Assessing self-reported oral health status of three Andean indigenous communities in Ecuador

Curtis, Denice; Ortega, Fernando; Monar, Johanna; Bay, R. Curt; Eckhart, Scott; Thompson, Paige

doi:10.4103/jioh.jioh_164_17

Cited by 4 publications

(12 citation statements)

References 2 publications

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“…Collectively, one-third of the mothers had experienced oral pain within the last 3 months and one-third of the children were experiencing oral pain at the time of the interview. Because dental care is often utilized only when symptoms arise, treatment is frequently limited to emergency care such as dental extraction, a common practice in many LMICs [33][34][35]. Antibiotics are also commonly given to treat abscesses, which can contribute to the proliferation of antibioticresistant bacterial strains [36], and analgesics including opioids are commonly given to treat pain, which can contribute to opioid addiction and overdoses [37].…”

Section: Discussionmentioning

confidence: 99%

Cross-Sectional Analysis of Oral Healthcare vs. General Healthcare Utilization in Five Low- and Middle-Income Countries

Susarla

Trimble

Sokal-Gutierrez

2022

Front. Oral. Health

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Oral health is integral to overall health and is often neglected, especially in low- and middle-income countries (LMICs). Oral disease, including untreated dental caries, affects nearly 3.5 billion people globally, contributing to poor health and quality of life. To examine the relationship between the utilization of general healthcare and oral healthcare, we conducted an exploratory cross-sectional study of first-visit interview data collected from a convenience sample of 3,422 low-income mothers and 4,324 children aged 6 months through 6 years participating in a community-based oral health and nutrition program in five LMICs (Ecuador, El Salvador, India, Nepal, and Vietnam) from 2006–2015. We used descriptive and exploratory association analysis to identify patterns of oral healthcare utilization for mothers and children compared to medical care utilization, specifically maternal prenatal care and child immunizations. Overall, 89.6% of the mothers had received prenatal care for at least one child, but only 76.4% had ever received dental care and 50% were currently suffering from oral health symptoms, primarily oral pain. Mothers who received prenatal care were significantly more likely to have accessed dental care compared to those who had not received prenatal care (OR = 2.62, 95% CI: 2.06, 3.32). Overall, 95.4% of the children had current immunizations, but only 30.1% had ever received dental care, and 32.4% were currently suffering from oral pain. Children whose immunizations were up-to-date were more likely to have received dental care, with a significant association in Ecuador (OR = 3.29, 95% CI: 2.06, 5.30). Compared to utilization of general healthcare, oral healthcare was under-utilized by mothers and children in our sample from five LMICs. Integration of prevention- and treatment-oriented oral healthcare into primary medical care services, particularly prenatal care and child immunizations, could help increase access to oral healthcare and improve women's and children's oral health.

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Section: Discussionmentioning

confidence: 99%

Cross-Sectional Analysis of Oral Healthcare vs. General Healthcare Utilization in Five Low- and Middle-Income Countries

Susarla

Trimble

Sokal-Gutierrez

2022

Front. Oral. Health

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“…One of the key elements to consider in the deployment of IOHP is the management of financial and material resources in the developmental stage (8,(45)(46)(47). As this project and other scholars have shown, the lack of stable financial resources affects both the deployment and monitoring of IOHP interventions (12,48), particularly in remote areas considering the costs associated with remoteness (49). The Peruvian health system faces several other health priorities, particularly in rural areas (25), which may explain the limited resources deployed in OH.…”

Section: Discussionmentioning

confidence: 93%

Intersectoral oral health promotion interventions for schoolchildren living in remote rural Andean communities: a realist evaluation

