Books by Andrea Muñoz Martínez
No hay mejor médico que uNo mismo Prevención de enfermedades y fomento de hábitos de vida más sanos.
Papers by Andrea Muñoz Martínez
Caries and fluorosis in the Santiago metropolitan region in Chile: The impact of the fluoridation of the water
PURPOSE: To assess the damage and the prevalence of caries and fluorosis in children and adolesce... more PURPOSE: To assess the damage and the prevalence of caries and fluorosis in children and adolescents in the metropolitan area after 8 years of drinking water fluoridation and to compare them with the baseline study. METHODS: This was a prevalence study. The sample was selected using two-step probability sampling and stratified according to socioeconomic level. Subjects included 2,323 schoolchildren aged 6 to 8 years and 12 years living within the metropolitan region. The parents of all students provided consent and were previously included in the study. The subjects were clinically examined by calibrated dentists, who used World Health Organization (WHO) screening criteria and indicators to determine the presence of caries and dental fluorosis. RESULTS: No cavity damage was found in 23.68% of the children. The average dmft was 3.18 for children aged 6 to 8 years. The DMFT was 0.59 in children aged 6 to 8 years and 2.6 in children 12 years compared with the baseline study. These diff...
Periodontal status and treatment needs of children from 6 to 8 years old in the Santiago Metropolitan Region of Chile
Revista Odonto Ciência (Online), 2011
Journal of Periodontology, 2010
Background: Data from national surveys regarding the periodontal status of the adult population i... more Background: Data from national surveys regarding the periodontal status of the adult population in Latin America are scarce. The aim of this study assesses the prevalence and extension of clinical attachment loss (AL) in the adult population of Chile. Age, sex, and sociodemographic and behavioral differences in the prevalence of clinical AL are also examined. Methods: A stratified, multistage probability design formula was used to separate the adult Chilean population into two age cohorts. The first group consisted of 1,092 young adults (age range: 35 to 44 years), and the second group consisted of 469 adult seniors (age range: 65 to 74 years). All subjects were examined to measure clinical AL. The research also included an evaluation, conducted through oral interviews, of social and health aspects of the subjects. Clinical AL was measured in all teeth surfaces, excluding third molars. Results were analyzed using a multivariable model and logistic regression. Results: A total of 93.45% of the young adults had ‡1 site with clinical AL >3 mm compared with 97.58% of the adult seniors, with an average of 6.51 and 15.81 missing teeth, respectively (P <0.05). The number of sites with severe clinical AL (>6 mm) was 38.65% in young adults and 69.35% in senior adults (P <0.05). Clinical AL was significantly higher in males than in females (P <0.05). The multivariate analyses identified that the main risk indicators for clinical AL >6 mm in ‡1 site were: age (65 to 74 years), sex (male) low education level (£12 years of education), and smoking (P <0.05). Conclusion: The adult population in Chile shows a high prevalence and extension of clinical AL with age, sex, education level, and smoking as the main risk indicators of severe clinical AL in this population.
Diverse and Participative Learning Methodologies: A Remedial Teaching Intervention for Low Marks Dental Students in Chile
Journal of Dental Education, 2011
Medir prevalencia de caries y pérdida de dientes en adultos mayores de nivel socio-económico bajo... more Medir prevalencia de caries y pérdida de dientes en adultos mayores de nivel socio-económico bajo y medio-bajo en Santiago, Chile. Métodos: Muestreo probabilístico estratificado, con criterio proporcional; muestra de 109 personas (74 mujeres; 35 hombres) de 65-74 años edad. Datos recogidos mediante cuestionario en entrevista personal. Todos los pacientes fueron examinados, previo consentimiento informado, por un dentista calibrado. El estudio fue realizado entre marzo y diciembre de 2008. Datos analizados usando chi-cuadrado y ANOVA. Resultados: CPOD promedio fue 24,9 (IC: 23,83; 25,96); 100% de individuos tenían historia de caries; 45,9% tenían lesiones no tratadas. El promedio de lesiones no tratadas fue 0,9 por individuo. El 38,5% de los sujetos usaban prótesis removible y 15 personas (13,76%) eran edéntulas. Conclusiones: Magnitud de la brecha e importancia del entorno social en la generación del daño de la salud oral, obliga a enfrentar el problema desde una perspectiva amplia de determinantes sociales de la salud al momento de establecer políticas públicas.
