BMC Oral Health | |
Social determinants of health and periodontal disease in Brazilian adults: a cross- sectional study | |
Andréa Maria Duarte Vargas3  Ana Cristina Viana Campos1  Efigênia Ferreira e Ferreira3  Flavio Freitas Mattos3  Maria de Lourdes Carvalho Bonfim2  | |
[1] Postgradute Program in Dentistry, Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil;Department of Dentistry, State University of Montes Claros, Montes Claros, MG, Brazil;Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil | |
关键词: Oral health; Periodontal disease; Social determinants of health; | |
Others : 1126096 DOI : 10.1186/1472-6831-13-22 |
|
received in 2013-01-15, accepted in 2013-05-07, 发布年份 2013 | |
【 摘 要 】
Background
Recently, increasing importance has been placed on the social determinants of health and disease. The present study aimed to determine the prevalence of periodontal disease in Brazilian adults and identify possible relationships with social determinants.
Methods
A cross-sectional study was performed using a sample of 743 adults (aged 35–49 years) living in an urban area of a large city in southeastern Brazil. The condition of the periodontium was assessed using the Community Periodontal Index (CPI) according to the diagnostic criteria established by the World Health Organization (WHO). The variables related to social determinants were collected using a structured questionnaire. A descriptive analysis of all study variables was performed. Multiple correspondence analysis was subsequently performed to identify relationships between periodontal disease and the social determinants of health.
Results
The periodontal exams showed that 36.5% of adults had a healthy periodontium, 2.0% had gingival bleeding, 47.1% had calculus and 9.5% had periodontal pockets of 4–5 mm. Periodontal pockets of 6 mm or more were the worst periodontal condition found (affecting only 2.1% of the participants). The correspondence analysis enabled us to form three groups with different profiles. The first group was distinguished by the presence of bleeding (gingivitis) or a healthy periodontium. The members of this group were typically aged 35 to 39 years and had 9–12 years or more than 12 years of education. The second group consisted of subjects with calculus and periodontal pockets of 4–5 mm. The members of this group were typically white men aged 40–44 years with incomes greater than $ 300.00. The third group was distinguished by the presence of periodontal pockets of 6 mm or more. The members of this group were typically adult females, black and mixed individuals who had 8 years or less of schooling, individuals with incomes ≤ $ 300.00 and widowers.
Conclusion
The results suggest that periodontal health is worse in the group for which the social indicators are worse. Therefore, the social determinants of health also affect the severity of periodontal disease in adults Brazilian society.
【 授权许可】
2013 Bonfim et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150218064636528.pdf | 291KB | download | |
Figure 1. | 48KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Watt RG: Emerging theories into the social determinants of health: implications for oral health promotion. Community Dent Oral Epidemiol 2002, 30:241-247.
- [2]Armitage GC: Analysis of gingival crevice fluid and risk progression of periodontitis. Periodontoly 2000 2004, 34:109-119.
- [3]Brasil. Ministério da Saúde: Saúde Brasil 2006: uma análise da desigualdade em saúde. Brasília: Ministério da Saúde; 2006.
- [4]World Health Organization Global: Review on oral health in ageing societies. Ageing and health. Technical report, volume 3. Kobe: WHO Kobe Centre for Health Development; 2002.
- [5]Benyamini Y, Leventhal H, Leventhal E: Self-rated oral health as on independent predictor of self-rated general health, self-esteem and life satisfaction. Soc Sci Med 2004, 59:1109-1116.
- [6]American Academy of Periodontology(AAP): Epidemiology of periodontal diseases. J Periodontol 2005, 67:1406-1419.
- [7]Hobdell MH, Oliveira ER, Batista R: Oral diseases and socioeconomical status. Br Dent J 2003, 194:91-96.
- [8]Person GR: Perpectives on periodontal risk factors. J Int Acad Periodontal 2008, 10:71-80.
- [9]Borrell LN, Burt BA, Warren RC, Neighbors HW: The role of individual and neighborhood social factors on periodontitis: the third national health and nutritional examination survey. J Periodontol 2006, 7:444-453.
- [10]Brasil. Ministério da Saúde: Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Projeto SB Brasil 2003: condições de saúde bucal da população brasileira 2002–2003. Resultados principais. Brasília: Ministério da Saúde; 2004.
