Abstract
ABSTRACT Objective To analyze the spatial distribution of decayed and restored teeth in adults according to the Social Exclusion Index (SEI) and the proximity of public dental service. Methods: This ecological study used secondary data from an epidemiological survey of oral health and from the Piracicaba Research and Planning Institute (IPPLAP). The oral examinations of the DMFT index examined in households by a single examiner calibrated in 2011, by probability sampling, 248 adults (aged 20 to 64 years) representing the residents in Piracicaba-SP, Brazil. Data on social exclusion and health units with dental service were extracted from IPPLAP. We performed georeferencing of the census tracts selected by draw in the epidemiological survey and their respective districts, in addition to the health units with dental service in a radius of 500 m and 1000 m. Spearman’s rank correlation coefficient was analyzed (p<0.05). Results: The smallest value of SEI, that is, the highest social exclusion, showed no correlation with decayed teeth (p=0.09), but had strong positive correlation with restored teeth (r=0.79; p<0.0001). Presence of public dental service in the vicinity of 500 m and 1,000 m showed no correlation, respectively, with the average number of decayed (p=0.07 and p=0.58) and restored (p=0.26 and p=0.56) teeth. Conclusion: Although the correlation between social exclusion and caries in adults was not observed, its case management, namely, the restored teeth, showed correlation with social inequalities. Presence of public dental service showed no correlation with components of caries experience evaluated in this study.
Highlights
Tooth decay is a sucrose-dependent, multifactorial, behavioral and polarized disease [1,2,3]
Sample calculation of the aforementioned study was accomplished through probability sampling for 202,131 adults residing in Piracicaba-SP aged between 20 and 64 years, according to methodology carried out by Batista et al.,16 with a sample of 248 adults distributed in 30 census tracts
Despite the fact that the spatial distribution of dental caries of adults has shown no correlation with social exclusion in the city, it showed correlation with its case management, that is, with the restored teeth
Summary
Tooth decay (dental caries) is a sucrose-dependent, multifactorial, behavioral and polarized disease [1,2,3]. Tooth decay (dental caries) is the most prevalent disease in the world; it affects about 35% of people and is the main problem of oral health in the world population [5,6,7]. Dental caries still remains as a public health problem. According to the Global Burden of Disease, both in 1990 and in 2010, untreated caries remains among one of the hundred conditions that most impacted the population health [5]. Despite advances in world public health, the incidence of dental caries has not reduced in recent decades and presents uneven distribution in the populations [5,6,7]. In Brazil, despite the reduction of caries experience in the children population [2], this tendency is not seen in other age groups and presents an increase in older populations such as in adults [8,9]
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