Human ecological and social determinants of dental caries among the Xavante Indigenous people in Central Brazil

Abstract

This community study evaluates complex interactions between macro and micro determinants of oral health in a local Indigenous population based on a theoretical framework of demographic, economic, and healthcare transformation over the last half century. The study population included all residents of eight Xavante villages in Central Brazil. Our hypothetical model posited multiple direct and indirect associations between dental caries and village groups with differentiated territorial and oral care histories, as well as household socioeconomic indicators and food acquisition patterns, individual sociodemographic characteristics, use of dental health services, and oral hygiene practices. Structural equation modelling methods were used to evaluate direct and indirect associations linking exogenous factors and dental caries. Results include 18 direct and 14 indirect statistically significant pathways between determinant variables and dental caries. Significant links with dental caries were shown for socioeconomic indicators, oral healthcare variables, household food acquisition patterns, sex, and age. These findings suggest that the oral health of Xavante residents in the villages studied is associated with determinant factors of different epidemiological and historical scales. The specific historical frame of territorial circumscription and demographic crisis followed by rapid population increase since the 1970s should be considered a cause-of-cause determinant of the economic, healthcare, and sociodemographic profile contributing to oral health among the Xavante. Considering the limitations of cross-sectional studies, our findings underline the importance for oral health determination of historical currents affecting minority ethnic groups within national societies.

Association between early childhood caries and malnutrition in a sub-urban population in Nigeria

“…Our study finding that malnutrition is associated with fair oral hygiene in the study population further strengthen our hypothesis. The Arantes et al [64] suggested a more comprehensive assessment of dietary risks related to caries beyond that addressing sugar intake alone. We feel that our study finding – the absence of a relationship between ECC and frequency of sugar consumption in an analysis model that included nutritional status – supports the suggestion of Arantes et al [64].…”

Association between early childhood caries and poverty in low and middle income countries

“…We found countries with sanitation, access to health, information and clean water problems had lower prevalence of ECC. We postulate that countries with sanitation, access to health, information and clean water challenges are likely to be poor indigenous communities still largely dependent on traditional agrarian diet with less consumption of industrialized and ultra-processed meals [66]. They are also more likely to be dealing with problems associated with infectious diseases rather than non-communicable disease (such as ECC) seen in countries with transitioning economies.…”

Association Between Early Childhood Caries And Malnutrition In A Sub-Urban Population In Nigeria

“…Our study finding that malnutrition is associated with fair oral hygiene in the study population further strengthen our hypothesis. The Arantes et al [59] suggested a more comprehensive assessment of dietary risks related to caries beyond that addressing sugar intake 10 alone. We feel that our study finding -the absence of a relationship between ECC and frequency of sugar consumption in an analysis model that included nutritional status -supports the suggestion of Arantes et al [59].…”

“…The Arantes et al [59] suggested a more comprehensive assessment of dietary risks related to caries beyond that addressing sugar intake 10 alone. We feel that our study finding -the absence of a relationship between ECC and frequency of sugar consumption in an analysis model that included nutritional status -supports the suggestion of Arantes et al [59]. We therefore postulate that our observed association between ECC and malnutrition may reflect a complex impact of the household dietary choices -consumption of oil, salt, fat, vegetable, carbohydrate, sugar and micronutrients -on nutritional status and ECC since malnutrition is not limited exclusively to a sugar-caries pathway.…”