PROGRAMA PREVENTIVO EN SALUD ORAL PARA CONTROLAR FACTORES DE RIESGO ASOCIADOS A CARIES DENTAL Y ENFERMEDAD PERIODONTAL EN MUJERES GESTANTES
Palabras clave:
Mujeres gestantes, Enfermedad periodontal, Factores de riesgo, Transmisión de Streptococcus mutans
Resumen
Objetivo: Diseñar, ejecutar y evaluar la efectividad de un programa preventivo en salud oral para controlar los factores de riesgo asociados a caries y enfermedad periodontal en las gestantes afiliadas a una EPS, en Bucaramanga.
Materiales y métodos: Cuarenta gestantes que se encontraban en el segundo y tercer trimestre de embarazo se dividieron, aleatoriamente, en grupo experimental (20) y control (20). A los dos grupos se les suministró un cuestionario sobre creencias en salud oral y prácticas de higiene oral; el estado periodontal, dental y de higiene oral inicial así como las necesidades de tratamiento fueron evaluadas a través de un examen clínico antes y después de un programa preventivo. El grupo experimental recibió terapia mecánica, kits de higiene oral, una conferencia y un video. El grupo control recibió la estrategia educativa desarrollada por la EPS. Para comparar según tipo de intervención se aplicó el test de X2 y exacto de Fisher para las variables cualitativas y prueba t de student o test de rangos de Wilcoxon para las cuantitativas.
Resultados: Para el índice de creencias y prácticas saludables sólo se observaron diferencias estadísticamente significativas entre grupo intervenido y control después de la intervención (p<0.0001 y p<0.001, respectivamente) siendo mejores en el grupo intervenido; igual fenómeno se observó para el índice periodontal comunitario (p<0.001). Para el índice cuantificado de placa se observaron diferencias estadísticamente significativas entre el grupo intervención y el control antes de la intervención (p=0.0038), el grupo control reportó mejor nivel de higiene. Sin embargo, después de la intervención la significancia estadística (p<0.0001) demostró una mejor higiene en el grupo intervenido.
Conclusión: La evidencia parece demostrar que este tipo de programas son eficientes y las EPS pueden implementar estas acciones sin mayor inversión y garantizar la prestación de un servicio integral que se ajuste a las necesidades de esta población.
[Riveros CM, Rodríguez MJ. Programa preventivo en salud oral para controlar factores de riesgo asociados a caries dental y enfermedad periodontal en mujeres gestantes Revista Ustasalud Odontología 2007; 6 17 - 28]
Referencias
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2. Herrera JA. Aplicación de un modelo biopsicosocial para la reducción de la morbilidad y mortalidad materna y perinatal en Colombia. Ministerio de Salud. República de Colombia. 1997.
3. Suresh L, Radfar L. Pregnancy and lactation. Oral Surg Oral Med Oral Pathol 2004; 97: 672 - 681.
4. Chacón AF, Gutiérrez ZA, Montañez J, Pieschacón MP, Camargo DM. Factores asociados a caries y enfermedad periodontal en mujeres gestantes, Bucaramanga 2001. Revista Ustasalud 2002; 1: 33 – 39.
5. Kinnby B, Matsson L, Astedt B. Aggravation of gingival inflammatory symptoms during pregnancy associated with the concentration of plasminogen activator inhibitor type 2 (PAI-2) in gingival fluid. J Periodon Res 1996; 3: 271-277.
6. Chamoschine FF, Cardoso M, Lindares SR, De Oliveira V. Processo de saúde-doencas peridontal genograma. Associação Brasileira de Odontologia – ABO-DF Escola de Aperfeiçoamento Profissional – DF Pós-Graduação em Saúde Coletiva. Brasília, julho de 2003.
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8. Academy Report. Position Paper Diagnosis of Periodontal Diseases. J Periodontol 2003; 74: 1237 - 1247.
9. Wiebe C, Putnins E. The periodontal disease classification system of the American Academy of Periodontology - An Update. J Can Dent Assoc 2000; 66: 594 - 597.
10. Academy Report. Position Paper. Periodontal diseases of children and adolescents. J Periodontol 2003; 74: 1696 - 1704.
11. Lopez NL, Smith PC, Gutierrez J. Higher risk of preterm birth and low birth weight in women with periodontal disease. J Dent Res 2002; 81: 58 - 63.
