Income‐ and education‐based inequalities of edentulism and dental services utilization in Brazil

Abstract

ObjectiveTooth loss is a worldwide public health problem affecting mainly socioeconomically disadvantaged groups. Dental services utilization may increase access to preventive actions and conservative treatment, reducing the prevalence of tooth loss. This study evaluated the income‐ and education‐based inequalities in edentulism according to the utilization of dental services among adults and older adults in Brazil.MethodsData from the National Oral Health Survey (SB Brazil, 2010) of adults (ages 35–44 years, n = 9779) and older adults (ages 65–74 years, n = 7619) were analysed. Socioeconomic indicators (SES) included education and income. The magnitude of inequality in edentulism by education and income levels was estimated by the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). The changes in the RII and SII according to the utilization of dental services were estimated. Regression models estimated the association between SES and edentulism and whether dental services utilization modified this association.ResultsHigher edentulism prevalence was observed among those with lower education and income levels. The utilization of dental services changed the education‐based inequality index in edentulism for adults, with percentage changes of 17.4% (RII) and 56.8% (SII). For adults with low education (0–4 years of study), the odds of edentulism were 80% (OR 0.2; 95% CI 0.1–0.6) and 90% (OR 0.1; 95% CI 0.01–0.2) lower for those who had used dental services within the preceding year and within 1–2 years compared with those who had used such services within the preceding 3 or more years, respectively.ConclusionThere was a social gradient in the prevalence of edentulism in adults and older adults, and the education‐based inequalities in edentulism were lower among adults reporting utilization of dental services in the preceding year.

Epidemiological study on dental caries in schoolchildren: A cross-sectional study

“…As for access to fluoridated public water supply, coverage of only 35.1% of this benefit was obtained, so that most families make use of water from wells or springs (Khemiss et al, 2022). Limited fluoridated public water supply is another determining factor for poor oral health (Ferreira et al, 2022). Thus, in order to reduce this public health problem, it is essential to adopt preventive measures that result in the control of all these factors: access to dental care and fluoridated public water supply, socioeconomic status and individual habits (Goes et al, 2022).…”

“…Preventive potency of water fluoridation can still be proven (Chisini et al, 2022;Ferreira et al, 2022;Paiva et al, 2022). Thus, the deficiency in the public supply of fluoridated water, in most of the rural area, tends to potentiate the phenomenon of polarization of dental caries (Melgar et al, 2016).…”