- [11]Brasil. Ministério da Saúde: Secretaria de Atenção à Saúde/Secretaria de Vigilância em saúde. Departamento de Atenção Básica.Coordenação Geral de Saúde Bucal . SB Brasil Pesquisa Nacional de Saúde Bucal - 2010: resultados principais. Brasília: Ministério da Saúde; 2011.
- [12]Caldas Junior AF, Joviano Silveira RC, Marcenes W: The impact of restorative treatment on tooth loss of prevencion. Pesqui Odontol Bras 2003, 17:166-170.
- [13]Hugo FN, Hilgert JB, De Souza M, Da Silva DD, Pucca JR GA: Correlates of partial tooth loss and edentulism in the Brazilian elderly. Community Dent Oral Epidemiol 2007, 35:224-32.
- [14]IBGE: Instituto Brasileiro de Geografia e Estatística.. Cidades [acesso em 2011 Dez 08]. Disponivel em: http//:http://www.ibge.gov.br webcite
- [15]World Health Organization: Oral health surveys: basic methods. 4th edition. Geneva: WHO; 1997:47p.
- [16]Lwanga SK, Lemeshow S: Sample size determination in health studies. A pratical manual. Geneva: WHO; 1991.
- [17]Szwarcwald CL, Damacenag N: Complex sampling design in population surveys: planning and effects on statistical data. Rev Bras Epidemiol 2008, 11:38-45.
- [18]Roncalli AG, Silva NN, Nascimento AC, Freitas CHSMF, Casotti E, Peres LM, Moura L, Peres AM, Freire MCM, Cortes MIS, Vettore MV, Paludetto Júnior M, Figueiredo N, Goes PSA, Pinto RS, Marques RAA, Moysés SJ, Reis SCGB, Narvai PC: Relevant methodological issues from the SBBrasil 2010 Project for national health surveys. Cad Saude Publica 2012, 28(Suppl):s 40-57.
- [19]IBGE: Instituto Brasileiro de Geografia Estatística.. http://www.ibge.gov.br/home/estatistica/populacao webcite
- [20]Greenacre MJ: Practical Correspondence Analysis. In Looking at Multivariate Data. Edited by Barnett V. New York: J. Wiley e Sons; 1981.
- [21]Cunha-Cruz J, Nadanovsky P, Faerstein E, Lopes CS: Routine dental visits Are associated with tooth retention in Brazilian adults: the Pro-saúde study. J Public Health Dent 2004, 64:216-222.
- [22]Comissão Nacional sobre Determinantes Sociais da Saúde (CNDSS): As causas sociais das iniqüidades em saúde no. Brasil: Relatório final da comissão Nacional sobre Determinantes Sociais da Saúde (CNDSS); 2008:216.
- [23]IBGE: Instituto Brasileiro de Geografia e Estatística.. http://www.ibge.gov.br/home/estatistica/populacao/trabalhorendimento/pnad2003/notas_brasil.pdf webcite
- [24]Coelho RS, Gusmão ES, Jovino-Silveira RC, Caldas Junior AF: Profile of periodontal conditions in a Brazilian adult population. Oral Health Prev Dent 2008, 6:139-145.
- [25]Borrell LN, Taylor GW, Borgnake WE, Nyquist LV, Woolfolk MW, Allen DJ, Lang WP: Factors influencing the effect of race on established periodontitis prevalence. J Public Health Dent 2003, 63:20-29.
- [26]Gjermo P, Rösing C, Susin C, Operman R: Periodontol 2000. 2002, 29:70-78.
- [27]Albandar JM, Brunelle JA, Kingman A: Destructive periodontal disease in adults 30 years of age and older in the United States, 1988–1994. J Periodontol 1999, 70:13-29.
- [28]Burt BA: Epidemiology of periodontal diseases. J Periodontol 1996, 67:935-945.
- [29]Petersen PE, Ogawa H: Strengthening the prevention of periodontal disease: the WHO approach. J Periodontol 2005, 76:2187-2193.
- [30]Holtfreter B: Prevalence of periodontal disease and treatment demands based on a German dental survey (DMS IV). J Clin Periodontol 2010, 37:211-219.
- [31]Peres MA, Antunes JLF, Boing AF, Peres KG, Bastos JLD: Skin colour is associated with periodontal disease in Brazilian adults: a population-based oral health survey. J Clin Periodontol 2007, 34:196-201.
