Socially unequal improvements in dental caries levels in Brazilian adolescents between 2003 and 2010.

Abstract

Although there are numerous reports on socioeconomic inequalities in dental caries, few studies have focused on whether improvements in dental status have been accompanied by changes in socioeconomic inequalities in caries. The objective of this study was to assess whether declines in caries between 2003 and 2010 were associated with reductions in inequalities in dental caries in adolescents. Data on dental caries in adolescents aged 15-19 were used from the Brazilian National Oral Health surveys conducted in 2003 (n = 16 833) and 2010 (n = 5445). The dependent variables were Decayed, Missing and Filled Teeth (DMFT) index and the percentage caries free. Household income and educational level were independent variables. Differences between surveys for DMFT and caries free were calculated, and measurement of inequality was performed using the Slope Index of Inequality (SII) and Relative Index of Inequality (RII). Both DMFT and percentage caries free showed significant differences in absolute (SII) and relative (RII) inequalities between the two surveys for both education and income. The SII for DMFT rose from 0.54 to 2.01 and from 1.44 to 3.67 for income and education, respectively. For caries free, these values were 3.64-19.40 and 5.06-22.93. Regarding to RII, a similar trend has been found. Despite the overall reduction in DMFT and an increase in caries free, there were increases in both income and education-related inequalities in caries in Brazilian adolescents. The findings on caries differ from those for other health conditions in Brazil, where there have been reductions in inequalities.