Itinerario y recorrido para la construcción de un currículo basado en competencias: experiencia de la Facultad de Odontología de la Universidad de Chile
Covid-19 y la odontología latinoamericana para pacientes con necesidades especiales
Odontoestomatología
Latin America has become the most affected region by the COVID-19 pandemic in the world. People w... more Latin America has become the most affected region by the COVID-19 pandemic in the world. People with special needs-an already vulnerable population-are suffering terrible consequences on account of this crisis. These people need to be protected and cared for at all times. Therefore, a group of lecturers from ten Latin American countries came together to analyze the regional situation of dental care for patients with special needs. Every country shows evidence that lockdowns and movement restrictions interrupt these people’s access to essential goods and services. The general course of action regarding dental care is to postpone routine procedures unless they are clinically urgent or an emergency, implement strict personal protection measures and avoid or minimize processes that may produce aerosols. Remote dental care is considered essential these days since it allows practitioners to assess the need for face-to-face care and offer support, information, and safety to patients and families. The pandemic has shown us all that supporting health promotion is the true path and that we should not wait until conditions that affect people’s quality of life appear to act.
La salud bucal en el afrontamiento de la covid-19 en países de nuestra América
Diálogos Bucaleiros: reflexões em tempos pandêmicos
Revista Chilena de Salud Pública, 2011
1758-APLICACIÓN DE METODOLOGÍAS PARTICIPATIVAS EN EL MATERIAL EDUCATIVO UTILIZADO EN ACTIVIDADES DEL PROGRAMA DE COMUNICACIÓN …
Cuba Salud …, 2012
Resumen Introducción: Debido a las altas prevalencias de caries en niños chilenos (4 años: 48%; 6... more Resumen Introducción: Debido a las altas prevalencias de caries en niños chilenos (4 años: 48%; 6 años: 69%), desde 2007 se implementó el Programa de Promoción y Prevención en Salud Bucal para Preescolares de comunas vulnerables de la ciudad de Santiago. Entre ...
1590-BARRERAS Y FACILITADORES PARA LA EJECUCIÓN DE UN PROGRAMA DE COMUNICACIÓN EDUCATIVA EN SALUD ORAL PARA PREESCOLARES, …
Cuba Salud …, 2012
Resumen Introducción: El programa de “Promoción y prevención en salud oral para preescolares” del... more Resumen Introducción: El programa de “Promoción y prevención en salud oral para preescolares” del Ministerio de salud nace el 2007 para prevenir daño desde la primera infancia (1). El área de Salud Pública de la Facultad de Odontología de la Universidad de ...
