The severity of dental caries in adults aged 35 to 44 years residing in the metropolitan area of a large city in Brazil: a cross-sectional study

BMC Oral Health

Mauro Henrique NG Abreu¹  João Paulo A Haddad²  Mara Vasconcelos¹  Simone M Costa³ 

[1] Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, ZIP Code 31270901, Belo Horizonte, Minas Gerais, Brazil;Department of Veterinary Preventive Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil;Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Brazil

关键词: Epidemiology;    Oral health;    Socioeconomic factors;   

Others  :  1126483
DOI  :  10.1186/1472-6831-12-25

 received in 2012-02-08, accepted in 2012-07-20,  发布年份 2012

【 摘 要 】

Background

In recent decades, studies in the field of public health have increasingly focused on social determinants that affect the health-illness process. The epidemiological perspective considers oral health to be a reflection of socioeconomic and environmental aspects, and it is particularly influenced by the social context. The aim of the present study was to assess the association between the severity of dental caries among adults aged 35 to 44 years and characteristics on the different levels at which the determinants of caries operate (individual, social structure and social context).

Methods

A home-based, cross-sectional field study was carried out involving a sample of 1,150 adults (35 to 44 years of age) residing in metropolitan Belo Horizonte, Brazil. The DMFT (decayed, missing, filled tooth) index (≥14) was used to determine the severity of dental caries. Bivariate and multivariate analyses were carried out using the Poisson regression model with the level of significance set at 5% (p < 0.05) and 95% confidence intervals.

Results

The majority of the participants (68.5%) had high caries severity. The rate of high-severity caries in the group between 40 and 44 years of age was 1.15-fold (CI: 1.04-1.26) greater than that among those aged 35 to 39 years. A greater prevalence of high caries severity was found among those who frequently visited the dentist (PR = 1.18; CI: 1.07-1.30), those with a lower income (PR = 1.11; CI: 1.01-1.23), those who reported that their neighborhood did not come together in the previous year to petition political leaders for benefits (PR = 1.16; CI: 1.05-1.28) and those who are unable to make decisions (without empowerment) (PR = 1.12; CI: 1.01-1.24).

Conclusions

The present study revealed high dental caries severity in adults, which was associated with individual characteristics, health-related behavior and social structure and contextual variables. These findings underscore the importance of considering social determinants involved in the health-illness process when carrying out epidemiological studies on dental caries.

