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Celeste RK, Boing AF, Peres KG, Peres MA. Life course social mobility, race and tooth loss in adulthood: The role of dental health services. Oral Dis 2024. [PMID: 38438701 DOI: 10.1111/odi.14918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 12/12/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVES To evaluate the extent to which dental care factors in adulthood modify and, at the same time, mediate the association between race/ethnicity and social mobility from childhood to adulthood with two oral health outcomes in adults. METHODS In 2012, 1222 individuals 20-59 years old participated in the second wave of the Epi-Floripa Study in Florianopolis, Brazil. Exposures included social mobility based on adulthood and childhood events, dental care in previous years, type of dental care coverage, reason for dental visits and race. The number of missing and decayed teeth were dichotomised as MT >0 and DT >0. RESULTS The prevalence of missing and decayed teeth was 61.9% and 23.0%, respectively. Age-sex adjusted inequalities in decayed and missing teeth among Black and White individuals were 41.2 percentage points (pp) (95% CI: 3.9-78.7) and 53.1 pp (19.5:86.7), respectively. Inequalities between those persistently higher and lower in socioeconomic position were 42.6 pp (14.6-70.7) and 90.0 pp (62.1-100). The Relative Excess of Risk due to Interaction (RERI) was not statistically significant (p < 0.05). Oaxaca-Blinder decomposition analyses showed that dental care variables accounted for a small proportion of inequalities. CONCLUSIONS This result implies that dental care is unlikely to significantly reduce or increase oral health inequalities in this particular population.
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Affiliation(s)
- Roger Keller Celeste
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Antonio Fernando Boing
- Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Karen Glazer Peres
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Marco Aurelio Peres
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
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Bomfim RA, de Lucena EHG, Cavalcanti YW, Celeste RK. Racial inequality in complete dental prosthesis delivered: can public services reduce inequities? Clin Oral Investig 2023; 28:17. [PMID: 38135856 DOI: 10.1007/s00784-023-05432-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES To investigate the association between access and delivery of complete dental prosthesis according to the proportion of the black population in Brazilian municipalities and to oral health policies. MATERIALS AND METHODS Ecological data from 2017 to 2021 relating to the delivery of complete dentures stratified by race was collected in all Brazilian cities. We calculated a racial inequality indicator by subtracting the percentage of the black population from the percentage of complete dental prostheses that were delivered to blacks in each municipality. Logistic and linear regression models were carried out. RESULTS We found that 49.2% (2737) of municipalities delivered complete prostheses. The service was more frequently available in municipalities where black individuals made up 20-80% (odds ratio [OR] = 1.45, 95% confidence interval [CI] 1.15; 1.81), those with dental specialty centers (DSC) (OR = 3.04, 95%CI 2.50; 3.68), and those with more oral health teams (OHTs) (OR = 3.43, 95%CI 2.81; 4.18). Where dental prostheses were available, racial inequities favored the white population by 7.7 percentage points (p < 0.01). Increased inequality was observed in municipalities with more OHTs and/or a higher proportion of black individuals (>80%). CONCLUSIONS Although municipalities with a DSC, and with more OHTs offer better access to complete dental prosthesis for blacks, racial inequality still impacts the delivery of the service. Primary and secondary healthcare services may even exacerbate this. CLINICAL RELEVANCE Policymakers should monitor racial inequities in healthcare services. The currently unmet needs of black people are critical, especially in cities with more OHTs and/or increased proportions of black people.
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Bomfim RA. Last dental visit and severity of tooth loss: a machine learning approach. BMC Res Notes 2023; 16:347. [PMID: 38001552 PMCID: PMC10668397 DOI: 10.1186/s13104-023-06632-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/20/2023] [Indexed: 11/26/2023] Open
Abstract
The aims of the present study were to investigate last dental visit as a mediator in the relationship between socioeconomic status and lack of functional dentition/severe tooth loss and use a machine learning approach to predict those adults and elderly at higher risk of tooth loss. We analyzed data from a representative sample of 88,531 Brazilian individuals aged 18 and over. Tooth loss was the outcome by; (1) functional dentition and (2) severe tooth loss. Structural Equation models were used to find the time of last dental visit associated with the outcomes. Moreover, machine learning was used to train and test predictions to target individuals at higher risk for tooth loss. For 65,803 adults, more than two years of last dental visit was associated with lack of functional dentition. Age was the main contributor in the machine learning approach, with an AUC of 90%, accuracy of 90%, specificity of 97% and sensitivity of 38%. For elders, the last dental visit was associated with higher severe loss. Conclusions. More than two years of last dental visit appears to be associated with a severe loss and lack of functional dentition. The machine learning approach had a good performance to predict those individuals.
