<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2215-3411</journal-id>
<journal-title><![CDATA[Odovtos International Journal of Dental Sciences]]></journal-title>
<abbrev-journal-title><![CDATA[Odovtos]]></abbrev-journal-title>
<issn>2215-3411</issn>
<publisher>
<publisher-name><![CDATA[Facultad de Odontología. Universidad de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2215-34112026000100271</article-id>
<article-id pub-id-type="doi">10.15517/at7ad013</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Regional Disparities in the Prevalence and Severity of Early Childhood Caries Among Preschoolers Living in Poverty in Costa Rica]]></article-title>
<article-title xml:lang="es"><![CDATA[Desigualdades regionales en la prevalencia y severidad de la caries de la primera infancia en preescolares en condición de pobreza en Costa Rica]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez-Fernández]]></surname>
<given-names><![CDATA[Adrián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Molina-Chaves]]></surname>
<given-names><![CDATA[Katherine]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gudiño-Fernández]]></surname>
<given-names><![CDATA[Sylvia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,University of Costa Rica Postgraduate Studies System Master's Program in Pediatric Dentistry, Faculty of Dentistry]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2026</year>
</pub-date>
<volume>28</volume>
<numero>1</numero>
<fpage>271</fpage>
<lpage>284</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S2215-34112026000100271&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S2215-34112026000100271&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S2215-34112026000100271&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Early childhood dental caries remains a major public health concern, especially among populations affected by socioeconomic and geographic disparities. In Costa Rica, persistent regional inequalities may influence the burden and severity of this condition. To analyze regional disparities in the prevalence and severity of dental caries among Costa Rican preschool children living in poverty. A secondary analysis was conducted using data from a descriptive, cross-sectional study carried out in 2013. The national sample included 803 children under 81 months of age enrolled in government-run centers for early childhood care and nutrition (CEN-CINAI). Clinical assessments were performed using the ICDAS system. Descriptive statistics and regional comparison tests were applied. The national caries prevalence in Costa Rica was 84.81%. Significant regional differences in severity were observed, with higher averages of affected teeth and surfaces in the Chorotega and Brunca regions. While incipient lesions (ICDAS 1-2) were most frequent, a substantial burden of moderate and severe lesions (ICDAS 3-6) was also detected, particularly in rural areas with greater structural vulnerability and limited access to oral health services.The high prevalence of dental caries and the documented regional inequalities highlight the need to strengthen prevention, early diagnosis, and timely treatment. Integrating a territorial approach into oral health policy-through early detection, preventive interventions, caregiver education, and mobile dental services-may help reduce disparities and improve pediatric oral health outcomes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La caries dental en la infancia temprana sigue siendo un problema importante de salud pública, especialmente en poblaciones afectadas por desigualdades socioeconómicas y geográficas. En Costa Rica, persisten desigualdades regionales que podrían influir en la carga y severidad de esta enfermedad. Analizar la prevalencia y severidad de caries dental en preescolares costarricenses en condición de pobreza, identificando desigualdades regionales. Se realizó un análisis secundario de datos provenientes de un estudio descriptivo, transversal, llevado a cabo en 2013, con una muestra nacional de 803 niños menores de 81 meses, matriculados en centros públicos de atención y nutrición infantil (CEN-CINAI). Las evaluaciones clínicas se realizaron mediante el sistema ICDAS. Se aplicaron estadísticas descriptivas y pruebas de comparación regional. La prevalencia nacional de caries fue del 84,81 %. Se identificaron diferencias regionales significativas en la severidad de la enfermedad, con mayores promedios de dientes y superficies afectadas en las regiones Chorotega y Brunca. Aunque predominaban las lesiones incipientes (ICDAS 1-2), se evidenció una carga considerable de lesiones moderadas y severas (ICDAS 3-6), especialmente en zonas rurales con mayor vulnerabilidad estructural y acceso limitado a servicios odontológicos. La alta prevalencia de caries y las desigualdades regionales evidenciadas destacan la necesidad de fortalecer la prevención, el diagnóstico precoz y la atención oportuna. Incorporar un enfoque territorial en las políticas de salud bucodental, mediante estrategias de detección temprana, intervenciones preventivas, educación a cuidadores y servicios móviles, puede ayudar a reducir desigualdades y mejorar los resultados en salud bucal infantil.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Dental caries]]></kwd>
<kwd lng="en"><![CDATA[Oral health]]></kwd>
<kwd lng="en"><![CDATA[Preschool children]]></kwd>
<kwd lng="en"><![CDATA[Health inequities]]></kwd>
<kwd lng="en"><![CDATA[Regional disparities]]></kwd>
<kwd lng="en"><![CDATA[Costa Rica]]></kwd>
<kwd lng="en"><![CDATA[Poverty]]></kwd>
<kwd lng="es"><![CDATA[Caries dental]]></kwd>
<kwd lng="es"><![CDATA[Salud bucal]]></kwd>
<kwd lng="es"><![CDATA[Niños preescolares]]></kwd>
<kwd lng="es"><![CDATA[Inequidades en salud]]></kwd>
<kwd lng="es"><![CDATA[Desigualdades regionales]]></kwd>
<kwd lng="es"><![CDATA[Costa Rica]]></kwd>
<kwd lng="es"><![CDATA[Pobreza]]></kwd>
</kwd-group>
</article-meta>
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