International Journal of Dentistry, Nov 21, 2012
The purpose of this study was to assess the prevalence of dental caries, tooth loss, and risk fac... more The purpose of this study was to assess the prevalence of dental caries, tooth loss, and risk factors among adult population of Chile. Furthermore, age, gender, and behavioural specific differences in caries prevalence and tooth loss were examined. A national stratified multistage probabilistic sample design in two-age cohorts was applied to the Chilean population. A sample of 1553 adults, comprising 1088 individuals aged 35–44 and 465 senior individuals aged 65–74, were examined. The DMFT was evaluated following WHO recommendations using diagnostic criteria of caries lesions into dentin. The data were analyzed by univariate and multivariate models using logistic regression analyses. Results showed a mean DMFT of 15.06 in the 35–44-year-old group and of 21.57 in the 65–74 group. Factors related to tooth loss in the 35–44 group through univariate logistic regression were depression (OR 1.9 CI 95% 1.26–2.85), education level <12 years (OR 2.24 CI 95% 1.31–3.73), personal income (OR 1.51 CI 95% 1.04–2.19), and familiar income (OR 2.05 CI 95% 1.34–3.13), and through multivariate logistic regression in the same age group were depression (OR 1.93 CI 95% 1.24–3.0), education level <12 years (OR 1.94 CI 95% 1.2–3.14), and familiar income (OR 1.71 CI 95% 1.09–2.68). Factors related to tooth loss in the 65–74-year-old group through univariate logistic regression were education level <12 years (OR 2.54 CI 95% 1.3–4.96) and personal income (OR 1.66 CI 95% 1.05–2.63), and for multivariate logistic regression in the same age group, it was education level <12 years (OR 2.51 CI 95% 1.21–5.18). In conclusion, adult population in Chile showed a high prevalence of dental caries and tooth loss, as age, education level, personal and familiar incomes, and depression are being the main risk factors.
Estrategia para fomentar el compromiso del odontólogo con la Salud Comunitaria.
La formación de los recursos humanos orientada a satisfacer las necesidades de salud de la comuni... more La formación de los recursos humanos orientada a satisfacer las necesidades de salud de la comunidad, es un elemento clave del cambio necesario para aumentar la eficiencia de los sistemas de salud. Como una de las estrategias para desarrollar en sus alumnos de pregrado el compromiso con la salud comunitaria, desde 1993 la Facultad de Odontología de la Universidad de Chile ha establecido un nuevo programa de internado basado en un modelo de integración Facultad-Servicio-Comunidad y ha desarrollado una metodología para el logro de una real interacción de los tres componentes. El propósito de este estudio es determinar la influencia que ejerce la estrategia propuesta, en el cambio en los conocimientos y actitudes de los alumnos sobre el quehacer odontológico en los Servicios Públicos de Atención Primaria de la Salud. El trabajo se efectuó en el total de los alumnos (91), que realizaron su internado en 1994. Se aplicó un cuestionario de 21 preguntas, 17 de respuesta estructurada en categorías correspondientes a la escala Lickert y 4 de respuesta categórica, el que fue respondido mediante autoaplicación antes y después del internado. La muestra final quedó constituída por 87 alumnos, 95,6 por ciento del total, que respondieron el pre y post test. Para el análisis de resultados se utilizó la prueba estadística de Chi cuadrado en relación a la variable independiente participación en el internado. Se consideró significativa la asociación estadística con valor p<0,05. Los resultados evidencia que, en los 5 años de la carrera previos al internado, los alumnos adquieren escasos conocimientos sobre las tareas que realizan los Centros de Atención Primaria, su organización y condiciones de trabajo. Después del internado, la intención de contratarse en un centro de A.P. aumenta al doble (61 por ciento) y el rechazo disminuye a la mitad (11 por ciento). El desagrado hacia la atención de niños disminuye 26 veces (a 1,1 por ciento). El significativo cambio (p<0,05) en los conocimientos, percepciones y actitudes de los alumnos hacia las tareas que se realizan en los Centros de Atención Primaria demuestra que un Programa de Internado apoyado en una metodología basada en los siguientes principios: lineamiento común y flexibilidad del programa de actividades; interacción permanente Facultad-Servicios de Salud; dinamismo del programa; adhesión de los Centros de A.P., constituye una estrategia eficaz para lograr el compromiso de los estudiantes con la salud comunitaria (AU)
Objectives: To measure prevalence of caries and tooth loss among low and middle-low socio-economi... more Objectives: To measure prevalence of caries and tooth loss among low and middle-low socio-economic level elderly from Santiago, Chile.