12. Offenbacher S, Katz V, Fertik G. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 1996; 67: 1103 - 1113.
13. Dasanayake AP. Poor periodontal health of the pregnant woman as a risk factor for low birth weight. Ann Periodontol. 1998; 3: 206 - 212.
14. Offenbacher S, Jared HL, O ́Reilly PG. Potential pathogenic mechanisms of periodontitis associated pregnancy complications. Ann Periodontol 1998; 3: 233 - 250.
15. Lopez NL, Smith PC, Gutierrez J. Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: A randomized controlled trial. J Periodontol 2002; 73: 911 - 924.
16. Saméer AM, Ghadeer NM. The Prevalence and relationship between periodontal disease and pre-term low birth weight infants at King Khalid University Hospital in Riyadh, Saudi Arabia. J Contemp Dent Practice 2004; 5: 2.
17. Diaz GL, Castellanos SJ. Lesions of the oral mucosa and periodontal disease behavior in pregnant patients. Med Oral Patol Oral Cir Bucal 2002; 9: 430 - 437.
18. Yeo BK, Lim LP, Paquette DW, Williams RC. Periodontal disease – The emergence of a risk for systemic conditions: pre-term low birth weight. Ann Acad Med Singapore 2005; 34: 111 - 116.
19. Davenport ES, Williams CE, Sterne JA, Murad S, Sivapathasundram V, Curtis MA. Maternal periodontal disease and preterm low birth weight: case-control study. J Dent Res 2002; 81: 313 - 318.
20. Louro MP, Fiori HH, Louro FP, Steibel J, Fiori MR. Periodontal disease in pregnancy and low birth weight. J Pediatr (Rio J) 2001; 77: 23 - 28.
21. Felice P, Pelliccioni GA, Checchi L. Periodontal disease as a risk factor in pregnancy. Minerva Stomatol 2005; 54: 255 - 264.
22. Löe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963; 21: 533 - 551.
23. Jarjoura K, Devine PC, Perez-Delboy A, Herrera-Abreu M, D’alton M, Papanou PN. Markers of periodontal infection and preterm birth. Am J Obstet Gynecol 2005; 192: 513 – 519.
24. Goepfert AR, Jeffcoat MK, Andrews WW, Faye-Petersen O, Cliver SP, Goldenberg RL, Hauth JC. Periodontal disease and upper genital tract inflammation in early spontaneous preterm birth. Obstet Gynecol 2004; 104: 777 – 783.
25. Lopez NL, Smith PC, Gutierrez J. Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: A randomized controlled trial. J Periodontol 2002; 73: 911 - 924.
26. Academy Report. Treatment of plaque-induced gingivitis, chronic periodontitis, and other conditions. J Periodontol 2001; 72:1790 - 1800.
27. Academy Report. Position Paper. Guidelines for Periodontal Therapy. J Periodontol 2001; 72: 1624 - 1628.
28. Aaltonen AS, Tenovuo J. Association between mother-infant salivary contacts and caries resistance in children: a cohort study. Pediatr Dent 1994; 16: 110 – 116.
29. Lindquist B, Emilson CG. Colonization of Streptococcus mutans and Streptococcus sobrinus genotypes and caries development in children to mothers harboring both species. Caries Res 2004; 38: 95 – 103.
30. Tanner AC, Milgrom PM, Ketn R Jr, Mokeen SA, Page RC, Liao SI Riedy CA, Bruss JB. Similarity of the oral microbiota of pre-school children with that of their caregivers in a population-based study. Oral Microbiol Immunol 2002; 17: 379 – 387.
31. Mattos-Graner RO, Li Y, caufiled PW, Duncan M, Smith DJ. Genotypic diversity of mutans streptococci in Brazilian nursery children suggests horizontal transmission. J Clin Microbiol 2001; 39: 2313 – 2316.
32. Arango M, Baena G. Caries de la infancia temprana y factores de riesgo. Revisión de la literatura. Revista Estomatología 2004. 12: 59 - 65.
33. Zanata RL, Navarro MF, Pereira JC, Franco EB, Lauris JR, Barbosa SH. Effect of caries preventive measures directed to expectant mothers on caries experience in their children. Braz Dent J 2003; 14: 75 -81.
34. Palomari DM, Höfling JF, Pizolitto AC, Rosa EA, Negrini TC, Spolidorio LC. Genetic polymorphism of Streptococcus mutans in Brazilian family members. Brazilian J Microbiol 2003; 34: 213 - 217.
