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10 propuestas para mejorar la salud bucal de Chile
- Elaborar índices de salud (quien está sano), de enfermedad (quien está enfermo) y de daño bucal (gente que puede estar sin caries activas, pero que tiene secuelas). (1,2)
- Hacer un mapa de salud, enfermedad y daño con los índices de 1.(3,4)
- Mientras, aplicar un plan de shock para que el 80% de niños de 2 años libres de caries se mantenga libre de daño por caries a los 6 años y 12 años. (5–7)
- Ofrecer incentivos al equipo de salud bucal para mantener a la población libre de daño por caries. Por ejemplo un dentista que mantenga a dos cohortes de niños de 0 a 2 años libres de caries puede elegir cash o postgrado. (8–10)
- Ofrecer incentivos a las familias para mantener a los niños libres de daño caries, por ejemplo, niños que tengan 0 caries a los 6 y 12 años tendrán cubierto necesidad de ortodoncia y atención integral de trauma dental o rehabilitación a padre, madre o apoderado. (11,10) O, mejor aun, que le den directamente a las familias con hijos libres de caries a los 6 años el dinero que el estado se ahorró en tratamientos.
- Impuesto al azúcar: Legislar contra la adición de cantidades adictivas de azúcar en los alimentos, la venta de alimentos no saludables en colegios y el consumo familiar de bebidas azucaradas.(12–15)
- Exigir un perfil de profesional específico para contratar en el servicio público y acreditar currículos universitarios enfocados en diagnostico y prevención más que en detección y rehabilitación. (16–19)
- Crear un equipo de salud bucal, con higienistas y asistentes dentales que cumplan funciones complementarias.(20–22)
- Descartar todas las prácticas que carezcan de evidencia de efectividad.(23–27)
- Evaluar y corregir mediante los índices de 1; involucrando a la comunidad en la toma de decisiones.(28–32)
Referencias
- Larmas M, Mäkinen KK. Insufficiency of currently used dental indices in epidemiology. Br J Med Med Res. 2014;4(10):2058.
- Baelum V. Dentistry and population approaches for preventing dental diseases. J Dent. 2011 Dec;39 Suppl 2:S9–19.
- Strömberg U, Magnusson K, Holmén A, Twetman S. Geo-mapping of caries risk in children and adolescents - a novel approach for allocation of preventive care. BMC Oral Health [Internet]. 2011 11-26;11.
- Strömberg U, Holmén A, Magnusson K, Twetman S. Geo-mapping of time trends in childhood caries risk - a method for assessment of preventive care. BMC Oral Health [Internet]. 2012 Apr 17;12(1).
- Gomez SS, Weber AA, Emilson CG. A prospective study of a caries prevention program in pregnant women and their children five and six years of age. ASDC J Dent Child. 2001 Jun;68(3):191–5, 152.
- Petti S. Why guidelines for early childhood caries prevention could be ineffective amongst children at high risk. J Dent. 2010;38(12):946–55.
- Uribe S. Prevention and management of dental decay in the preschool child. Aust Dent J. 2006 Sep;51(3):272–5.
- Brocklehurst P, Price J, Glenny A-M, Tickle M, Birch S, Mertz E, et al. The effect of different methods of remuneration on the behaviour of primary care dentists. Cochrane Database Syst Rev. 2013;11:CD009853.
- Clarkson J, Turner S, Grimshaw J, Ramsay C, Johnston M, Scott A, et al. Changing Clinicians’ Behavior: a Randomized Controlled Trial of Fees and Education. J Dent Res. 2008 Jul 1;87(7):640–4.
- Sutherland K, Christianson JB, Leatherman S. Impact of Targeted Financial Incentives on Personal Health Behavior A Review of the Literature. Med Care Res Rev. 2008 Dec 1;65(6 suppl):36S – 78S.
- Volpp KG, John LK, Troxel AB, Norton L, Fassbender J, Loewenstein G. A randomized controlled trial of financial incentives for weight loss. J Am Med Assoc. 2008 Dec 10;300(22):2631–7.