- [32]Marmot M: Social determinants of heath inequalities. Lancet 2005, 365:1099-104.
- [33]Braveman P, Gruskin S: Defining equity in health. J Epidemiol Community Health 2003, 57:254-258.
- [34]Bastos JL, Gigante DP, Peres KG: Toothache prevalence and associated factors: A population based study in southern Brazil. Oral Dis 2008, 14:320-326.
- [35]Barbato PR, Nagano HCM, Zanchet FN, Boing AF, Peres MA: Tooth loss and associated socioeconomic, demographic, and dental-care factors inBrazilian adults: an analysis of the BrazilianOral Health Survey, 2002–2003 (Projeto SB Brasil 2002–2003). Cad Saude Publica 2007, 23:1803-1814.
- [36]Kallestal C, Fjelddahl A: A four-year cohort study of caries and its risk factors in adolescents with high and low risk at baseline. Swed Dent J 2007, 31:11-25.
- [37]Pattussi MP, Olinto MT, Hardy R, Sheiham A: Clinical, social and psychosocial factors associated with self-rated oral health in Brazilian adolescents. Community Dent Oral Epidemiol 2007, 35:377-386.
- [38]De Reu G, Vanobbergen J, Martens LC: The influence of social indices on oral health and oral health behaviour in a group of Flemish socially deprived adolescents. Community Dent Health 2008, 25:33-37.
- [39]Heikkinen AM, Pajukanta R, Pitkaniemi J, Broms U, Sorsa T, Koskenvuo M: The effect of smoking on periodontal health of 15- to 16-year-old adolescents. J Periodontol 2008, 79:2042-2047.
- [40]Albandar JM, Rams TF: Global Epidemiology of periodontal diseases: an overview. Periodontogy 2000 2002, 29:7-10.
- [41]Marmot M, Bell R: Social Determinants and Dental Health. Adv Dent Res 2011, 23:201-206.
- [42]Macêdo TC, Costa Mda C, Gomes-Filho IS, Vianna MI, Santos CT: Factors related to periodontal disease in a rural population. Braz Oral Res 2006, 20:257-262.
- [43]Borrell LN, Burt BA, Neighbors HW, Taylor GW: Social factors and periodontitis in an older population. Am J Public Health 2004, 94:748-754.
- [44]Krieger N, Women and social class: a methodological study comparing individual, household, and census measures as predictors of black ⁄ white differences in reproductive history. J Epidemiol Community Health 1991, 45:35-42.
- [45]Soobader M, LeClere FB, Hadden W, Maury B: Using aggregate geographic data to proxy individual socioeconomic status: does size matter? Am J Public Health 2001, 91:632-636.
- [46]Krieger N, Chen JT, Waterman PD, Soobader M-J, Subramanian SV, Carson : Geocoding and monitoring of US socioeconomic inequalities in mortality and cancer incidence:does the choice of area-based measure and geographic level matter?: The Public Health Disparities Geocoding Project. Am J Epidemiol 2002, 156:471-482.
- [47]Reis DM, Pitta DR, Ferreira HMB, Jesus MCP, Morães MEL, Soares MG: Health education as a strategy for the promotion of oral health in the pregnancy period. Cien Saude Colet 2010, 15:269-276.
- [48]Silva DD, Rihs LB, Sousa MLR: Factors associated with maintenance of teeth in adults in the State of São Paulo, Brazil. Cad Saude Publica 2009, 25:2407-2418.
- [49]McGrath CM, Bedi R, Gilthorpe MS: Oral heath related quality of life-views of the public in the United Kingdom. Community Dent Health 2000, 17:3-7.
- [50]Cascaes AM, Peres KG, Peres MA: Periodontal disease is associated with poor self- rated oral health among Brazilian adults. J Clin Periodontol 2008, 36:25-33.
- [51]Bassini G, Silva CM, Opperman RV: Validity of community Periodontal Index of Treatment Need(CPITN) for population periodontis screening. Cad Saude Publica 2007, 23:33-42.
- [52]Dowsett SA, Eckert GJ, Kowolik J: The Applicability of half-mouth examination to periodontal disease assessment in untreated adult populations. J Periodontol 2002, 73:975-981.