Contextual and individual indicators associated with the presence of teeth in adults

Barbato, Paulo Roberto; Peres, Marco Aurélio; Höfelmann, Dorotéia Aparecida; Peres, Karen Glazer

doi:10.1590/s0034-8910.2015049005535

Cited by 16 publications

(25 citation statements)

References 29 publications

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“…socioeconomic groups 10 . Marked social inequalities are commonly found in oral conditions 11,12 in different age groups 9 . Scenarios of greater socioeconomic inequality present greater inequality in oral health indicators 6 .…”

Section: Introductionmentioning

confidence: 99%

Income inequalities in oral health and access to dental services in the Brazilian population: National Health Survey, 2013

Bastos

Medina

Sousa

et al. 2019

Rev. bras. epidemiol.

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Introduction: Despite the improvement in oral health conditions observed in the Brazilian population, there are still high social inequalities that must be monitored. Objective: To evaluate income inequality in oral hygiene practices, oral health status and the use of dental services in the adult and senior Brazilian population. Methods: Data from the National Health Survey conducted in 2013 (Pesquisa Nacional de Saúde - PNS 2013) were used for the population aged 18 years old or older. Results: Inequalities were found among the income strata in most of the oral health indicators evaluated. The greatest inequalities were observed in the use of dental floss, in hygiene practices (PR = 2.85 in adults and PR = 2.45 in seniors), and in total tooth loss (PR = 6.74 in adults and PR = 2.24 in seniors) and difficulty in chewing (PR = 4.49 in adults and PR = 2.67 in seniors) among oral condition indicators. The magnitude of inequalities was high in both groups in most oral condition indicators. Income was a factor that persisted in limiting access to dental services, and even the lower income segments had high percentages that paid for dental consultations. Conclusion: Based on data from the first PNS, the findings of this study enabled the identification of oral health and dental care aspects more compromised by income differentials, thus, contributing to the planning of dental care in Brazil and to stimulate the monitoring of these disparities with data from future surveys.

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Section: Introductionmentioning

confidence: 99%

Income inequalities in oral health and access to dental services in the Brazilian population: National Health Survey, 2013

Bastos

Medina

Sousa

et al. 2019

Rev. bras. epidemiol.

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“…It is also associated with high economic burden as its treatment, combined with other oral disorders, accounts for approximately 4.7% of overall global health expenditure . Several factors such as low socio‐economic status, oral health compromising behaviours such as smoking and high sugar consumption are reported to be associated with tooth loss . Negative impacts of tooth loss on daily activities such as phonation, eating and socializing are well documented .…”

Section: Introductionmentioning

confidence: 99%

Is there a relationship between obesity and tooth loss and edentulism? A systematic review and meta‐analysis

et al. 2016

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This study conducted a systematic review to assess the bi-directional association between tooth loss/edentulism and obesity. Electronic searches were performed in four different databases. Observational studies that tested associations between tooth loss/edentulism and obesity as either exposures or outcomes were included. Additionally, meta-analyses, funnel plots and sensitivity analyses were conducted to synthesize the evidence. A total of 549 articles were identified in the electronic database search. Out of which, 16 studies were included within the meta-analyses: 75% considered tooth loss/edentulism as exposure and obesity as outcome, whereas 25% alternatively considered obesity as exposure and tooth loss/edentulism as outcome. Pooled estimates showed that obese individuals had 1.49 (95%CI 1.20-1.86) and 1.25 (95%CI 1.10-1.42) times higher odds of having any tooth loss and edentulism, respectively. Alternatively, when tooth loss or edentulism were considered as exposures, individuals with any tooth loss had 1.41 (95%CI 1.11-1.79) times higher odds for obesity, while edentates had even higher odds (OR 1.60; 95%CI 1.29-2.00). The results indicate a bi-directional association between tooth loss and obesity. Considering that all selected studies were of cross-sectional study design limiting inferences on temporality, longitudinal prospective studies are required to test the causal relationship between tooth loss/edentulism and obesity or vice a versa. © 2016 World Obesity.

