Individual and contextual determinants of dental pain in adolescents: Evidence from a national survey

Abstract

Objective To investigate the prevalence of dental pain among adolescent students and its association with individual, school and city variables, using a multilevel approach. Subjects and Methods Individual and school data were obtained from the National Adolescent School‐Based Health Survey (PeNSE) conducted in Brazil in 2015 in a sample of 34,776 students from 1,339 schools in the 27 Brazilian capital cities. Secondary data on socioeconomic, structural and health indicators of the cities were obtained from public databases. The outcome was the prevalence of dental pain in the last six months (yes/no). Independent variables, consisting of potential social and behavioural determinants of dental pain, were structured in three levels: individual, school and city. Multilevel logistic regression was performed. Results Prevalence of dental pain was 21.8% (95% CI = 21.0–22.7). Unadjusted analysis showed significant associations between the outcome and most of the factors in the individual and in the contextual levels. In the final adjusted model, adolescents who reported unfavourable health‐related behaviours, adverse socioeconomic or psychosocial characteristics, as well as those attending public schools and living in cities with high caries prevalence (DMFT) at age 12, were more likely to report dental pain. Conclusions Prevalence of dental pain was high and associated with adverse individual and contextual factors in the school and city levels.

Dental pain prevalence associated with caries experience in pediatric patients in a clinical sample in Mexico

“…With regard to age, we observed that older children had higher experience of previous dental pain. 11,25 This is not surprising, since older children are more likely to have more untreated carious lesions in Mexico. 5 However, this trend did not hold when age and current dental pain were examined.…”

“…8,10 Among factors associated with dental pain in both developed and developing countries are demographic, socioeconomic, family, psychosocial and cultural issues, as well as oral health status. 11 Recommendations from both the World Health Organization and the International Dental Federation include amelioration of dental pain as a priority goal in the International Agenda for the Oral Health Promotion. 12 However, in Mexico there are few epidemiological studies about dental pain.…”

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

“…12 Adolescence is the period of development between the ages of 10 and 19 years, 13 during which important biological and psychosocial changes occur. 13,14,15 A high prevalence of dental caries, gingival bleeding, and tooth loss has been commonly found in adolescents. 14,16 Despite the existence of public policies that benefit this group, such as a fluoridated water supply and universal healthcare, there are few specific programs directed at the oral health of adolescents.…”

Factors associated with toothache among Brazilian adults: a multilevel analysis

“…Multilevel studies about dental pain are rare and focused on children 24,25 or adolescents. 15,26 There is a gap in the literature on dental pain in the adult population adopting a multilevel approach. Therefore, it is important to evaluate health outcomes using individual and contextual determinants.…”