Marginalization and fluorosis its relationship with dental caries in rural children in Mexico: A cross-sectional study

Objective: Examine the association between marginalization and fluorosis with caries experience in Mexican rural children aged 8-12, in Oaxaca, Mexico. Methods: Cross-sectional study of 283 rural schoolchildren selected from two locations with high and medium levels of marginalization where the water fluoride concentration ranged from 2.0 to 2.5 ppm/F. Caries was evaluated using the DMFT index and dental fluorosis with the Thylstrup-Fejerskov Index (TFI). Socioeconomic data were collected from participants' parents, with data on the children's characteristics collected from them via a questionnaire. Results: The prevalence of caries was 72.4% (DMFT >= 1) in the permanent dentition. The prevalence of fluorosis was 98.0% (TFI >= 4=71.4%). 54.8% of the children brushed their teeth two or more times daily. In logistic regression children living in high levels of marginalization were more likely to present caries (OR=2.11, 95% CI 1.13 - 3.93) than children living in medium levels. Children with severe fluorosis (TFI >= 4) (OR=1.93, 95% CI 1.06 - 3.53) were more likely have caries than those with TFI <3. Conclusion: Rural children with a high level of marginalization and fluorosis (TFI >= 4) were more likely to present caries. Poor oral hygiene and low dental service levels were found in both marginalized areas. Populations with medium/high marginalization are more susceptible to caries.