title: The implementation and preliminary evaluation of an ART strategy in Mexico: a country example.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Ministry of Health, Mexico. heriberto.vera@salud.gob.mx
authors.forename: Vera Heriberto
authors.initials: VH
authors.lastname: Hermosillo
authors.forename: Luengas Elisa
authors.initials: LE
authors.lastname: Quintero
authors.forename: Namihira Delia
authors.initials: ND
authors.lastname: Guerrero
authors.forename: Díaz Dante Sergio
authors.initials: DD
authors.lastname: Suárez
authors.forename: Muñúzuri Jorge Alejandro
authors.initials: MJ
authors.lastname: Hernández
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Holmgren
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D057087:Dental Atraumatic Restorative Treatment / Q000706:statistics & numerical data; D003731:Dental Caries / Q000175:diagnosis / Q000628:therapy*; D003793:Dental Restoration, Permanent / Q000379:methods*; D005500:Follow-Up Studies; D006291:Health Policy; D006801:Humans; D008800:Mexico; D009909:Oral Health; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D015397:Program Evaluation; D011446:Prospective Studies; D011634:Public Health; D011795:Surveys and Questionnaires
chemical_list: D010895:Pit and Fissure Sealants