Increase in dental caries and change in the socioeconomic profile of families in a child cohort of the primary health care in Northeast Brazil

Abstract

Background Factors associated with increases in dental caries and changes in the family socioeconomic profile were investigated in a paediatric primary health care (PHC) cohort in Northeast Brazil during the implementation of social and income transfer programmes. Method A prospective analytical study compared data from two surveys on caries in primary dentition conducted in 2006 (age: 18–36 months, n = 1045) and 2010 (age: 5–7 years). Data from the sample recruited and re-examined in 2010 ( n = 469) were analysed. Prevalences (P) and the mean primary decayed, missing and filled teeth (dmft) index, cumulative incidence and mean increase were calculated. Differences ( p ≤ 0.05 and 95% CI) in dmft ≥1 were identified via McNemar’s test. Differences in the mean dmft were evaluated according to socioeconomic variables (Kruskal-Wallis test and p ≤ 0.05). Multivariate analysis with a negative binomial model was used for the risk factors associated with increasing dmft. In the univariate analyses, nonparametric methods (Kruskal-Wallis test) were used to compare subsamples. Variables with p ≤ 0.20 were included in the multivariate model and retained when p ≤ 0.05. Results The prevalence and mean dmft (18–36 months and 5–7 years: p = 28.6 and 68.9%, mean = 1.01 and 3.46, respectively) and variation in mean dmft changed significantly ( p < 0.005) with the education level and occupation of the mother; the prevalence and mean dmft were lower for higher maternal education level and maternal participation in the labour market. The cumulative incidence and mean increase in dmft were 8.71% and 2.45, respectively. Common risk predictors for increases in caries were consumption of sweets (RR = 1.53, 95% CI 1.09–2.14) and attendance at public schools (RR = 1.49, 95% CI: 1.81–1.89). Use of private clinical services was a protective factor (RR = 0.68, 95% CI 0.54–0.87). Conclusion Increases in caries were observed despite positive changes in the distribution of socioeconomic indicators for the analysed children’s families. The risk factors identified for the increase in caries suggest ongoing problems regarding the effectiveness of intersectoral and health measures for controlling caries in populations exposed to PHC programmes.

The impact of oral health literacy and family cohesion on dental caries in early adolescence

“…At the same time, the prevalence of dental cavities was found to be greater in early adolescents who in their last dental appointment had visited a public rather than a private dental service. The use of a private dental service thus appears to be a protective factor for dental caries among children . It is possible that the higher demand for public services may engender a diminished capacity to cater for the oral health needs of adolescents.…”

Trends and age-period-cohort effect on dental caries prevalence from 2008 to 2019 among Brazilian pre-school children

“…Between the years 2015 and 2016, Brazil faced one of the ve biggest economic crises in its history [22]. Since the occurrence of dental caries in pre-schoolers in 2019 is the result of worse conditions in the rst years of life, lower income, worse housing conditions, and parental unemployment may result in higher levels of disease over time [6,23].…”

Atenção em Saúde Bucal ofertada a crianças e adolescentes na Atenção Básica

“…Quanto a maior disponibilidade de resinas em relação ao amálgama, ela poderia ser explicada pela atual tendência, também no âmbito de serviços públicos de saúde, dos profissionais optarem pela restauração em resina, sendo evidenciada uma expressiva diminuição do número de CDs que realizam restaurações em amálgama (Meurer, 2013). Tal mudança, constatada particularmente entre os profissionais graduados mais recentemente, poderia ser atribuída ao fato de, nos cursos de graduação, ser enfatizada a utilização de resinas para restaurações em dentes posteriores (Kielbassa, Glockner, Wolgin, & Glockner, 2016 (Melo, Souza, & Goes, 2019;Kramer et al, 2019;Moura et al, 2021) Não foi constatada associação entre o desfecho e as variáveis explicativas relacionadas à acessibilidade e às características estruturais, coletadas a partir do instrumento Módulo I do PMAQ-AB, 1º ciclo. Este fato nos leva a supor que a inadequação das unidades de saúde para facilitar o acesso dos usuários com necessidades especiais não se constitui em uma dificuldade para o atendimento a estes pacientes, podendo os problemas na oferta de assistência a crianças a adolescentes ser atribuídos a outros fatores.…”