Socioeconomic inequalities and changes in oral health behaviors among Brazilian adolescents from 2009 to 2012

Abstract

OBJECTIVE To analyze oral health behaviors changes over time in Brazilian adolescents concerning maternal educational inequalities.METHODS Data from the Pesquisa Nacional de Saúde do Escolar (Brazilian National School Health Survey) were analyzed. The sample was composed of 60,973 and 61,145 students from 26 Brazilian state capitals and the Federal District in 2009 and 2012, respectively. The analyzed factors were oral health behaviors (toothbrushing frequency, sweets consumption, soft drink consumption, and cigarette experimentation) and sociodemographics (age, sex, race, type of school and maternal schooling). Oral health behaviors and sociodemographic factors in the two years were compared (Rao-Scott test) and relative and absolute measures of socioeconomic inequalities in health were estimated (slope index of inequality and relative concentration index), using maternal education as a socioeconomic indicator, expressed in number of years of study (> 11; 9-11; ≤ 8).RESULTS Results from 2012, when compared with those from 2009, for all maternal education categories, showed that the proportion of people with low toothbrushing frequency increased, and that consumption of sweets and soft drinks and cigarette experimentation decreased. In private schools, positive slope index of inequality and relative concentration index indicated higher soft drink consumption in 2012 and higher cigarette experimentation in both years among students who reported greater maternal schooling, with no significant change in inequalities. In public schools, negative slope index of inequality and relative concentration index indicated higher soft drink consumption among students who reported lower maternal schooling in both years, with no significant change overtime. The positive relative concentration index indicated inequality in 2009 for cigarette experimentation, with a higher prevalence among students who reported greater maternal schooling. There were no inequalities for toothbrushing frequency or sweets consumption.CONCLUSIONS There were changes in the prevalences of oral health behaviors during the analyzed period; however, these changes were not related to maternal education inequalities.

Are school and home environmental characteristics associated with oral health‐related quality of life in Brazilian adolescents and young adults?

“…Temporal trend analysis on adolescent's oral health behaviours related to maternal educational inequalities showed that poor oral hygiene habits, unhealthy diet and cigarette experimentation were inversely associated with maternal schooling. 37 The cross-sectional nature of the data imposes limits concerning the temporal relationship between the investigated predictors and…”

“…High parental education has positive consequences on attitudes towards adolescent's oral health. Temporal trend analysis on adolescent's oral health behaviours related to maternal educational inequalities showed that poor oral hygiene habits, unhealthy diet and cigarette experimentation were inversely associated with maternal schooling …”

Influência da saúde bucal sobre a qualidade de vida de adolescentes escolares

“…Além disso, nessa fase da vida, os pais não delegam tarefas de cuidados de saúde bucal para os filhos, e estes tendem a não aceitar a interferência dos familiares nas práticas diárias de higiene (3) . Um percentual considerável de adolescentes relatou que não necessita ser lembrado por seus pais para higienizar os dentes (4) . Para avaliar o comportamento de adolescentes, bem como as mudanças ocorridas em suas vidas e alterações socioeducativas, é importante que as avaliações sejam feitas em escolas, visto que as instituições de ensino agregam grande parte dos adolescentes e jovens da comunidade, e representam um espaço de socialização, formação e informação (5) .…”

“…A análise de fatores sociodemográficos tornase relevante, visto que condições de saúde bucal são influenciadas não somente por hábitos comportamentais, mas também por questões sociais. A prevalência e incidência da cárie dentária são fortemente associadas a indivíduos pertencentes às classes sociais mais necessitadas, cujos pais possuem baixo nível de escolaridade (8,9) , assim como hábitos de higiene bucal também são influenciados pelo nível socioeconômico (4) . Condições sociais críticas nas primeiras fases da vida podem predispor indivíduos a uma condição dentária que, por sua vez, pode ter impacto negativo na qualidade de vida na adolescência.…”

Simultaneidade de comportamentos de risco à saúde bucal em adolescentes: evidência da Pesquisa Nacional de Saúde do Escolar

“…Health risk behaviors tend to start at this stage of life and continue into adulthood 4,5 . In Brazil, the increase in school adolescents with nonfrequent dental brushing between 2009 and 2012 have drawn attention 6 , an attitude that may lead to the accumulation of dental biofilm throughout life and, consequently, to a higher risk of developing chronic oral diseases such as cavities and periodontal diseases 7 .…”