【 授权许可】

   
2012 Costa et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Bedos C, Brodeur JM, Arpin S, Nicolau B: Dental caries experience: a two-generation study. J Dent Res 2005, 84:931-935.
• [2]Petersen PE: Sociobehavioural risk factors in dental caries- international perspectives. Community Dent Oral Epidemiol 2005, 33:274-279.
• [3]Holst D, Schuller AA, Aleksejuniené J, Eriksen HM: Caries in population – a theoretical, causal approach. Eur J Oral Sci 2001, 109:143-148.
• [4]Locker D, Ford J: Using area-based measures of socio-economic status in dental health services research. J Public Health Dent 1996, 56:69-75.
• [5]Aggarwal V, Macfarlane T, Macfarlane G: Why is pain more common amongst people living in areas of low socio-economic status? A population-based cross-sectional study. Br Dent J 2003, 194:383-387.
• [6]Krieger N: Theories for social epidemiology in the 21st century: an ecosocial perspective. Int J Epidemiol 2001, 30:668-677.
• [7]Rothman KJ, Stein Z, Susser M: Rebuilding bridges: what is the real role of social class in disease occurrence? Eur J Epidemiol 2011, 26:431-432.
• [8]Watt RG: Emerging theories into the social determinants of health: implications for oral health promotion. Community Dent Oral Epidemiol 2002, 30:241-247.
• [9]Cimões R, Caldas Júnior AF, Souza EHA, Gusmão ES: Influência da classe social nas razões clínicas das perdas dentárias. Cien Saude Colet 2007, 12:1691-1696.
• [10]Boing AF, Peres MA, Kovaleski DF, Zange SE, Antunes JLF: Estratificação sócio-econômica em estudos epidemiológicos de cárie dentária e doenças periodontais: características da produção na década de 90. Cad Saude Publica 2005, 21:673-678.
• [11]Alcksejúniené J, Holst D, Eriksen HM, Grytten JI: Dental health patterns in Young adults in Lithuania: an exploratory, analytical approach. Acta Odontol Scand 2002, 60:223-230.
• [12]Geyer S, Schneller T, Micheelis W: Social gradients and cumulative effects of income and education on dental health in the Fourth German Oral Health Study. Community Dent Oral Epidemiol 2010, 38:120-128.
• [13]IBGE: Instituto Brasileiro de Geografia e Estatística. http://www.ibge.gov.br/home/estatistica/populacao webcite
• [14]Brasil. Ministério da Saúde Secretaria de Atenção à Saúde Departamento de Atenção Básica Coordenação de Saúde Bucal: Projeto SB Brasil 2003. Condições de saúde bucal da população brasileira: 2002–2003. Resultados principais. Ministério da Saúde, Brasília; 2004:68p.
• [15]Brasil Secretaria de Políticas de Saúde Coordenação de Desenvolvimento de Práticas da Atenção Básica: Área Técnica de Saúde Bucal. Projeto SB2000: condições de saúde bucal da população brasileira no ano 2000 – manual do coordenador. Ministério da Saúde, Brasília. DF; 2001:53f.
• [16]Levy P, Lemeshow S: Sampling for health professionals. Lifetime Learning Publications, Belmont; 1980:320p.
• [17]Brasil. Ministério da Saúde: Quantos Brasis? Equidade para Alocação de recursos no SUS. Ministério da Saúde, Brasília; 2002.
• [18]World Health Organization: Oral Health surveys: basic methods. 4th edition. WHO, Genova; 1997:47p.
• [19]Petersen PE, Bourgeois D, Ogawa H, Day-Estupinan S, Ndiaye C: The global burden of diseases and risk to oral health. Bulletin of Word Health Organization 2005, 83:661-669.
• [20]IBGE: Instituto Brasileiro de Geografia e Estatística. http://www.ibge.gov.br/home/estatistica/populacao/trabalhorendimento/pnad2003/notas_brasil.pdf webcite
• [21]Fleck MPA, Louzada S, Xavier M, Chachamovich E, Vieira G, Santos L, Pinzon V: Aplicação da versão em português do instrumento abreviado de avaliação da qualidade de vida “WHOQOL-Bref”. Rev Saude Publica 2000, 34:178-183.
• [22]Grootaert C, Narayan D, Jones VN, Woolcock M: Questionário Integrado para Medir Capital Social (QI-MCS). Banco Mundial, Washington D.C; 2003:73p.
• [23]Rodriguez Añez CR, Reis RS, Petroski EL: Versão brasileira do questionário "estilo de vida fantástico": tradução e validação para adultos jovens. Arq Bras Cardiol 2008, 91:102-109.