2019

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Background: Intersectoral oral health promotion entails the participation of local communities. IOHP interventions were introduced in Peru in primary schools in 2013 but oral health among schoolchildren living in rural Andean communities remains suboptimal. Objectives: To understand the contextual elements and the underlying mechanisms associated with intersectoral oral health promotion interventions’ current effects on schoolchildren living in remote rural Andean communities. Method: A realist evaluation was carried out in three rural Andean communities where intersectoral oral health promotion interventions aimed at schoolchildren have been implemented. Following an evaluation of the effects among schoolchildren, contextual elements and mechanisms were explored with various stakeholders involved in intersectoral oral health promotion through focus groups and semi-structured interviews. Subsequently, an iterative data analysis and a validation process resulted in the identification of context-mechanism configurations. Results: Previous positive experiences of collaboration, a focus on communication, feelings of being respected and considered, and development of leadership and trust among stakeholders involved in intersectoral oral health promotion were elements of configurations that positively influence intersectoral oral health promotion. On the other hand, unfavorable physical, social and political environments, previous negative health experiences, feelings of not being respected or considered, demotivation, development of mistrust and insufficient leadership were shown to negatively influence outcomes. Conclusion: This research highlights the complexity associated with the deployment of intersectoral oral health promotion interventions in rural communities. Local stakeholders should be further involved to build trust, to facilitate coordination processes among remote rural communities and oral health professionals, and to optimize deployment of intersectoral oral health promotion interventions.

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“…[ 1 ] Next, rural communities in Latin America have undergone, in last decades, major changes in their traditional lifestyle, including the introduction of various processed foods rich in refined sugar, which increase the prevalence of DC among children. [ 38 ] Other factors specific to rural areas, such as the geographical remoteness (which limits access to fresh healthy foods, OH products,[ 38 ] and OH services[ 27 28 , 39 ]), and social and cultural particularities[ 40 ] might explain the actual OH status among schoolchildren living in rural area. Several other factors associated with the health systems such as the lack of financial, material and human resources,[ 1 40 ] downstream implementation process, insufficient cooperation with local stakeholders,[ 1 ] and “health-system-related determinants”[ 40 ] might also help to explain the current situation.…”

Section: Discussionmentioning

confidence: 99%

“…To understand more precisely which interactions of factors contribute most strongly to the present OH status of schoolchildren, it is necessary to have a more holistic vision[ 28 41 ] and several levels of analysis (macro, meso, and micro). [ 41 ] This process can help to tailor OHP interventions to the realities of remote rural communities,[ 28 39 ] and encourage the involvement of different local stakeholders in OHP activities. [ 1 ]…”

Section: Discussionmentioning

confidence: 99%

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Oral health status of schoolchildren living in remote rural Andean communities: A cross-sectional study

Bergeron

Talbot

Gaboury

2020

J Int Soc Prevent Communit Dent

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A BSTRACT Objective: Oral health promotion (OHP) was introduced in Peruvian primary schools in 2013, and no evaluation has been undertaken in rural areas since then. To measure OHP outcomes, this cross-sectional study aimed to assess the oral health (OH) status of schoolchildren living in a remote rural area of the Cusco region. Materials and methods: Sixty-six children were recruited in three remote rural communities and in a rural district capital. Six dimensions of OH (knowledge, attitudes, behaviors, dental plaque, dental caries, and quality of life related to OH) were measured using self-administered questionnaires and dental examinations. Wilcoxon–Mann–Whitney tests were conducted to compare outcomes between two types of settings (remote rural community and district capital). Multiple linear regression models were fit to identify which variables can explain the variance observed in the decayed, missing, and filled teeth (DMFT) index. Results: The median percentage of dental plaque in remote rural communities was 78.7+ (interquartile range [IQR] 71.5–82.8) and 78.6+ (IQR 72.7–82.2) in the district capital ( P = 0.90). The prevalence of dental caries was estimated to be 94.1+ (95+ confidence interval [CI] 71.1–>99.9) in the district capital and 98.0+ (95+ CI 88.3–>99.9) in remote rural communities ( P = 0.43). Conclusion: These results suggested that OHP interventions had not reached their full potential. Identifying different factors that influence the reported outcomes would provide a more comprehensive understanding and help to tailor OHP interventions.

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Assessing self-reported oral health status of three Andean indigenous communities in Ecuador

Cited by 4 publications

References 2 publications

Cross-Sectional Analysis of Oral Healthcare vs. General Healthcare Utilization in Five Low- and Middle-Income Countries

Cross-Sectional Analysis of Oral Healthcare vs. General Healthcare Utilization in Five Low- and Middle-Income Countries

Intersectoral oral health promotion interventions for schoolchildren living in remote rural Andean communities: a realist evaluation

Oral health status of schoolchildren living in remote rural Andean communities: A cross-sectional study

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