Socioeconomic position and self-rated oral health in Brazil: results of the Brazilian National Health Survey

Abstract

The study analyzed self-rated oral health in the Brazilian adult population according to socioeconomic status (region of residence, schooling, income, and social class), exploring the variables with the greatest sensitivity to measure the association. The study sample included 59,758 individuals 18 years or older who participated in the Brazilian National Health Survey in 2013, a population-based household survey. Self-rated oral health (teeth and gums) was analyzed as positive, fair, or negative. Multinomial logistic regression was used to estimate crude and adjusted odds ratios (OR) and respective 95% confidence intervals (95%CI). Percentage of agreement and kappa values were calculated to compare the values obtained with the regression models and the expected values. Self-rated oral health was positive in 67.4%, fair in 26.7%, and negative in 5.9%. After adjustment, the odds of negative self-rated health were significantly higher in individuals with per capita household income up to one minimum wage, or approximately USD 270/month (OR = 4.71; 95%CI: 2.84-7.83), without complete primary schooling (OR = 3.28; 95%CI: 2.34-4.61), in the social class devoid of assets (OR = 3.03; 95%CI: 2.12-4.32) and residents of Northeast Brazil (OR = 1.50; 95%CI: 1.19-1.89). Various indicators of socioeconomic status influence self-rated oral health, but per capita household income, schooling, and social class accounted for the largest gradient in self-rated oral health in Brazilian adults in 2013.