Oral health programming and its relationship to epidemiology: challenges and opportunities

Moysés, Samuel Jorge

doi:10.1590/0102-311xpe010614

Cited by 2 publications

(3 citation statements)

References 5 publications

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“…The present study has several strengths and some weaknesses. There are some criticisms regarding the public dental service indicators . The current study is based on state goals for the year 2015.…”

Section: Discussionmentioning

confidence: 99%

“…These goals lack supporting evidence to prove their accuracy and relevance. Moyses highlighted some limitations of using public dental service provision indicators that are currently applied in Brazil. They primarily fulfil purposes of monitoring of services and are incapable of reflecting underlying inequalities by socioeconomic status and demographic characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…There are some criticisms regarding the public dental service indicators. 11,29 The current study is based on state goals for the year 2015. These goals lack supporting evidence to prove their accuracy and relevance.…”

Section: Discussionmentioning

confidence: 99%

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Area‐level social development and indicators of public dental services in Southern Brazil

Godoi

Singh

Mello

et al. 2019

Comm Dent Oral Epid

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Objectives This study aimed to test associations between a municipal social development indicator and indicators of public dental services; examine differences in the achievement of public dental services goals between fluoridated and nonfluoridated municipalities; and, quantify contribution of a municipal social development indicator in estimated mean differences in the public dental services indicators between fluoridated and nonfluoridated municipalities. Methods A secondary analysis of data from 293 municipal dental health services records from Southern Brazil between 2010 and 2015 was conducted. Multivariable log‐binomial regression models were fitted to test the associations between municipal Human Development Index (HDI) and multiple public dental services indicators (proportion of public dental health service coverage, the proportion of tooth extraction among all clinical procedures, and monthly participation in supervised tooth brushing). Cut‐off points for outcomes were based on state goals for public dental services. Blinder‐Oaxaca decomposition analyses were performed to quantify the relative contribution of HDI in the differences in outcomes according to the municipal water fluoridation status. Results Municipalities within the lowest tertile of HDI had 66% lower prevalence of having insufficient public dental health service coverage (less than state goals)than those in the highest tertile of HDI (PR: 0.44; 95% CI: 0.24, 0.50). Municipalities with lowest HDI had nearly 30% higher prevalence of failing the state goals regarding the proportion of extraction and supervised tooth brushing (PR: 1.30; 95% CI: 1.20, 1.40 and PR: 1.34; 95% CI: 1.23, 1.45, respectively). Mean public dental health service coverage was higher in nonfluoridated municipalities than fluoridated municipalities, and municipal HDI explained 36% of the total estimated mean difference. Conclusions This study found associations between municipal social development and public dental services indicators in Southern Brazil. However, higher HDI was associated with lower public dental health service coverage, lower proportion of extraction and higher coverage of supervised tooth brushing [Correction added on 2 April 2019, after first online publication: In the preceding sentence, the text “but with a higher proportion of extraction and supervised tooth brushing” was changed to “lower proportion of extraction and higher coverage of supervised tooth brushing”]. Municipal HDI contributed significantly towards the gap in public dental coverage between fluoridated and nonfluoridated municipalities, favoring nonfluoridated municipalities. These findings have important policy implications for reducing oral health inequalities as it highlights the interplay between key oral health policies and their distribution according to municipal social development.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Area‐level social development and indicators of public dental services in Southern Brazil

Godoi

Singh

Mello

et al. 2019

Comm Dent Oral Epid

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Individual and contextual factors associated to the self-perception of oral health in Brazilian adults

Silva

Oliveira

2018

Rev. saúde pública

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OBJECTIVE To analyze how individual characteristics and the social context, together, are associated with self-perception of the oral health.METHODS A multilevel cross-sectional study with data from the Brazilian National Health Survey 2013, the United Nations Development Program, and the National Registry of Health Establishments. The explanatory variables for the “oral health perception” outcome were grouped, according to the study framework, into biological characteristics (sex, color, age), proximal social determinants (literacy, household crowding, and socioeconomic stratification), and distal (years of schooling expectancy at age 18, GINI, Human Development Index, and per capita income). The described analysis was performed, along with bivariate Poisson analysis and multilevel Poisson analysis for the construction of the explanatory model of oral health perception. All analyzes considered the sample weights.RESULTS Both the biological characteristics and the proximal and distal social determinants were associated with the perception of oral health in the bivariate analysis. A higher prevalence of bad oral health was associated to lower years of schooling expectancy (PR = 1.31), lower per capita income (PR = 1.45), higher income concentration (PR = 1.41), and worse human development (PR = 1.45). Inversely, oral health services in both primary and secondary care were negatively associated with oral health perception. All the biological and individual social characteristics, except reading and writing, made up the final explanatory model along with the distal social determinants of the Human Development Index and coverage of basic care in the multilevel analysis.CONCLUSIONS Biological factors, individual and contextual social determinants were associate synergistically with the population’s perception of oral health. It is necessary to improve individual living conditions and the implementation of public social policies to improve the oral health of the population.

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Oral health programming and its relationship to epidemiology: challenges and opportunities

Cited by 2 publications

References 5 publications

Area‐level social development and indicators of public dental services in Southern Brazil

Area‐level social development and indicators of public dental services in Southern Brazil

Individual and contextual factors associated to the self-perception of oral health in Brazilian adults

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