Abstract
This study assessed the effect of area of residence (rural vs. urban) on dental caries experience among southern Brazilian schoolchildren. This cross-sectional survey was conducted in Rosário do Sul, southern Brazil, and included 373 9-14-year-old schoolchildren attending public municipal schools (122 living in the rural area, and 251, in the urban area). Data collection included a questionnaire and a clinical examination. Clinical examination of the permanent dentition involved visible plaque index, gingival bleeding index and dental caries experience (non-cavitated and cavitated, inactive and active lesions). Samples of water were collected to check the fluoride concentration. Caries prevalence and extent using different criteria were compared between rural and urban schoolchildren using the chi-square test and the Mann-Whitney test, respectively. The association between explanatory variables and the extent of caries activity (number of active caries lesions) was assessed using Poisson regression. When caries was recorded at the cavity level (WHO criterion), no difference was observed between rural and urban populations (p ≥ 0.05). Conversely, higher caries prevalence and extent were found among urban schoolchildren when active non-cavitated lesions were also computed (p < 0.05). In the adjusted Poisson regression model, urban schoolchildren were 57% more likely to present more active lesions than rural students (RR = 1.57; 95%CI = 1.29-1.92). Rural communities did not have sufficient fluoride in the water supply, whereas ideal concentrations were detected in the urban areas. In conclusion, this cross-sectional study found that urban schoolchildren showed greater caries experience than rural students, and that this increment was related to active non-cavitated lesions.
Highlights
Submitted: January 10, 2020 Accepted for publication: April 4, 2020 Last revision: May 19, 2020Despite the significant decline in caries prevalence and progression over the last decades, dental caries remains a global public health challenge.[1]
Considering that further evidence is needed on this issue, the aim of this study was to assess the effect of the area of residence on the dental caries experience among southern Brazilian schoolchildren according to two different detection criteria
Study design and sample This cross-sectional survey was conducted in Rosário do Sul, a small-sized city located in southern Brazil, with an estimated population of 39,707 in habitants in 2010.19 According to the guidelines set by the Brazilian Institute of Geography and Statistics, the city’s population resides in two contrasting geographical settings: rural (4,776 inhabitants) and urban (34,931 inhabitants) areas.[19]
Summary
Submitted: January 10, 2020 Accepted for publication: April 4, 2020 Last revision: May 19, 2020Despite the significant decline in caries prevalence and progression over the last decades, dental caries remains a global public health challenge.[1]. Previous studies have investigated whether there are differences in the caries experience between rural and urban populations. Some studies have reported poorer oral health conditions with a higher caries experience in small cities and rural communities.[2,5,6,7,8] In this sense, rural life could expose individuals to limited access to both health services and fluoridated water, as well as to a low educational level,[9,10] all of which notably play a role in dental caries development. The differences in caries prevalence between these populations are not clear, even when comparing areas with and without fluoride in the public water supply system.[17,18]
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