Maria Rodriguez Tates

Background: Although toothbrushing is widely recognized as a cornerstone of caries prevention, oral hygiene has traditionally been assessed using self-reported frequency or categorical plaque indices. Evidence regarding the relationship between objectively quantified brushing efficacy and cumulative caries severity remains limited. This study evaluated the association between a quantitative brushing efficacy index and dental caries severity among schoolchildren. Methods: A cross-sectional analytical study was conducted among 200 schoolchildren examined during a community dental campaign in 2025. Caries was assessed using Decayed, Missing, and Filled Teeth indices following Word Health Organization criteria. Severe caries was defined as Decayed, Missing, and Filled Teeth ≥ 5. Oral hygiene was measured using a brushing efficacy index, expressed as the percentage of biofilm removed after supervised brushing. Associations were evaluated using chi-square tests and logistic regression models adjusted for age and sex. Results: Caries prevalence was 95.5%, with a mean Decayed, Missing, and Filled Teeth of 4.99 ± 2.96. Severe caries was observed in 49% of participants. No statistically significant differences were found across tertiles of brushing efficacy (χ² (2) = 2.18; p = 0.336). In regression analysis, each 10% increase in brushing efficacy was not significantly associated with severe caries (adjusted OR = 0.92; 95% CI: 0.81–1.03; p = 0.154). Conclusions: Dental caries prevalence was high in this population, and nearly half of the participants presented severe caries. Quantitative brushing efficacy was not significantly associated with severe dental caries after adjustment for age and sex.

Background: Although toothbrushing is widely recognized as a cornerstone of caries prevention, oral hygiene has traditionally been assessed using self-reported frequency or categorical plaque indices. Evidence regarding the relationship between objectively quantified brushing efficacy and cumulative caries severity remains limited. This study evaluated the association between a quantitative brushing efficacy index and dental caries severity among schoolchildren. Methods: A cross-sectional analytical study was conducted among 200 schoolchildren examined during a community dental campaign in 2025. Caries was assessed using Decayed, Missing, Filled Teeth indices following Word Health Organization criteria. Severe caries was defined as Decayed, Missing, Filled Teeth ≥5. Oral hygiene was measured using a brushing efficacy index, expressed as the percentage of biofilm removed after supervised brushing. Associations were evaluated using chi-square tests and logistic regression models adjusted for age and sex. Results: Caries prevalence was 95.5%, with a mean Decayed, Missing, Filled Teeth of 4.99 ± 2.96. Severe caries was observed in 49% of participants. No statistically significant differences were found across tertiles of brushing efficacy (χ² (2) =2.18; p=0.336). In regression analysis, each 10% increase in brushing efficacy was not significantly associated with severe caries (adjusted OR=0.92; 95% CI: 0.81–1.03; p=0.154), although a protective trend was observed. Conclusions: This population exhibited an extremely high burden of dental caries. Quantitative brushing efficacy showed a non-significant protective trend, suggesting that in high-risk contexts, caries severity is influenced by multifactorial determinants beyond isolated oral hygiene performance.

Background: Temporomandibular disorders (TMD) comprise a heterogeneous group of musculoskeletal conditions that may manifest during childhood and adolescence. However, standardized information regarding TMD-related clinical findings in pediatric populations remains limited because of methodological heterogeneity and the inconsistent application of validated diagnostic protocols. Objective: The aim of this study was to characterize clinical findings related to temporomandibular disorders in schoolchildren and to explore their potential contribution to individualized assessment strategies within the framework of personalized pediatric oral healthcare. Methods: A multicenter cross-sectional study was conducted in 1052 schoolchildren recruited from participating educational institutions. All participants underwent a standardized clinical examination that included assessment of masticatory muscle tenderness, temporomandibular joint tenderness, joint sounds, pain intensity, and perceived stress using an adapted pediatric DC/TMD protocol. Categorical variables were summarized as frequencies, percentages, and 95% confidence intervals (95% CIs). Associations between categorical variables were evaluated using Pearson’s chi-square test, and multivariable logistic regression was performed to identify factors independently associated with pain. Results: Pain during clinical examination was identified in 111 participants (10.6%; 95% CI: 8.8–12.6%), whereas temporomandibular joint sounds and myofascial pain were detected in 1.4% and 0.3% of participants, respectively. Most pain was classified as mild, and the masseter muscle was the most frequently affected anatomical site. Increasing age and female sex were independently associated with pain. Compared with children aged 4–6 years, participants aged 10–12 years (adjusted OR = 9.61; 95% CI: 2.22–41.51) and 13–16 years (adjusted OR = 35.49; 95% CI: 8.59–146.61) showed significantly greater odds of pain. Female participants also demonstrated higher odds of pain than males (adjusted OR = 7.49; 95% CI: 3.68–15.21; all p < 0.05). Conclusions: Clinically detectable TMD-related findings were generally uncommon among schoolchildren aged 4–16 years and were predominantly mild and muscular. Increasing age and female sex were independently associated with pain, emphasizing the importance of demographic factors in the early clinical expression of TMD. Standardized pediatric clinical examination protocols may facilitate early identification of TMD-related findings and support preventive strategies during childhood and adolescence. These findings support the implementation of individualized clinical assessment strategies for early identification of children at risk of temporomandibular disorders, contributing to personalized preventive and therapeutic approaches in pediatric oral healthcare.

