The massive use of preventive measures in Mexico including fluoride toothpaste, a national program of salt fluoridation and education on prevention has resulted in a large decline in dental caries over the past two decades. There does however remain a largely unmet need for restorative treatment. This paper describes the steps leading up to the adoption of a strategy, as part of general health policy, to use Atraumatic Restorative Treatment (ART) within the Mexican public health service as a means to address this. This included the development of training materials, the organization of training courses for existing dentists and the incorporation of ART into the undergraduate curriculum. RESULTS: Six years after the introduction of ART in the year 2000, it was estimated that over 2 million ART procedures had been provided. As part of the planning cycle, an evaluation was undertaken in 2008 to determine amongst Mexican dentists what were the perceived problems when implementing the ART approach. Such research identified that the scarcity of appropriate dental materials and the lack of suitable instruments were the major problems. In addition, a preliminary evaluation of ART restorations and sealants placed as part of this National Oral Health Program was undertaken. The survival outcomes after one year compared favorably with one other study conducted in Mexico but were somewhat lower than the results reported from a number of other countries. CONCLUSION: The ambitious and forward thinking policy for improving the oral health in Mexico is now showing dividends. One example is the ART strategy, which has been successful both in terms of the number of ART procedures provided and generally in terms of clinical outcomes.

OBJECTIVE: To compare the prevalence and severity of dental caries found in epidemiological surveillance studies conducted in three areas of Mexico in two different periods, 1987-1988 and 1997-1998. METHODS: The 1987-1988 survey was done with representative samples of schoolchildren 6 to 10 years old in two states, Nuevo León and Tabasco, as well as in the country's Federal District (which includes Mexico City). The Federal District's 1987- 1988 sample also included schoolchildren who were 12 years old. The total number of students examined in the 1987-1988 period was 7 590. The 1997-1998 survey included schoolchildren who were 6-10 years old and 12 years old, in all three of the areas. The total number of students included in the 1997-1998 survey was 8164. To compare the prevalence and severity of dental caries in the two periods, the average value for the index of decayed, missing, and filled teeth (DMFT) was used with all of the age groups. RESULTS: The values of the DMFT indices were significantly lower in the 1997-1998 period for all of the age groups studied (P < 0.05 for all the age groups). In the 1997- 1998 period both Tabasco and Nuevo León achieved the goal recommended by the World Health Organization of an average of no more than three decayed, missing, and filled teeth among the 12-year-olds, with DMFT indices of 2.67 and 1.72, respectively. However, in the Federal District in that 1997-1998 period the DMFT index exceeded the recommended level, with a value of 3.11. CONCLUSIONS: The reduction seen in the DMFT indices could be due to several factors, including the consumption of fluoridated salt, the use of dentifrices and fluoride rinses, and broader access to dental services.

OBJETIVO: Comparar la prevalencia y la gravedad de la caries dental en dos estudios de vigilancia epidemiológica realizados en tres regiones de México en los años 1987-1988 y en 1997-1998. MÉTODOS: La encuesta de 1987-1988 se aplicó a una muestra representativa de escolares de 6 a 10 años de edad de los estados de Nuevo León, Tabasco y el Distrito Federal (D.F.); adicionalmente se incluyeron escolares de 12 años del D.F. El total de alumnos examinados en 1987-1988 fue de 7590. En la encuesta de 1997-1998 se incluyó a escolares de 6 a 10 y 12 años de edad de las tres regiones estudiadas. El total de alumnos incluidos en 1997-1998 fue de 8164. Se compararon las medias del índice de dientes cariados, perdidos u obturados (CPOD) de cada grupo de edad en ambos períodos. RESULTADOS: Los resultados mostraron una disminución de la prevalencia y de la gravedad de la caries dental en los grupos de edad examinados (P < 0,05). En 1997-1998, tanto en el estado de Tabasco como en el de Nuevo León se logró la meta propuesta por la Organización Mundial de la Salud de reducir a no más de tres los dientes cariados, perdidos u obturados a los 12 años de edad, con índices de CPOD de 2,67 y 1,72, respectivamente, aunque el D.F. sobrepasó esa cifra tope (CPOD = 3,11). CONCLUSIÓN: La disminución observada en los índices CPOD podría deberse a varios factores, tales como el consumo de sal fluorada, el uso de dentífricos y enjuagues fluorados, y un mayor acceso a los servicios odontológicos.