Abstract
BackgroundThere is limited evidence on possible associations between social determinants and dental pain. This study investigated the relationship of neighborhood and individual social capital with dental pain in adolescents, adults and the elderly.MethodsA population-based multilevel study was conducted involving 624 subjects from 3 age groups: 15–19, 35–44 and 65–74 years. They were randomly selected from 30 census tracts in three cities in the State of Paraíba, Brazil. A two-stage cluster sampling was used considering census tracts and households as sampling units. The outcome of study was the presence of dental pain in the last 6 months. Information on dental pain, demographic, socio-economic, health-related behaviors, use of dental services, self-perceived oral health and social capital measures was collected through interviews. Participants underwent a clinical examination for assessment of dental caries. Neighborhood social capital was evaluated using aggregated measures of social trust, social control, empowerment, political efficacy and neighborhood safety. Individual social capital assessment included bonding and bridging social capital. Multilevel logistic regression was used to test the relationship of neighborhood and individual social capital with dental pain after sequential adjustment for covariates.ResultsIndividuals living in neighborhoods with high social capital were 52% less likely to report dental pain than those living in neighborhoods with low social capital (OR = 0.48, 95% CI = 0.27-0.85). Bonding social capital (positive interaction) was independently associated with dental pain (OR = 0.88, 95% CI = 0.80-0.91). Last dental visit, self-perceived oral health and number of decayed teeth were also significantly associated with dental pain.ConclusionsOur findings suggest that contextual and individual social capital are independently associated with dental pain.
Highlights
There is limited evidence on possible associations between social determinants and dental pain
None of the oral health-related behaviors were associated with dental pain, all dental services variables and oral health measures showed significant associations with dental pain (Table 1)
According to the final model (Model 5), individuals living in neighborhoods with high social capital were 52% less likely to report dental pain than those living in neighborhoods with low social capital (OR, 0.48; 95% CI, 0.27-0.85)
Summary
There is limited evidence on possible associations between social determinants and dental pain. Evidence in oral health research highlights the underlying influence of social, economic, environmental and political determinants that act via material, behavioral and psychosocial pathways [1] on oral diseases [2]. Both compositional and contextual factors of where people live influence their health [3]. There are few epidemiological studies on the social determinants of dental pain They predominantly address the relationship of a family’s social position, its socioeconomic status and cumulative episodes of poverty to children’s dental pain [7,8,9] and to adult’s orofacial and dental pain [10]. It was reported that dental pain was 33% less prevalent in adolescents living in more developed areas of the city, compared to those from less developed ones [11]
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