Abstract
OBJECTIVETo evaluate the association between being a recipient of the Bolsa Família program and oral health conditions in Brazilian schoolchildren.METHODSA cross-sectional study was conducted with 1,107 schoolchildren aged between eight and 12 years from 20 public and private schools in Pelotas, RS, Southern Brazil. A list of all children receiving the Bolsa Família program was provided by the participant schools. Demographic, socioeconomic and oral hygiene information were assessed using a questionnaire completed by the schoolchildren and their parents. Dental exams were performed to assess the presence of dental plaque and prevalence of dental caries. Data were analyzed by Chi-square test, Chi-square test for linear trend and multivariate Poisson Regression (prevalence ratio; 95% confidence interval).RESULTSSchoolchildren from non-nuclear families, with a DMFT ≥ 1 and who had never visited a dentist were associated with receiving the Bolsa Família. Final model showed that caries prevalence was twice as high (PR 2.00; 95%CI 1.47;2.69) in schoolchildren benefiting from the Bolsa Família . It was also showed that schoolchildren benefiting from the program presented greater severity of dental caries compared to school children from private schools (RR 1.53; 95%CI 1.18;2.00). After final adjustments, the prevalence of schoolchildren who have never visited a dentist was six times higher in children who received the government benefit (PR 6.18; 95%CI 3.07;12.45) compared to those from private schools.CONCLUSIONSSchoolchildren benefiting from the Bolsa Família program experienced more caries lesions and have less frequently accessed dental care services, which suggest the need to include oral health in the program.
Highlights
In oral health, the main health problem is dental caries, a chronic, avoidable disease, which is cumulative, and is considered a significant cause of toothache[4] and tooth loss in its most advanced stage.[19,20] The etiology of dental caries is composed of a complex interaction between biological environmental and social conditions.[21]
Schoolchildren benefiting from the Bolsa Família program experienced more caries lesions and have less frequently accessed dental care services, which suggest the need to include oral health in the program
The prevalence of dental caries has decreased in Brazil over the last few decades, there are still large inequalities in its distribution.[15]
Summary
The main health problem is dental caries, a chronic, avoidable disease, which is cumulative, and is considered a significant cause of toothache[4] and tooth loss in its most advanced stage.[19,20] The etiology of dental caries is composed of a complex interaction between biological environmental and social conditions.[21] the prevalence of dental caries has decreased in Brazil over the last few decades, there are still large inequalities in its distribution.[15] This phenomenon, named polarization of the disease, means that it is in the poorest segments of the population where almost the entire disease load is concentrated.[12]. The relationship between socioeconomic position and health conditions is clearly explained in the literature. Individuals with higher positions in the social hierarchy have better health conditions than those below, showing a social gradient in morbidity and mortality.[9,10] Oral health is a strong socioeconomic and behavioral indicator[21] and can be taken into consideration when studying social inequalities in health care
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