Factors associated with toothache among Brazilian adults: a multilevel analysis

Abstract

The aim of this study was to evaluate the factors associated with toothache in the adult population of Minas Gerais, Brazil. Individual data from a population sample (age 35 to 44 years) were collected from a secondary database of the SB Minas survey. Sampling was carried out by clusters and with multiple drawing stages. The eligibility criteria were to reside in areas chosen for the research, be within the age group, and accept to participate in the research. The individual variables assessed by a questionnaire and dental exams were sex, income, race/skin color, root caries, periodontal condition, need for dental treatment, and last dental appointment. The contextual variables, assessed by municipal indexes, were Human Development Index (HDI), illiteracy, unemployment, half minimum wage, quarter minimum wage, oral health team coverage, access to individual health care, and supervised tooth brushing average. The dependent variable was toothache in the past six months. A descriptive analysis was made using the Statistical Package for the Social Sciences and Hierarchical Linear and Nonlinear Modeling Software was used to perform the multilevel analyses for individual and contextual levels. An association was found between toothache and low income (OR = 2.00; 95%CI = 1.32-3.13), dental caries (OR = 1.86; 95%CI = 1.22-2.86), periodontal condition, and living on a quarter of the minimum wage or less (OR = 1.03; 95%CI = 1.00-1.08). Clinical and social factors were associated with toothache, reinforcing the need to improve public polices in oral health focused on the adult population.

Factors associated with oral pain and oral health-related productivity loss in the USA, National Health and Nutrition Examination Surveys (NHANES), 2015–2018

“…The prevalence of oral pain was similar to the range identified in a 2001 review of the literature [ 17 ] and to findings from more recent oral surveys in Brazil and South Africa [ 18 , 19 ]. Oral pain is considered a public health problem due to its frequency, impact on daily living, and the feasibility of prevention.…”

“…The role of socioeconomic status in oral pain has already been demonstrated in different contexts [ 17 – 19 ]. Social disparities have been also identified historically; most socially vulnerable populations are at high risk of oral disease [ 11 , 21 ], and the barriers to accessing timely dental treatment increase the odds of oral pain [ 20 ].…”

Contextual and individual factors associated with dental pain in adolescents from Southeastern Brazil

“…14 A study conducted in Brazil has shown that periodontal health status, such as probing depth greater than 3 mm, was associated with dental pain in adults. 11 This condition may perpetuate unhealthy oral habits that cause dental pain.…”

“…1 The literature reports that individual (behavioral) and contextual factors are associated with dental pain, especially with lower socioeconomic status. 2,10,11 This outcome is also more common in individuals with less access to primary healthcare and with a lower degree of social development measured by the Human Development Index (HDI). 12 Adolescence is the period of development between the ages of 10 and 19 years, 13 during which important biological and psychosocial changes occur.…”

“…18 Therefore, it is fundamental to assess health outcomes using multilevel analysis. This strategy allows inferences at the contextual and individual levels 11 and it is essential to underpin public policies to tackle oral healthcare needs, mainly in adolescents. Health promotion actions and intersectoral policies focusing on social development through improvements and on the expansion of primary healthcare should be implemented to reduce social inequalities related to oral health disparities.…”