Inequalities in the distribution of dental caries among 12-year-old Brazilian schoolchildren

Chaiana Piovesan,Fausto Medeiros Mendes,José Leopoldo Ferreira Antunes,Thiago Machado Ardenghi

doi:10.1590/s1806-83242011000100012

Chaiana Piovesan, Fausto Medeiros Mendes + Show 2 more

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https://doi.org/10.1590/s1806-83242011000100012

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Abstract

We assessed the inequality in the distribution of dental caries and the association between indicators of socioeconomic status and caries experience in a representative sample of schoolchildren. This study followed a cross-sectional design, with a sample of 792 schoolchildren aged 12 years, representative of this age group in Santa Maria, RS, Brazil. Guardians answered questions on socioeconomic status and a dental examination provided information on the dental caries experience (DMF-T). Inequality in dental caries distribution was measured by the Gini coefficient and the Significant Caries Index (SiC). The assessment of association used Poisson regression models. Socioeconomic factors were associated with prevalence of dental caries for the whole sample and also for individuals with a high-caries level. Children from low-income households had the highest prevalence of dental caries. The Gini coefficient was 0.7 and the SiC Index 2.5. The percentage of caries prevalence was 39.3% (95% CI: 35.8%-42.8%) and the mean for DMF-T was 0.9 (± SD 1.5). Inequalities in the distribution of dental caries were observed and socioeconomic factors were found to be strong predictors of the prevalence of oral disease in children of this age group.

Highlights

Socioeconomic gradients have been simultaneously associated with both caries experience and distribution among preschool and schoolchildren.[1,2] Despite a global decline in dental caries experience in children, inequalities in oral health exist,[3] leading to a high prevalence of disease in some minorities.[4,5]An impressive body of scientific evidence demonstrates the underlying influence of psychosocial, economic, environmental, and political determinants on general health inequalities
In 2008, the city population was 263,403 inhabitants, with 3,180 children aged 12 years old enrolled in public schools, which corresponds to nearly 85% of all 12-year-old schoolchildren in the city
For the sample calculation to assess the prevalence of dental caries, we adopted a standard error of 5%, a confidence interval level of 95%, and an expected prevalence of 50%

Summary

Introduction

Socioeconomic gradients have been simultaneously associated with both caries experience and distribution among preschool and schoolchildren.[1,2] Despite a global decline in dental caries experience in children, inequalities in oral health exist,[3] leading to a high prevalence of disease in some minorities.[4,5]An impressive body of scientific evidence demonstrates the underlying influence of psychosocial, economic, environmental, and political determinants on general health inequalities. It is widely acknowledged that a more comprehensive and detailed understanding of oral health inequalities is needed to enable public health agencies to take effective action against this fundamental health problem.[6] it is important to know the pattern of dental caries distribution among different population groups. To investigate this problem, Bratthall proposed using the Significant Caries Index (SiC) to identify individuals with the highest prevalence of caries in each population. It was observed that 70% of caries cases were concentrated among 34% of the adolescents

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