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“…However, these indicators may demonstrate the effect of other policies and environmental characteristics that favor access to primary health care in general, sanitation, access to cultural and social opportunities, more social capital, more work and economic security, and more healthy food available. All these contextual factors are potential mediators of the association between HDI and tooth loss and have been pointed out as determinants of oral health [34,60] in previous studies that had demonstrated the main effect of social-level indicators on tooth loss using multilevel approaches in Brazil, United States, European countries, Australia and Japan [18,[20][21][22][23][24][27][28][29][30][31][32].…”

Section: Discussionmentioning

confidence: 99%

“…The in uence of contextual determinants on oral health after accounting for individual-level factors (compositional effect) had been extensively shown assuming the xed effects [18,[20][21][22][23][24][27][28][29][30][31][32][33]. In general, these studies had found higher tooth loss in socially disadvantaged areas independently of individual socioeconomic indicators [22,24,[32][33][34].…”

Section: Introductionmentioning

confidence: 99%

“…Different levels of education can also explain such disparities, because this socioeconomic indicator may capture the long-term in uences of both early life circumstances on adult health, as well as the in uence of adult resources on health (for example, through employment status) [19]. Previous studies have shown a consistent independent effect of lower individual education on tooth loss among adults [20][21][22][23] and elders [24]. Education equips individuals with knowledge and skills that are useful for the prevention of disease and attitudes toward healthy behavior.…”

Section: Introductionmentioning

confidence: 99%

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Education and income-based inequality in tooth loss among Brazilian adults: does the place you live make a difference?

Ferreira

Senna

Rodrigues

et al. 2020

Preprint

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Background: Socioeconomic inequalities in tooth loss might be minimized or potentialized by the characteristics of the context where people live. We examined whether there is contextual variation in socioeconomic inequalities in tooth loss across Brazilian municipalities. Methods: Data from the 2010 National Oral Health Survey of 9,633 adults living in 157 Brazilian municipalities were used. The individual socioeconomic indicators were education and household income. At the municipal level, we used the Municipal Human Development Index (HDI) as our contextual indicator of socioeconomic status (low:<0.699 versus high: >0.70). The Relative (RII) and Slope (SII) Indexes of Inequality, Relative (RCI), and Absolute (ACI) Concentration Indexes were calculated to compare the magnitude of education and income-based inequalities among municipalities with low versus high HDI. Multilevel Poisson regression models with random intercepts and slopes were developed. Results: At the individual level, adults with lower education & income reported more tooth loss. The mean number of missing teeth was 9.52 (95%CI: 7.93-11.13) and 6.95 (95%CI: 6.43-7.49) in municipalities with low and high HDI, respectively. Municipalities with high HDI showed higher relative and absolute education-based inequality. For income-based inequalities, higher SII and RCI was observed in municipalities with lower HDI. A significant cross-level interaction indicated that high-education adults reported fewer missing teeth when they lived in municipalities with high HDI compared to adults with the same education level living in low HDI municipalities. For individuals with the lowest education level, there was no difference in the number of teeth between those from municipalities with high and low HDI.Conclusions: There was a social gradient in tooth loss by education and income. Living in disadvantaged municipalities cannot overcome the risk associated with low schooling. The protective effect of higher education can be reduced when people live in disadvantaged areas.

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Contextual and individual indicators associated with the presence of teeth in adults

Cited by 16 publications

References 29 publications

Income inequalities in oral health and access to dental services in the Brazilian population: National Health Survey, 2013

Income inequalities in oral health and access to dental services in the Brazilian population: National Health Survey, 2013

Is there a relationship between obesity and tooth loss and edentulism? A systematic review and meta‐analysis

Education and income-based inequality in tooth loss among Brazilian adults: does the place you live make a difference?

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