The main objective of this study was to determine whether there is a significant association between body mass index (BMI) and the presence and number of dental caries in the analyzed participants. In the oral cavity, various modulating factors can result in the presence of dental caries; moreover, this condition is considered to be an infectious-contagious disease that exhibits a broad incidence. Materials and methods: A total of 2,689 children were recruited for this study, with 314 children aged 5–14 years (95% confidence level margin of error of 0.5%). The participants received dental care in 2024 in Quito, Ecuador. Assessments of height and weight were performed, along with the calculation of the BMI and nutritional diagnosis. The patients were classified as obese, overweight, normal, malnourished, or severely malnourished. An odontogram was performed; moreover, the cariogenic index CPO-D (measuring decayed, lost, or filled teeth) was performed on permanent teeth, whereas the ceo-d (measuring decayed, extracted, or filled teeth) was performed on primary teeth. The descriptive analysis revealed a high prevalence of dental caries in all the BMI categories, with percentages ranging from 70.2% in normal-weight children to 84.6% in underweight children. Specifically, children with obesity exhibited a prevalence of dental caries of 76%, whereas those who were overweight exhibited a prevalence of 75.4%. These findings suggest that there is a high burden of dental caries across all nutritional groups, thus reinforcing the notion that both undernutrition and excess weight may be associated with an increased risk of dental disease. This study revealed that there is a high burden of dental caries across all nutritional groups, particularly with respect to the association between BMI and the presence and number of caries. Diagnosing dental caries is a mandatory diagnostic process in dentistry; however, correlating with diseases should be a priority for dentists, applying it mandatorily in children and adolescents. We present this small analysis that demonstrates correlation with BMI. Hidalgo AC, Miquilena AA, Farias DQ, et al. Correlation of Dental Caries with Body Mass Index in Children Aged 5–14 Years: A Cross-sectional Study. Int J Clin Pediatr Dent 2026;19(5):624–629.

Background: Oral diseases such as periodontitis, dental infections, and oral dysbiosis have been increasingly associated with systemic conditions. Emerging evidence suggests a potential relationship between oral health and neurological disorders, including brain abscesses, structural brain alterations, and gliomas. However, the strength and mechanisms of these associations remain incompletely understood. Objective: To systematically review clinical, neuroimaging, genetic, and mechanistic evidence linking oral diseases with brain pathologies. Methods: A systematic literature search was conducted in PubMed, Scopus, Web of Science, and EBSCO, with complementary screening of SciELO, Redalyc, and LILACS databases. Studies evaluating associations between oral diseases (periodontitis, dental infections, caries, or oral microbiota alterations) and neurological outcomes were considered. Eligible study designs included observational clinical studies, Mendelian randomization analyses, neuroimaging studies, and experimental investigations. Seventeen studies met the inclusion criteria. Due to the substantial heterogeneity in study designs, outcomes, and effect metrics, quantitative meta-analysis was not feasible. Findings were therefore synthesized using a structured narrative approach following PRISMA guidelines. Results: Clinical studies consistently identified odontogenic infections as a relevant source of brain abscesses, frequently originating from chronic or clinically silent dental foci. Neuroimaging and genetic studies reported associations between poor oral health indicators and structural brain alterations, including reduced cortical thickness and white matter abnormalities. Experimental investigations suggested potential biological mechanisms involving microbial dissemination, systemic inflammation, and immune modulation. Virulence factors from Porphyromonas gingivalis have been shown to induce inflammatory signaling pathways and immune checkpoint activation in glioma cells. Conclusions: The current evidence suggests a possible association between oral diseases and several brain pathologies. Although causality cannot be established, the findings highlight the importance of oral health as a potentially modifiable factor relevant to neurological health. Further longitudinal and mechanistic studies are required to clarify these relationships.

