.0% (95% IC:40.6-77.3) y padres 76.7% (95% IC:57.7-90.0), ambos con experiencia moderada CPOD 3.13±2.86 (C=2.73±2.82, P=0, O=0.40±1.0) y CPOD 9.5±5.76 (C=4.23± 3.30, P=1.07± 1.68, O=4.20± 4.16) respectivamente. El 56.7% escolares presentaron higiene bucal buena y 43.3% regular, 50.0% nivel riesgo alto CAMBRA donde 13.3% presentaron Hiposalivación, 46.7% caries (36.7% padres), 43.3% asistieron a consulta dental por dolor, 90.0% manifestaron un elevado consumo de azúcares, 86.7% NSE medio y 53.3% no contaban con servicios de salud, 33.3% presentaron lesiones en estadio moderado siendo el indicador de enfermedad. De acuerdo con ICCMSTM, 50% de escolares tuvieron una alta probabilidad de riesgo, 10.0% moderado y 40.0% bajo. Conclusiones: La presencia de lesiones cariosas activas fueron un fuerte indicador de riesgo de caries en los escolares que tuvieron una asociación estadísticamente significativa. El 50% se clasificaron en estado de riesgo CAMBRA alto y la probabilidad de riesgo de caries ICCMSTM fue del 50.0%, siendo mayor en el sexo femenino

Dental caries is a multifactorial disease and a public health problem. 60-90% of children in schools suffer from it worldwide. Various variables called risk factors have been proposed and evaluated for their prediction. Objective: Identify caries risk factors at the patient level (extraoral) and intraoral in 12-year-old schoolchildren using the International Caries Classification and Management System (ICCMTM). Method: A cross-sectional study was carried out, with a universe (60 school children, 12 years old and 60 parents) of both genders from a public primary school. The sample was for convenience, 30 schoolchildren and 30 caregivers. An interview and clinical examination were carried out, it was evaluated: oral hygiene of schoolchildren using IHOS-S, salivary flow (resting saliva test), PUFA detection, DMFT (schoolchildren and parents), socioeconomic level (NSE) by AMAI, access barriers to oral health services, frequency, and consumption of sugars. The CAMBRA caries risk level was calculated, the cariogenic activity was evaluated, and it was categorized according to ICDAS-ICCMSTM. The probability of new caries lesions was determined by means of a descriptive statistical analysis, Pearson Chi- square test and use of the ICCMSTM matrix. The prevalence of caries in schoolchildren 60.0% (95% CI:40.6-77.3) and parents 76.7% (95% CI:57.7-90.0), being the moderate experience for both DMFT 3.13±2.86 (D=2.73±2.82, M=0, F=0.40±1.0) and DMFT 9.5±5.76 (D=4.23± 3.30, M=1.07± 1.68, F=4.20± 4.16) respectively. 56.7% school children presented good oral hygiene and 43.3% regular, 50.0% were CAMBRA high risk level where 13.3% presented hyposalivation, 46.7% caries (36.7% parents), 43.3% attended dental consultation due to pain, 90.0% manifested a high consumption of sugar, 86.7% average NSE and 53.3% did not have health services, 33.3% had moderate stage lesions being the indicator of disease. According to ICCMSTM, 50.0% of schoolchildren had a high probability of risk, 10.0% moderate and 40.0% low. Conclusions: The presence of active caries lesions was a strong predictor of caries risk in schoolchildren that had a statistically significant, 50% were classified as CAMBRA high risk and the probability of risk of ICCMSTM caries was 50.0%, being higher in the female gender.