• [24]Griep RH, Chor D, Faerstein E, Lopes C: Test-retest reliability of measures of social network in the "Pró-Saúde" Study. Rev Saude Publica 2003, 37:379-385.
• [25]Dargatz DA, Hill GW: Analysis of survey data. Prev Vet Med 1996, 28:225-237.
• [26]Szwarcwald CL, Damacena GN: Amostras complexas em inquéritos populacionais: planejamento e implicações na análise estatística dos dados. Rev Bras Epidemiol 2008, 11:38-45.
• [27]Victora CG, Huttly SR, Fuchs SC, Olinto MTA: The role of conceptual frameworks in epidemiological analysis: a hierarquical approach. Int J Epidemiol 1997, 26:224-227.
• [28]Greeland S: Modeling and variable selection in epidemiologic analyses. Am J Public Health 1989, 79:340-349.
• [29]Pesquisa de Emprego e Desemprego – PED. A mulher no mercado de trabalho na região metropolitana de Belo Horizonte. Apoio do Ministério do Trabalho e Emprego –TEM e Fundo de Amparo ao Trabalhador – FAT. 200: A mulher no mercado de trabalho na região metropolitana de Belo Horizonte. Apoio do Ministério do Trabalho e Emprego –TEM e Fundo de Amparo ao Trabalhador – FAT. 2008, 6p. http://www.mte.gov.br/observatorio/RMBH_Mulheres_07.pdf webcite
• [30]Burt BA: Concepts of risk in dental public health. Community Dent Oral Epidemiol 2005, 33:240-247.
• [31]Busato IMS, Gabardo MCL, França BHS, Moysés SJ, Moysés ST: Avaliação da percepção das equipes de saúde bucal da Secretaria Municipal da Saúde de Curitiba (PR) sobre o tratamento restaurador atraumático (ART). Cienc Saude Colet 2011, 16:1017-1022.
• [32]Elderton RJ: Changing the course of dental education to meet future requirements. J Can Dent Assoc 1997, 63:633-639.
• [33]Brodeur JM, Payette M, Benigeri M, Gagnon PF, Olivier M, Chabot D: Dental caries in Quebec adults aged 35 to 44 years. J Can Dent Assoc 2000, 66:374-379.
• [34]Skudutyte-Rysstad R, Sandvik L, Aleksejuniene J, Eriksen HM: Dental health and disease determinants among 35-year-old in Oslo, Norway. Acta Odontol Scand 2009, 67:50-56.
• [35]Gilbert GH, Duncan RP, Dolan TA, Foerster U: Twenty-four month incidence of root caries among a diverse group of adults. Caries Res 2001, 35:366-375.
• [36]Bernabe E, Sheiham A, Sabbah W: Income, income inequality, dental caries and dental care levels: an ecological study in rich countries. Caries Res 2009, 43:294-301.
• [37]Celeste RK, Nadanovsky P, Ponce DL, Fritzell J: The individual and contextual pathways between oral health and income inequality in Brazilian adolescents and adults. Soc Sci Med 2009, 69:1468-1475.
• [38]Pattussi MP, Moyses SJ, Junges JR, Sheiham A: Capital social e a agenda de pesquisa em epidemiologia. Cad Saude Publica 2006, 22:1525-1546.
• [39]Lei N° 8.142/ 1990. DOU. Brasil: Dispõe sobre a participação da comunidade na gestão do Sistema Único de Saúde (SUS) e sobre as transferências intergovernamentais de recursos financeiros na área da saúde e dá outras providências. http://www010.dataprev.gov.br/sislex/paginas/42/1990/8142.htm webcite
• [40]Bastos FA, Santos E, Tovo MF: Capital Social e Sistema Único de Saúde (SUS) no Brasil. Saude Soc. 2009, 18:177-188.
• [41]Goldberg M, Dab W, et al.: Complex indexes for measuring a complex phenomenon. In Measurement in health promotion and protection. WHO Regional Publications; 1987:174-194. [European Series nº22]
• [42]Pattussi MP, Marcenes W, Croucher R, Sheiham A: Social deprivation, income, inequality, social cohesion and dental caries in Brazilian school children. Soc Sci Med 2001, 53:915-925.
• [43]Bower E, Gulliford M, Eteele J, Newton T: Area deprivation and oral health in Scottish adults: a multilevel study. Community Dent Oral Epidemiol 2007, 35:118-129.
• [44]Bedos C, Levesque MC: Poverty: A challenge for our society, a challenge for oral health care professionals. J Can Dent Assoc 2008, 74:693-694.
• [45]Ivankovíc A, Lukié IK, Ivankovic Z, Radié A, Vukié I: Simic: Dental caries in postwar Bosnia and Herzegovina. Community Dent Oral Epidemiol 2003, 31:100-104.
• [46]Abreu MH, Drummond SN, Paixão HH, Pordeus IA: Correction factor for the M-component of DMFS index in an adult Brazilian population [Portuguese]. Rev Odontol Univ Sao Paulo 1998, 12:323-328.