Methods: Proportionate stratified probabilistic sampling techniques; sample of 109 people (74 women and 35 men) aged 65 to 74. Data gathered by means of a face-to-face questionnaire. Informed consent was obtained; individuals were examined by a calibrated dentist. The study was carried out from March to December 2008. Data analysis considered chi-square and ANOVA. Results: DMFT was 24.9 (CI: 23.83; 25.96). All the individuals had caries experience; 45.9% had active caries lesions. The mean of non-treated active caries lesions was 0.9 per individual. Concerning prosthesis, 38.5% of individuals were found to use removable prosthesis and 15 people (13.76%) were edentulous. Conclusions: The size of the gap and the importance of social environment on damaging oral health should lead to face this problem from a wider perspective of social determinants of health when building public policies.
Methods: Proportionate stratified probabilistic sampling techniques; sample of 109 people (74 women and 35 men) aged 65 to 74. Data gathered by means of a face-to-face questionnaire. Informed consent was obtained; individuals were examined by a calibrated dentist. The study was carried out from March to December 2008. Data analysis considered chi-square and ANOVA. Results: DMFT was 24.9 (CI: 23.83; 25.96). All the individuals had caries experience; 45.9% had active caries lesions. The mean of non-treated active caries lesions was 0.9 per individual. Concerning prosthesis, 38.5% of individuals were found to use removable prosthesis and 15 people (13.76%) were edentulous. Conclusions: The size of the gap and the importance of social environment on damaging oral health should lead to face this problem from a wider perspective of social determinants of health when building public policies.
Background: Data from national surveys regarding the periodontal
status of the adult population i... more Background: Data from national surveys regarding the periodontal
status of the adult population in Latin America are scarce. The aim of this study assesses the prevalence and extension of clinical attachment loss (AL) in the adult population of Chile. Age, sex, and sociodemographic and behavioral differences in the prevalence of clinical AL are also examined.
Methods:Astratified, multistage probability design formula was used to separate the adult Chilean population into two age cohorts. The first group consisted of 1,092 young adults (age range: 35 to 44 years), and the second group consisted of 469 adult seniors (age range: 65 to 74 years). All subjects were examined to measure clinical AL. The research also included an evaluation, conducted through oral interviews, of social and health aspects of the subjects. Clinical AL was measured in all teeth surfaces, excluding third molars. Results were analyzed using a multivariable model and logistic regression.
Results: A total of 93.45% of the young adults had ‡1 site with clinical AL >3mmcompared with 97.58% of the adult seniors, with an average of 6.51 and 15.81 missing teeth, respectively (P <0.05). The number of sites with severe clinical AL (>6 mm) was 38.65% in young adults and 69.35% in senior adults (P <0.05). Clinical AL was significantly higher in males than in females (P <0.05). The multivariate analyses identified that the main risk indicators for clinical AL >6 mm in ‡1 site were: age (65 to 74 years), sex (male) low education level (£12 years of education), and smoking (P <0.05).
Conclusion: The adult population in Chile shows a high prevalence and extension of clinical AL with age, sex, education level, and smoking as the main risk indicators of severe clinical AL in this population.
KEY WORDS
Edentulous; epidemiology; periodontal disease; periodontitis; risk factors.
status of the adult population in Latin America are scarce. The aim of this study assesses the prevalence and extension of clinical attachment loss (AL) in the adult population of Chile. Age, sex, and sociodemographic and behavioral differences in the prevalence of clinical AL are also examined.
Methods:Astratified, multistage probability design formula was used to separate the adult Chilean population into two age cohorts. The first group consisted of 1,092 young adults (age range: 35 to 44 years), and the second group consisted of 469 adult seniors (age range: 65 to 74 years). All subjects were examined to measure clinical AL. The research also included an evaluation, conducted through oral interviews, of social and health aspects of the subjects. Clinical AL was measured in all teeth surfaces, excluding third molars. Results were analyzed using a multivariable model and logistic regression.