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Affiliation(s)
- Rafael Aiello Bomfim
- School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil.
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Leite JR, Bomfim RA. Sedentary behaviour and traumatic dental injuries in adolescents: A population-based study. Dent Traumatol 2023; 39:478-482. [PMID: 37010883 DOI: 10.1111/edt.12846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/22/2023] [Accepted: 03/21/2023] [Indexed: 04/04/2023]
Abstract
OBJECTIVE Analyse factors associated with dental trauma in 12-year-old adolescents. METHODS An epidemiological survey was carried out in the five largest cities in the state of Mato Grosso do Sul, Brazil. Data on traumatic dental injuries (TDI) based on the World Health Organization (WHO), sociodemographic characteristics and individual clinical and behavioural characteristics in 615 adolescents were collected. Univariate and adjusted multilevel logistic regressions were performed to test the association of dental trauma with behavioural and sociodemographic factors. The study was approved by the Ethics Committee (CAAE number 85647518.4.0000.0021). RESULTS The prevalence of TDI at 12 years was 3.4% (95% CI 1.8; 6.4). In the adjusted models, clinical characteristics of adolescents such as overjet >3 mm (OR = 1.51 [95% CI 1.00; 2.41]) were associated with trauma. Sociodemographic characteristics such as female sex (OR = 0.13 [95% CI 0.07; 0.25]), income above the poverty level (OR = 0.34 [95% CI 0.15; 0.78]), who declared themselves white (OR = 0.23 [95% CI 0.11; 0.47]) and with sedentary behaviour (OR = 0.69 [95% CI 0.59; 0.80]) were associated with trauma, as protective factors. CONCLUSION Sociodemographic, behavioural and individual clinical characteristics were associated with TDI in adolescents. Oral health teams should focus on the most vulnerable groups, encouraging the use of mouthguards and access to treatment services.
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Affiliation(s)
- Jean Ribeiro Leite
- School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Rafael Aiello Bomfim
- School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
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do Amaral Júnior OL, Fagundes MLB, Menegazzo GR, Giordani JMDA. Wealth index association with self-reported oral health between white and non-white older Brazilians. CAD SAUDE PUBLICA 2023; 39:e00188122. [PMID: 37377295 PMCID: PMC10494672 DOI: 10.1590/0102-311xen188122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/02/2023] [Accepted: 03/30/2023] [Indexed: 06/29/2023] Open
Abstract
This cross-sectional study aimed to identify the association between self-reported oral health status and a wealth index among white and non-white older adults in Brazil. Data from individual assessments of 9,365 Brazilians aged 50 years or older were analyzed. Poisson regression models were performed to estimate the prevalence ratio between wealth index and self-reported oral health among whites and non-whites adjusted for intermediate and proximal determinants. The total prevalence of poor self-reported oral health on white and non-white individuals was 41.6% (95%CI: 40.0-43.4) and 48% (95%CI: 47.1-49.8) respectively. The adjusted analysis showed that, for whites, the wealth index is associated with self-reported oral health since individuals in the 3rd, 4th, and 5th quintiles have 25% (PR = 0.75; 95%CI: 0.65-0.88), 20% (PR = 0.80; 95%CI: 0.67-0.95), and 39% (PR = 0.61; 95%CI: 0.50-0.75) lower prevalence of poor self-reported oral health than those in the poorest quintile. For non-white individuals, the wealth index is associated with self-reported oral health only for those in the 5th quintile, with 25% (PR = 0.85; 95%CI: 0.72-0.99) lower prevalence of poor self-reported oral health than those in the poorest quintile. The wealth index showed different effects on self-reported oral health among whites and non-whites. Socioeconomic status indicators may reflect racial inequalities due to the historical legacy of institutional discrimination. This study highlights the importance of developing policies to combat racial inequities and how these can contribute to better oral health conditions for the older Brazilian population.
