Adolescents with worse levels of oral health literacy have more cavitated carious lesions.

Laio Da Costa Dutra,Monalisa Cesarino Gomes,Franklin Delano Soares Forte,Ana Flávia Granville-Garcia,Luíza Jordânia Serafim De Araújo,Érick Tássio Barbosa Neves,Larissa Chaves Morais De Lima,Saul Martins Paiva,Fernanda Morais Ferreira,Mariana Minatel Braga

doi:10.1371/journal.pone.0225176

Abstract

The aim of the present study was to investigate whether the ability to recognize and read oral health terms is associated with the number of teeth with cavitated carious lesions in adolescents. A population-based cross-sectional study was conducted involving a sample of 746 adolescents representative of students aged 15 to 19 years at the public and private school systems in a city in northeast Brazil. Two examiners who had undergone a training and calibration exercise (inter-examiner and intra-examiner Kappa coefficient: 0.87 to 0.93) performed the diagnosis of caries using the Nyvad Index and evaluated the level of OHL (BREALD-30) of the adolescents. The participants answered questions regarding their history of visits to the dentist and the parents/caregivers answered a questionnaire addressing socioeconomic characteristics. A directed acyclic graph was created to direct the selection of covariables for adjustments in the Poisson multiple regression analysis to test the association between dental caries and OHL (α = 5%). Cavitated carious lesions (codes 3 to 6 on the Nyvad index) were found in 41.6% of the adolescents. Only 29.4% had a high level of OHL (BREALD-30 scores between 23 and 30); 42.3% of the families belonged to the A-B social class and 93% of the adolescents had been to the dentist at least once in their lifetimes. In the multivariate analysis, adolescents with inadequate (PR: 1.69; 95% CI: 1.18–2.41; p = 0.004) and marginal (PR; 1.42; 95% CI: 1.01–1.99; p = 0.042) OHL and those in the lower social classes (C-D-E) (PR: 1.85; 95% CI: 1.39–2.47; p<0.001) had more teeth with cavitated carious lesions. In conclusion, adolescents aged 15 to 19 years with poorer levels of OHL had a larger number of teeth with cavitated carious lesions, independently of their socioeconomic status and history of visiting a dentist.

Highlights

Adolescence is a period of considerable transformations in which individuals often reject predetermined norms and create their own language and behaviors [1]
The intraclass correlation coefficient (ICC) was used to evaluate agreement on the total BREALD-30 scores; inter-examiner agreement— ICC = 0.987 and 0.874; and intra-examiner agreement—ICC = 0.973 and 0.994
Cavitated carious lesions were found in 41.6%

Summary

Introduction

Adolescence is a period of considerable transformations in which individuals often reject predetermined norms and create their own language and behaviors [1]. It can be a vulnerable period in terms of health due to inadequate behavior, the underuse of preventive services and greater independence from one’s parents [2,3]. Previous studies reveal that socioeconomic factors may be associated with dental caries in adolescents [5,6] Such investigations show that an unfavorable economic status is reflected in a lower brushing frequency, inadequate sanitary installations and the consumption of more cariogenic foods and beverages. This fact makes socioeconomic status an important determinant for the greater prevalence of dental caries [7,8,9]

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Conclusion