Subjective oral symptoms associated with self-rated oral health among Indigenous groups in Central-West Brazil.

Abstract

To determine whether subjective oral symptoms were associated with self-rated oral health after controlling for sociodemographic characteristics and dentition status in 4 different Indigenous peoples from Central-West Brazil. A population-based cross-sectional study of oral health was conducted between 2012 and 2014. The randomly selected sample was stratified according to 4 ethnic groups (Kaiwoá, Kadiwéu, Terena and Guarani) and 2 age groups (15-19 and 35-44years). The outcome was poor self-rated oral health. Independent variables obtained by interviews were age, sex, ethnicity, schooling, family income, self-reported toothache, difficulty chewing and difficulty speaking due to dental problems. Dentition status, oral morbidity and normative treatment needs were obtained through oral examinations. Unadjusted and adjusted prevalence ratios (PR) and respective 95% confidence intervals (CI) were estimated using Poisson regression modelling with robust variance estimation. Poor self-rated oral health was more common in the older age group and in Guarani peoples than their counterparts (PR=1.06 [1.00-1.12]; PR=1.09 [1.02-1.16], respectively). After adjusting for sociodemographic characteristics, fewer functional teeth (PR=1.11 [1.02-1.20]), 2 or more untreated decayed teeth (PR=1.15 [1.07-1.23]), normative need for extraction (PR=1.15 [1.05-1.25]) and normative need for restoration of one or more surfaces (PR=1.16 [1.05-1.27]) were positively associated with self-rated oral health. Toothache and difficulty speaking remained positively associated with the outcome after controlling for all previous variables (PR=1.10 [1.05-1.18]; PR=1.20 [1.09-1.32]). Oral symptoms such as toothache and difficulty speaking due to dental problems play an important role in oral health self-rating. Self-rated oral health is an appropriate indicator for use in diverse sociocultural contexts.