Examining the Relationship between Social and School Environment and Children’s Caries Experience Using Primary and Secondary Data: A Cluster Analysis

Abstract

Dental caries is still prevalent worldwide, even with advances in preventive and curative measures. The aim was to examine clustering patterns of socioeconomic and environmental characteristics of schools and their associations with caries experience of schoolchildren. An epidemiological survey with cross-sectional design was conducted in 2014/2015 and included 5,213 students (aged 2–11 years) from 38 public schools of Carapicuíba (SP, Brazil). Primary data consisted of dental examinations performed at schools by 6 calibrated examiners to evaluate caries experience (dmf/DMFT index). Secondary data were extracted from the last official Demographic Census (2010) and School Census (2014 and 2015) to assess the socioeconomic and environmental characteristics of the territorial units and infrastructure of each school, respectively. Cluster analysis and ANOVA were applied to identify schools with similar social and environmental aspects and children’s caries experience. A logistic regression model was used to ascertain the effects of cluster variables on the likelihood that participants have caries experience, controlling for the stage of dentition and sex. Two valid and reliable clusters were identified: cluster 1 (“advantaged group”), characterized by 33 schools with the highest percentages of children without caries experience and located in regions with better socioenvironmental indicators, and cluster 2 (“least advantaged group”), characterized by 5 schools with higher percentages of children with caries experience, lower percentages of households with sanitary sewer and water supply, higher residents/household ratio and higher percentages of families living with up to 1 minimum wage. An increase in the odds of having caries experience for each percent of houses with well water and families which live with up to 1 minimum wage was observed. By using primary and secondary data, the study draws attention to the relationship between socioeconomic and environmental indicators and caries experience, identifying least advantaged regions and helping to design strategic health plans for this target population.

Relation between caries experience and the consumption of sweetened drinks and processed food in children: A population‐based study

“…The study included data from a large epidemiological survey of the municipality of Carapicuíba, carried out in 2014 and 2015, as previously described 15 . While the previous study focused on the relationship between sociodemographic variables and dental caries using an ecological design and school approach, the present study focused on individual characteristics of schoolchildren and the relation between caries experience, diet, access to oral health services, and oral hygiene habits.…”

Socioeconomic Position and Dental Caries in Latin America: A Systematic Review

“…However, it should be considered that global targets in terms of absolute values are limited and, instead, health management and planning at local and national levels should formulate realistic goals for the oral health of each community. (17). The prevalence of children with caries in this sample was higher than that stipulated by the World Health Organization -WHO for the year 2000 in Latin America, whose objective was that 50% of children between 5 and 6 years old were free of caries.…”

“…In addition, there was a 3% increase in the odds of having cavities for each additional percentage of families living on up to minimum wage. (17,18).…”

Geographic Information Systems (GIS) to Assess Dental Caries, Overweight and Obesity in Schoolchildren in the City of Alfenas, Brazil

“…Several studies have been demonstrating that dental caries is still highly incident and prevalent in many regions of Brazil [38][39][40][41][42], therefore, it is necessary to identify the population and the risk factors involved with a higher occurrence risk in order to trace an efficient surveillance. Boing et al [36] have identified that dental caries has higher rates among the poorest individuals, and the identification of populations at higher risk may support interventional strategies to minimize the incidence of this condition [43].…”