Background: Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder associated with multiple systemic comorbidities. Gastroesophageal reflux disease (GERD) has been frequently reported among patients with OSA; however, the magnitude of this association remains uncertain. Objective: To systematically evaluate and quantify the association between obstructive sleep apnea and gastroesophageal reflux disease in adult populations. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and a protocol registered in PROSPERO (CRD420261278563). Electronic searches were performed in PubMed/MEDLINE, Scopus, Web of Science, and Embase. Observational studies assessing the association between OSA and GERD were included. Risk of bias was assessed using the Newcastle–Ottawa Scale. A random-effects meta-analysis was performed to pool odds ratios (ORs) with 95% confidence intervals (CIs). Results: Six observational studies were included in the quantitative synthesis. The pooled analysis demonstrated a statistically significant association between obstructive sleep apnea and gastroesophageal reflux disease, with a combined OR of 1.96. Moderate heterogeneity was observed among studies (I² = 65%). No substantial evidence of publication bias was identified based on funnel plot assessment. Conclusions: These findings suggest that obstructive sleep apnea is associated with nearly two-fold increased odds of gastroesophageal reflux disease and support increased clinical awareness rather than formal screening recommendations.

To perform minimally invasive and preventive treatment in patients with Marfan syndrome (MFS) with hyperdontia in the upper jaw. Marfan syndrome is an autosomal dominant genetic disease of the connective tissue that is characterized by manifestations in cardiovascular, musculoskeletal, ophthalmological, and oral structures. The diagnosis of this disease is based on clinical and genetic criteria called the Ghent criteria. Within the oral manifestations, hyperdontia may occur, which corresponds to a numerical variation in the number of normal teeth; it can occur in a single or multiple ways, affecting both jaws unilaterally or bilaterally. A 6-year-old male patient attended the Dental Care Center of the University of the Americas (CAO/UDLA) for evaluation. The reason for consultation was an anomaly in the shape of the upper central incisor. Clinical examination revealed tooth 21 in the shape of a nail, compatible with microdontia. The periapical radiographic examination determined the presence of supernumerary teeth, and the tomographic examination confirmed the diagnosis of hyperdontia in the definitive central incisors, altering the chronological eruption. Surgery and correction of the alteration are scheduled with the interdisciplinary team. A successfully planned minimally invasive surgical treatment was performed. The initiation of preventive orthopedic treatment will provide the patient with an appropriate expansion of the upper jaw to provide adequate space for the eruption of their permanent anterosuperior teeth. Marfan syndrome brings important dental complications to consider and know. Valdiviezo JP, Hidalgo AC, Tates MR, et al. Marfan Syndrome—Comprehensive Dental/Surgical Management: Clinical Case Report. Int J Clin Pediatr Dent 2026;19(1):100–104.

Introduction: Oral health in children is essential for their overall well-being, influencing nutrition, language development, and self-esteem. Dental caries represent one of the most prevalent chronic diseases in childhood. Objective: The objective of this study is to evaluate the association between parents’ self-perceived knowledge of oral health and the presence of dental caries in their children. Materials and Methods: A cross-sectional observational study was conducted with 1052 children aged 4 to 14 years and their parents in Quito, Ecuador. Parents completed validated questionnaires (OHIP-14, OIDP, CPQ, and OHQoL-UK) to assess their self-perceived oral health knowledge. Clinical examinations were performed to detect cavitated carious lesions. Statistical analysis included Chi-square tests and odds ratio (OR) calculations. Results: A significant association was found between lower parental knowledge and higher prevalence of dental caries in children (Chi-square = 16.245, p = 0.0062; OR = 18.18, 95% CI [1.80–183.75]). Most caries cases were found in children whose parents rated their knowledge as “good” or “very good,” suggesting a gap between perceived and actual knowledge. Conclusions: The findings highlight the need for targeted educational strategies that address both knowledge and behavioral practices in oral health, especially among parents with low self-perceived knowledge.

Traffic accidents worldwide are considered a public health problem and traumatic injuries due to the phenomenon of whiplash with clinical manifestations such as neck or head pain and temporomandibular joint pain are considered common. The aim was to determine the prevalence of lesions in the cervical craniomandibular complex after traffic accidents in Quito, Ecuador. This was an observational, cross-sectional study with data provided by the Fire Department of the Metropolitan District of Quito Emergency Department (911) for the years 2019, 2020, 2021, 2022, and the first semester of 2023. Five hospitals with maxillofacial surgery departments had a standard clinical history according to the Diagnostic Criteria for temporomandibular disorders. The treatment of temporomandibular disorders such as cervical pain, muscular palpation tenderness, difficulty opening the mouth, regular headache, joint crackles, and arthralgia was considered. The results revealed that the muscle palpation tenderness had a considerably high prevalence (71.03%), followed by difficulty opening the mouth (14.33%), and regular headache (25.31%). Among the participants, the highest prevalence of muscle palpation tenderness (32.56%) and regular headache (30.23%) was found in older adults aged 55 years and older. Injuries to the cranio-cervico-mandibular complex because of traffic accidents found a prevalence of muscle pain (32.5/25%) and headaches (headaches 30/20%) in the entire population studied: children, adolescents, adults and older adults.