Fatores contextuais e individuais associados à cárie dentária entre crianças e adolescentes

Abstract

Dental caries can cause pain and consequently eating and sleeping difficulties, tooth loss and systemic infections (GILCHRIST et al., 2015); and despite being preventable, it remains a common oral disease in childhood (MACEY et al., 2020) and adolescence (SKINNER et al., 2015). This dissertation was composed of two manuscripts. The first study aimed to identify contextual and individual factors associated with dental caries among Brazilian adolescents. A multilevel cross-sectional study was carried out with data from 5,445 participants in the 2010 National Oral Health Survey and contextual information extracted from official public databases. The dependent variable was the number of decayed teeth, measured by the CPOD C component. Multilevel Negative Binomial Regression was conducted and the Ratio of Means (RM) was estimated. There was an average of 1.76 (±2.93) decayed teeth. Among the contextual variables, the mean number of decayed teeth was higher (RM=1.78; CI=1.19-2.65) among adolescents living in municipalities with medium/low and lower MHDI (RM=0.76; CI=0.59-0.97) in those residing in municipalities with a higher proportion of dentists/inhabitants. Dental caries among adolescents was associated with unfavorable contextual and individual conditions. The second study presents a systematic review of observational studies that investigated contextual determinants for dental caries in 12-year-old children. Searches were carried out in Medline/PubMed, SciElo and in the Virtual Health Library (VHL), using the following main terms: (("child"[mesh]) AND (“residence characteristics”[mesh] OR “social determinants of health”[mesh] OR "contextual"[TIAB] OR "contextual factors "[TIAB] OR "environment"[TIAB] OR "neighborhood"[TIAB]). methodological quality analysis in analytical cross-sectional studies by the Joanna Briggs Institute (JBI) research group. 4,049 articles were identified, of which 7 met the eligibility criteria for inclusion in the review. Contextual determinants such as fluoridated water supply, households connected to the water, average income in the neighborhood, HDI, geographic regions, life expectancy at birth, individuals in houses with three rooms or more, administrative nature of the school, coverage by public health programs and GDP per capita, are associated with the occurrence of dental caries in 12-year-old children. In view of the results of both studies, it is concluded that there is a need to expand access to dental services and highlights the need to implement public policies aimed at the most vulnerable groups.