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Browsing by Author "Martinez Mier, Esperanza Angeles"
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Item Blood levels of lead and dental caries in permanent teeth(Wiley, 2020) Yepes, Juan F.; McCormick-Norris, Jayme; Vinson, LaQuia A.; Eckert, George J.; Hu, Howard; Wu, Yue; Jansen, Erica C.; Peterson, Karen E.; Téllez-Rojo, Martha M.; Martinez Mier, Esperanza Angeles; Pediatric Dentistry, School of DentistryObjectives: The purpose of this study was to determine whether there is an association between lead exposure within the ages of 1-4 years and dental caries in the permanent dentition between ages 9-17 among Mexican youth. Methods: Data were collected for the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort from a group of 490 children born and reared in Mexico City. Among ages 1-4 years, blood lead levels were measured in micrograms of lead per deciliter of blood (μg/dL) and the presence of caries in adolescence was determined using the International Caries and Detection and Assessment System (ICDAS). The relationship between blood levels of lead and decayed, missing, or filled surfaces (DMFS) was examined using negative binomial regression. Covariates were selected based on previous studies and included age, gender, socioeconomic status, oral hygiene, body mass index, and diet. The nonlinear relationship between lead and DMFS was examined using smoothing splines. Results: The mean overall blood lead level (BLL) was 4.83 μg/dL (S.D. of 2.2). The mean overall caries level (DMFS) was 4.1. No statistically significant association was found between early childhood blood lead levels and dental caries in adolescence. Conclusion: This study shows a lack of association between exposure to lead between the ages of 1-4 years of age and dental caries in permanent dentition later in life. Other covariates, such as age and sugar consumption, appeared to play a more prominent role in caries development.Item Distal and Proximal Influences on Self-Reported Oral Pain and Self Rated Oral Health Status in Saudi Arabia, 2017(2022-08) Abogazalah, Naif Nabel F.; Martinez Mier, Esperanza Angeles; Yepes, Juan Fernando; Yiannoutsos, Constantin T.; Bindayel, Naif A.; Soto Rojas, Armando ErnestoAlthough complex phenomena such as oral diseases can be studied using generalizable conceptual frameworks, the differences in the underlying influences across countries necessitate adaptation of existing oral health frameworks to the specific conditions in each country. The aim of this dissertation was to investigate distal (indirect) and proximal (direct) influences of oral health and their interactions with both self-reported oral pain (OP) and self-rated oral health status (SROH) in Saudi Arabia (SA). Two secondary data analyses were conducted utilizing data from the national demographic and health survey (DHS) of SA in 2017. The objective of the first study was to describe the study design, and the distal and proximal influences reported in the 2017 SA DHS. The objective of second study was to explore associations between proximal and distal factors that affect OP and SROH, using the adapted framework. Path analysis modeling was used to estimate direct, indirect, and total effects. The 2017 SA DHS used an innovative multistage stratified random-sampling technique to select the population sample by using primary health care centers’ catchment areas as the primary sampling unit. The final analysis included 29,274 adults, 9910 adolescents, and 11653 children. OP in the past year was experienced in 39% in children and, 48.5% for the adolescents, and 47.1% in adults. The proportion of respondents who reported good, very good, or excellent self-rated oral health status was 92.9 % in children, 87.1% in both adolescents and adults. In children group, OP was linked to less tooth brushing, more dental visits and less dental routine examination, while less favorable SROH was linked to less tooth brushing, more dental visits and sweets consumption. In adolescents and adults groups, OP and less favorable SROH were linked to more dental visits, complaint dental visits, less tooth brushing. Many distal influences showed significant effects (direct, indirect, and total) on OP and SROH; however, differences existed among the three age groups. The studies suggest that future investigations should focus on why Saudi residents perceive their oral health positively while the prevalence of negative oral health influences and OP was high.