35. Grönroos L, Saarela M, Matto J, Tanner-Salo U, Vuorela A, Alaluusua S. Mutacin production by Streptococcus mutans may promote transmission of bacteria from mother to child. Infect and immun 1998; 2595 - 2600.
36. Berkowitz RJ. Acquisition and transmission of Mutans Streptococci. J Calif Dent Assoc 2003; 31: 135 - 138.
37. Berkowitz RJ, Jordan V. Similarity of bacteriocins of Streptococcus mutans from mother and infant. Arch Oral Biol 1982; 26: 147 – 149
38. Van AKL, Seon WK, Purdie DM, Bird PS, Walsh LJ, Tudehope DI. Oral colonization of Streptococcus mutans in six-month-old predentate infants. J Dent Res 2001; 80: 2060 - 2065.
39. Van AKL, Seon WK, Purdie DM, Bird PS, Walsh L J, Tudehope DI. A longitudinal study of Streptococcus mutans colonization in infants after tooth eruption. J Dent Res 2003; 20: 504 - 508.
40. Kohler B, Brattahall D, Krasse B. Preventive measures in mothers influence the establishment of the bacterium Streptococcus mutans in their infants. Arch Oral Biol 1983; 28: 225 – 231.
41. Caufield PW, Cutter GR, Dasanayake AP. Initial acquisition of mutans streptococci by infants: evidence for a discrete window of infectivity. J Dent Res 1993; 72: 37 - 45.
42. Ekstrand KR, Christiansen m, Qvist V. Influence of different variables on the inter-municipality variation in caries experience in Danish adolescents. Caries Res 2003; 37:130 - 41.
43. El método Nexodent. Un programa no operativo de tratamiento de caries NOCTP. URL disponible en: http://www.nexodent.dk.
44. Lima KC, Neves AA, Sanchez AL, Valente AG, Marsia JG, Castro RA, Ribeiro AA. Relevância clínica do conceito de transmissibilidade da cárie dental. J Bras Odontopediatr Odontol Bebê 2002; 5: 113 – 118.
45. República de Colombia. Ministerio de Salud. III Estudio Nacional de Salud Bucal – ENSAB III, II Estudio Nacional de factores de riesgo de enfermedades crónicas – ENFREC II, 1999.
46. Greene JC Vermillon JR. The oral hygiene index: a method for classifying oral hygiene status. J Am Dent Assoc 1960; 61: 172.
47. Greene JC, Vermillon JR. The simplified oral hygiene index. J Am Dent Assoc 1964; 68: 7.
48. Ferreira A, Benfatti S, Bausells J. Evaluación del conocimiento de las prácticas de salud bucal en gestantes del municipio de Adamantina –SP. Rev Ibero-am Odontopediatr Odontol Bebe 2004; 75: 66 - 77.
49. Garbero I, Delgado A, De Cardenas B. Salud oral en embarazadas: Conocimientos y actitudes. Acta Odontológica Venezolana 2005; 43: 135 - 140.
2. Herrera JA. Aplicación de un modelo biopsicosocial para la reducción de la morbilidad y mortalidad materna y perinatal en Colombia. Ministerio de Salud. República de Colombia. 1997.
3. Suresh L, Radfar L. Pregnancy and lactation. Oral Surg Oral Med Oral Pathol 2004; 97: 672 - 681.
4. Chacón AF, Gutiérrez ZA, Montañez J, Pieschacón MP, Camargo DM. Factores asociados a caries y enfermedad periodontal en mujeres gestantes, Bucaramanga 2001. Revista Ustasalud 2002; 1: 33 – 39.
5. Kinnby B, Matsson L, Astedt B. Aggravation of gingival inflammatory symptoms during pregnancy associated with the concentration of plasminogen activator inhibitor type 2 (PAI-2) in gingival fluid. J Periodon Res 1996; 3: 271-277.
6. Chamoschine FF, Cardoso M, Lindares SR, De Oliveira V. Processo de saúde-doencas peridontal genograma. Associação Brasileira de Odontologia – ABO-DF Escola de Aperfeiçoamento Profissional – DF Pós-Graduação em Saúde Coletiva. Brasília, julho de 2003.