Results: A total of 93.45% of the young adults had ‡1 site with clinical AL >3mmcompared with 97.58% of the adult seniors, with an average of 6.51 and 15.81 missing teeth, respectively (P <0.05). The number of sites with severe clinical AL (>6 mm) was 38.65% in young adults and 69.35% in senior adults (P <0.05). Clinical AL was significantly higher in males than in females (P <0.05). The multivariate analyses identified that the main risk indicators for clinical AL >6 mm in ‡1 site were: age (65 to 74 years), sex (male) low education level (£12 years of education), and smoking (P <0.05).
Conclusion: The adult population in Chile shows a high prevalence and extension of clinical AL with age, sex, education level, and smoking as the main risk indicators of severe clinical AL in this population.
KEY WORDS
Edentulous; epidemiology; periodontal disease; periodontitis; risk factors.
Purpose: To evaluate the periodontal status and the treatment needs of Chilean school-
children
M... more Purpose: To evaluate the periodontal status and the treatment needs of Chilean school-
children
Methods: Prevalence study. Sample: 1,637 schoolchildren from 6 to 8 years old belonging to 26 communes of the Santiago Metropolitan Region of Chile, stratified according to socioeconomic level in accordance with the 2003 CASEN survey (National Socioeconomic Characterization Survey). Periodontal status was estimated using the Community Periodontal Index of Treatment Needs (CPITN) and following the recommendations of the WHO (World Health Organization), along with the records of the Clinical Criteria of Gingival Inflammation. Data were analyzed using a chi-square test.
Results: Gingivitis prevalence was 68.42%, a result that is higher than the national prevalence (P<0.01; 95% CI=0.66-0.70). The prevalence increased with age (P<0.01) but was similar in both sexes (P=0.838). Prevalence was relatively constant among three socioeconomic levels (P=0.417). According to the CPITN, gingivitis prevalence was 29.57%: 27.49% consisting of children with gingival hemorrhage and 2.08% consisting of children with gingival calculus. The treatment needs of this population are that 27.49% of children require oral-hygiene instruction, and 2.08% need oral-hygiene instruction and subgingival and supragingival scaling.
Conclusion: The gingivitis prevalence found in this study was higher than the national proportion in Chile.
Key words: Prevalence of gingivitis; Community Periodontal Index of Treatment Need; epidemiology
children
Methods: Prevalence study. Sample: 1,637 schoolchildren from 6 to 8 years old belonging to 26 communes of the Santiago Metropolitan Region of Chile, stratified according to socioeconomic level in accordance with the 2003 CASEN survey (National Socioeconomic Characterization Survey). Periodontal status was estimated using the Community Periodontal Index of Treatment Needs (CPITN) and following the recommendations of the WHO (World Health Organization), along with the records of the Clinical Criteria of Gingival Inflammation. Data were analyzed using a chi-square test.
Results: Gingivitis prevalence was 68.42%, a result that is higher than the national prevalence (P<0.01; 95% CI=0.66-0.70). The prevalence increased with age (P<0.01) but was similar in both sexes (P=0.838). Prevalence was relatively constant among three socioeconomic levels (P=0.417). According to the CPITN, gingivitis prevalence was 29.57%: 27.49% consisting of children with gingival hemorrhage and 2.08% consisting of children with gingival calculus. The treatment needs of this population are that 27.49% of children require oral-hygiene instruction, and 2.08% need oral-hygiene instruction and subgingival and supragingival scaling.
Conclusion: The gingivitis prevalence found in this study was higher than the national proportion in Chile.
Key words: Prevalence of gingivitis; Community Periodontal Index of Treatment Need; epidemiology
PURPOSE: To assess the damage and the prevalence of caries and fluorosis in children and adolesce... more PURPOSE: To assess the damage and the prevalence of caries and fluorosis in children and adolescents in the metropolitan area after 8 years of drinking water fluoridation and to compare them with the baseline study.
METHODS: This was a prevalence study. The sample was selected using two-step probability sampling and stratified according to socioeconomic level. Subjects included 2,323 schoolchildren aged 6 to 8 years and 12 years living within the metropolitan region. The parents of all students provided consent and were previously included in the study. The subjects were clinically examined by calibrated dentists, who used World Health Organization (WHO) screening criteria and indicators to determine the presence of caries and dental fluorosis.