- Merrick J, Chong A, Parker E, Roberts-Thomson K, Misan G, Spencer J, et al. Reducing disease burden and health inequalities arising from chronic disease among Indigenous children: an early childhood caries intervention. BMC Public Health. 2012;12:323.
- Lustig RH, Schmidt LA, Brindis CD. Public health: The toxic truth about sugar. Nature. 2012;482(7383):27–9.
- Moss M. Salt, sugar, fat: how the food giants hooked us. 1st ed. New York: Random House; 2013. 446 p.
- Moynihan PJ, Kelly SAM. Effect on Caries of Restricting Sugars Intake: Systematic Review to Inform WHO Guidelines. J Dent Res. 2013 Dec 9;93(1):8–18.
- Brown J. A New Curriculum Framework for Clinical Prevention and Population Health, with a Review of Clinical Caries Prevention Teaching in U.S. and Canadian Dental Schools. J Dent Educ. 2007 May;71(5):572–8.
- Schulte AG, Pitts NB, Huysmans MCDNJM, Splieth C, Buchalla W. European Core Curriculum in Cariology for undergraduate dental students. Eur J Dent Educ. 2011 Nov;15 Suppl 1:9–17.
- Shuler CF. Keeping the curriculum current with research and problem-based learning. J Am Coll Dent. 2001;68(3):20–4.
- Splieth CH, Innes N, Söhnel A. Evidence-based cariology in clinical and public health practice as part of the European Core Curriculum in Cariology. Eur J Dent Educ. 2011 Nov;15 Suppl 1:45–51.
- Wright JT, Graham F, Hayes C, Ismail AI, Noraian KW, Weyant RJ, et al. A systematic review of oral health outcomes produced by dental teams incorporating midlevel providers. J Am Dent Assoc. 2013;144(1):75–91.
- Braun PA, Kahl S, Ellison MC, Ling S, Widmer-Racich K, Daley MF. Feasibility of colocating dental hygienists into medical practices. J Public Health Dent. 2013;73(3):187–94.
- Brocklehurst P, Ashley J, Walsh T, Tickle M. Relative performance of different dental professional groups in screening for occlusal caries. Community Dent Oral Epidemiol. 2012 Jun;40(3):239–46.
- Chou R, Cantor A, Zakher B, Mitchell JP, Pappas M. Preventing Dental Caries in Children <5 Years: Systematic Review Updating USPSTF Recommendation. Pediatrics. 2013 Jul 15;
- Baelum V. Caries management: technical solutions to biological problems or evidence-based care? J Oral Rehabil. 2008 Feb;35(2):135–51.
- Ricketts D, Lamont T, Innes NPT, Kidd E, Clarkson JE. Operative caries management in adults and children. Cochrane Database Syst Rev. 2013;3:CD003808.
- Uribe S, Gómez SS, Ortíz ME. Systematic review on the use of fluoride toothpastes in preschool children. Medwave. 2014 Mar 20;14(S.1):e5773–e5773.
- Azarpazhooh A, Main PA. Pit and fissure sealants in the prevention of dental caries in children and adolescents: a systematic review. J Can Dent Assoc. 2008;74(2):171–7.
- Burnside G, Pine CM, Williamson PR. Statistical Aspects of Design and Analysis of Clinical Trials for the Prevention of Caries. Caries Res. 2006;40(5):360–5.
- Bandyopadhyay D, Reich B, Slate E. A spatial beta-binomial model for clustered count data on dental caries. Stat Methods Med Res. 2010 May 28.
- Green E, Yothers G, Sargent DJ. Surrogate endpoint validation: statistical elegance versus clinical relevance. Stat Methods Med Res. 2008;17(5):477–86.
- Linden A. Assessing regression to the mean effects in health care initiatives. BMC Med Res Methodol. 2013;13(1):119.
- Baelum V, Heidmann J, Nyvad B. Dental caries paradigms in diagnosis and diagnostic research. Eur J Oral Sci. 2006;114(4):263–77.
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