7. Rodríguez He, López M. El embarazo: Su relación con la salud bucal. Rev Cubana Estomatol. [en línea]. Mayo-ago. 2003, vol.40, no.2 [fecha de acceso: febrero 13 de 2005], p.0-0. URL disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S003475072003000200009&lng=es&nrm=iso
8. Academy Report. Position Paper Diagnosis of Periodontal Diseases. J Periodontol 2003; 74: 1237 - 1247.
9. Wiebe C, Putnins E. The periodontal disease classification system of the American Academy of Periodontology - An Update. J Can Dent Assoc 2000; 66: 594 - 597.
10. Academy Report. Position Paper. Periodontal diseases of children and adolescents. J Periodontol 2003; 74: 1696 - 1704.
11. Lopez NL, Smith PC, Gutierrez J. Higher risk of preterm birth and low birth weight in women with periodontal disease. J Dent Res 2002; 81: 58 - 63.
12. Offenbacher S, Katz V, Fertik G. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 1996; 67: 1103 - 1113.
13. Dasanayake AP. Poor periodontal health of the pregnant woman as a risk factor for low birth weight. Ann Periodontol. 1998; 3: 206 - 212.
14. Offenbacher S, Jared HL, O ́Reilly PG. Potential pathogenic mechanisms of periodontitis associated pregnancy complications. Ann Periodontol 1998; 3: 233 - 250.
15. Lopez NL, Smith PC, Gutierrez J. Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: A randomized controlled trial. J Periodontol 2002; 73: 911 - 924.
16. Saméer AM, Ghadeer NM. The Prevalence and relationship between periodontal disease and pre-term low birth weight infants at King Khalid University Hospital in Riyadh, Saudi Arabia. J Contemp Dent Practice 2004; 5: 2.
17. Diaz GL, Castellanos SJ. Lesions of the oral mucosa and periodontal disease behavior in pregnant patients. Med Oral Patol Oral Cir Bucal 2002; 9: 430 - 437.
18. Yeo BK, Lim LP, Paquette DW, Williams RC. Periodontal disease – The emergence of a risk for systemic conditions: pre-term low birth weight. Ann Acad Med Singapore 2005; 34: 111 - 116.
19. Davenport ES, Williams CE, Sterne JA, Murad S, Sivapathasundram V, Curtis MA. Maternal periodontal disease and preterm low birth weight: case-control study. J Dent Res 2002; 81: 313 - 318.
20. Louro MP, Fiori HH, Louro FP, Steibel J, Fiori MR. Periodontal disease in pregnancy and low birth weight. J Pediatr (Rio J) 2001; 77: 23 - 28.
21. Felice P, Pelliccioni GA, Checchi L. Periodontal disease as a risk factor in pregnancy. Minerva Stomatol 2005; 54: 255 - 264.
22. Löe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963; 21: 533 - 551.
23. Jarjoura K, Devine PC, Perez-Delboy A, Herrera-Abreu M, D’alton M, Papanou PN. Markers of periodontal infection and preterm birth. Am J Obstet Gynecol 2005; 192: 513 – 519.
24. Goepfert AR, Jeffcoat MK, Andrews WW, Faye-Petersen O, Cliver SP, Goldenberg RL, Hauth JC. Periodontal disease and upper genital tract inflammation in early spontaneous preterm birth. Obstet Gynecol 2004; 104: 777 – 783.
25. Lopez NL, Smith PC, Gutierrez J. Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: A randomized controlled trial. J Periodontol 2002; 73: 911 - 924.
26. Academy Report. Treatment of plaque-induced gingivitis, chronic periodontitis, and other conditions. J Periodontol 2001; 72:1790 - 1800.
27. Academy Report. Position Paper. Guidelines for Periodontal Therapy. J Periodontol 2001; 72: 1624 - 1628.
28. Aaltonen AS, Tenovuo J. Association between mother-infant salivary contacts and caries resistance in children: a cohort study. Pediatr Dent 1994; 16: 110 – 116.
29. Lindquist B, Emilson CG. Colonization of Streptococcus mutans and Streptococcus sobrinus genotypes and caries development in children to mothers harboring both species. Caries Res 2004; 38: 95 – 103.
30. Tanner AC, Milgrom PM, Ketn R Jr, Mokeen SA, Page RC, Liao SI Riedy CA, Bruss JB. Similarity of the oral microbiota of pre-school children with that of their caregivers in a population-based study. Oral Microbiol Immunol 2002; 17: 379 – 387.