RESULTS: No cavity damage was found in 23.68% of the children. The average dmft was 3.18 for children aged 6 to 8 years. The DMFT was 0.59 in children aged 6 to 8 years and 2.6 in children 12 years compared with the baseline study. These differences were statistically significant. There were also significant differences in the DMFT index for each socioeconomic status group. The average number of dams was higher among children of low socioeconomic status. Of the studied children, 14.3% of children had dental fluorosis. Fluorosis was very mild in 12.35% of the cases, mild in 1.98% and moderate in 0.26%. There were no cases of severe fluorosis (classified according to Dean's index).
CONCLUSION: We conclude that after 8 years drinking water fluoridation in the metropolitan area, the number of children with no history of caries has increased by approximately 100%. The number of cases significantly affected by caries has also decreased significantly. The incidence of dental fluorosis has increased, but to milder degrees.
Key words: Dental caries; dental fluorosis; cross-sectional study; water fluoridation
METHODS: This was a prevalence study. The sample was selected using two-step probability sampling and stratified according to socioeconomic level. Subjects included 2,323 schoolchildren aged 6 to 8 years and 12 years living within the metropolitan region. The parents of all students provided consent and were previously included in the study. The subjects were clinically examined by calibrated dentists, who used World Health Organization (WHO) screening criteria and indicators to determine the presence of caries and dental fluorosis.
RESULTS: No cavity damage was found in 23.68% of the children. The average dmft was 3.18 for children aged 6 to 8 years. The DMFT was 0.59 in children aged 6 to 8 years and 2.6 in children 12 years compared with the baseline study. These differences were statistically significant. There were also significant differences in the DMFT index for each socioeconomic status group. The average number of dams was higher among children of low socioeconomic status. Of the studied children, 14.3% of children had dental fluorosis. Fluorosis was very mild in 12.35% of the cases, mild in 1.98% and moderate in 0.26%. There were no cases of severe fluorosis (classified according to Dean's index).
CONCLUSION: We conclude that after 8 years drinking water fluoridation in the metropolitan area, the number of children with no history of caries has increased by approximately 100%. The number of cases significantly affected by caries has also decreased significantly. The incidence of dental fluorosis has increased, but to milder degrees.
Key words: Dental caries; dental fluorosis; cross-sectional study; water fluoridation
Diverse and Participative Learning Methodologies: A Remedial Teaching Intervention for Low Marks Dental Students in Chile
The purpose of this educational intervention was to diagnose the learning style of a group of low... more The purpose of this educational intervention was to diagnose the learning style of a group of low marks (i.e., grades) dental students in Chile and improve their academic achievement by means of remedial teaching. The intervention group was composed of ten students in endodontics and eleven in pedodontics with low marks. These two groups were mutually exclusive. The Kolb test of learning styles was applied to the low mark students group and to the rest of the class (n=72). Diverse methodologies were applied to the low marks students, such as seminars, case-based learning and problem-based learning, directed study, plenary discussions and debate, integration and questions, and web-based learning in an effort to cover all learning styles. Students’ perceptions of the educational intervention were assessed by means of a questionnaire. The learning styles of the low marks group were mainly divergent (52.4 percent) and convergent (19 percent). Accommodators and assimilators were 14.3 percent each. The rest of the class showed a very distinct frequencies distribution: divergent 18 percent, convergent 20 percent, accommodators 28 percent, and assimilators 34 percent. After the educational intervention, the mean of the scores obtained by the intervention group in formal evaluations was higher than the average scores obtained before the intervention for both courses. Students’ perceptions of the activities were that they were effective for their learning process (76 percent) and that the teaching methodologies were useful mainly to clarify concepts and contents from both courses (82 percent). We can conclude that the use of diverse and participative teaching methodologies in a remedial teaching intervention, to cover all the different learning styles of the students, contributes to improve their marks in formal evaluations.