31. Mattos-Graner RO, Li Y, caufiled PW, Duncan M, Smith DJ. Genotypic diversity of mutans streptococci in Brazilian nursery children suggests horizontal transmission. J Clin Microbiol 2001; 39: 2313 – 2316.
32. Arango M, Baena G. Caries de la infancia temprana y factores de riesgo. Revisión de la literatura. Revista Estomatología 2004. 12: 59 - 65.
33. Zanata RL, Navarro MF, Pereira JC, Franco EB, Lauris JR, Barbosa SH. Effect of caries preventive measures directed to expectant mothers on caries experience in their children. Braz Dent J 2003; 14: 75 -81.
34. Palomari DM, Höfling JF, Pizolitto AC, Rosa EA, Negrini TC, Spolidorio LC. Genetic polymorphism of Streptococcus mutans in Brazilian family members. Brazilian J Microbiol 2003; 34: 213 - 217.
35. Grönroos L, Saarela M, Matto J, Tanner-Salo U, Vuorela A, Alaluusua S. Mutacin production by Streptococcus mutans may promote transmission of bacteria from mother to child. Infect and immun 1998; 2595 - 2600.
36. Berkowitz RJ. Acquisition and transmission of Mutans Streptococci. J Calif Dent Assoc 2003; 31: 135 - 138.
37. Berkowitz RJ, Jordan V. Similarity of bacteriocins of Streptococcus mutans from mother and infant. Arch Oral Biol 1982; 26: 147 – 149
38. Van AKL, Seon WK, Purdie DM, Bird PS, Walsh LJ, Tudehope DI. Oral colonization of Streptococcus mutans in six-month-old predentate infants. J Dent Res 2001; 80: 2060 - 2065.
39. Van AKL, Seon WK, Purdie DM, Bird PS, Walsh L J, Tudehope DI. A longitudinal study of Streptococcus mutans colonization in infants after tooth eruption. J Dent Res 2003; 20: 504 - 508.
40. Kohler B, Brattahall D, Krasse B. Preventive measures in mothers influence the establishment of the bacterium Streptococcus mutans in their infants. Arch Oral Biol 1983; 28: 225 – 231.
41. Caufield PW, Cutter GR, Dasanayake AP. Initial acquisition of mutans streptococci by infants: evidence for a discrete window of infectivity. J Dent Res 1993; 72: 37 - 45.
42. Ekstrand KR, Christiansen m, Qvist V. Influence of different variables on the inter-municipality variation in caries experience in Danish adolescents. Caries Res 2003; 37:130 - 41.
43. El método Nexodent. Un programa no operativo de tratamiento de caries NOCTP. URL disponible en: http://www.nexodent.dk.
44. Lima KC, Neves AA, Sanchez AL, Valente AG, Marsia JG, Castro RA, Ribeiro AA. Relevância clínica do conceito de transmissibilidade da cárie dental. J Bras Odontopediatr Odontol Bebê 2002; 5: 113 – 118.
45. República de Colombia. Ministerio de Salud. III Estudio Nacional de Salud Bucal – ENSAB III, II Estudio Nacional de factores de riesgo de enfermedades crónicas – ENFREC II, 1999.
46. Greene JC Vermillon JR. The oral hygiene index: a method for classifying oral hygiene status. J Am Dent Assoc 1960; 61: 172.
47. Greene JC, Vermillon JR. The simplified oral hygiene index. J Am Dent Assoc 1964; 68: 7.
48. Ferreira A, Benfatti S, Bausells J. Evaluación del conocimiento de las prácticas de salud bucal en gestantes del municipio de Adamantina –SP. Rev Ibero-am Odontopediatr Odontol Bebe 2004; 75: 66 - 77.
49. Garbero I, Delgado A, De Cardenas B. Salud oral en embarazadas: Conocimientos y actitudes. Acta Odontológica Venezolana 2005; 43: 135 - 140.
Cómo citar
Riveros Alejo, C., & Rodríguez Gómez, M. (1). PROGRAMA PREVENTIVO EN SALUD ORAL PARA CONTROLAR FACTORES DE RIESGO ASOCIADOS A CARIES DENTAL Y ENFERMEDAD PERIODONTAL EN MUJERES GESTANTES. Ustasalud, 6(1), 17-28. https://doi.org/https://doi.org/10.15332/us.v6i1.1801
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Sección
Artículos de Investigación Científica y Tecnológica