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Affiliation(s)
| | | | - Gabriele Rissotto Menegazzo
- Programa de Pós-graduação em Ciências Odontológicas, Universidade Federal de Santa Maria, Santa Maria, Brasil
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Bomfim RA, Constante HM, Cascaes AM. Explaining income inequities in tooth loss among Brazilian adults. J Public Health Dent 2023; 83:101-107. [PMID: 36700483 DOI: 10.1111/jphd.12556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/30/2022] [Accepted: 12/02/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To determine the extent to which individual and contextual variables explain income inequities in tooth loss in Brazilian adults. METHODS A nationally representative sample of 65,784 Brazilian adults aged 18-59 who participated in the Brazilian National Health Survey 2019 was analyzed. Self-reported tooth loss was the outcome. Per capita income was the main exposure, and minimum wage was the cutoff point. Individual covariates included sex, race, and schooling, dental visits, smoking status, use of dental floss, and self-reported chronic conditions. Contextual covariates included access to treated water and geographic region of residence. Blinder-Oaxaca decomposition analysis was used to estimate the share of each factor in income-related tooth loss inequities by age groups. RESULTS Age-standardized tooth loss showed large income inequities. The average difference in tooth loss related to income inequities in the 18-34-year-old group was 0.50 (95% CI 0.39; 0.60), increasing to 4.51 (95% CI 4.09; 4.93) in the 45-59 years. Individual and contextual covariates explained almost 90% of income inequities in the 45-59 year group. Use of dental floss, schooling, and geographic region of residence (a proxy for human development level) had a higher proportion of contribution to the inequities examined. CONCLUSIONS Individual and contextual covariates (proxy for human development level and water fluoridation coverage) explained a large share of income-related tooth loss inequities. Tailored strategies to act at both levels can help reduce tooth loss inequities among Brazilian adults.
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Affiliation(s)
- Rafael Aiello Bomfim
- School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Helena Mendes Constante
- Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Andreia Morales Cascaes
- Department of Public Health, Graduate Program in Dentistry and Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Beltrán V, Flores M, Sanzana C, Muñoz-Sepúlveda F, Alvarado E, Venegas B, Molina JC, Rueda-Velásquez S, von Marttens A. Tooth Loss and Caries Experience of Elderly Chileans in the Context of the COVID-19 Pandemic in Five Regions of Chile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3001. [PMID: 36833696 PMCID: PMC9967189 DOI: 10.3390/ijerph20043001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/26/2023] [Accepted: 01/29/2023] [Indexed: 06/18/2023]
Abstract
Risk factors associated with tooth loss have been studied; however, the current status of the epidemiological profiles and the impact of the pandemic on the oral health of the elderly is still unknown. This study aims to determine the experience of caries and tooth loss among elderly Chilean citizens in five regions and to identify the risk factors associated with tooth loss. The sample includes 135 participants over 60 years old assessed during COVID-19 lockdown. Sociodemographic variables such as education and RSH (Social Registry of Households) were obtained through a teledentistry platform called TEGO. The history of chronic diseases such as diabetes, obesity, depression and dental caries reported by DMFT index scores were incorporated. The statistical analysis included Adjusted Odds Ratios (ORs) to assess risk factors associated with the lack of functional dentition. Multivariate hypothesis testing was used to compare the mean equality of DMFT and its components between regions (p-value < 0.05). Individuals with RSH ≤ 40% were at higher risk of having no functional dentition with OR 4.56 (95% CI: 1.71, 12.17). The only mean difference between regions was the filled tooth component. Tooth loss was associated with multidimensional lower income, where the elderly belonging to the 40% most vulnerable population had a higher prevalence of non-functional dentition. This study highlights the importance of implementing a National Oral Health Policy that focuses on oral health promotion and minimally invasive dentistry for the most vulnerable population.
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Affiliation(s)
- Víctor Beltrán
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco 4811230, Chile
- Postgraduate Program in Oral Rehabilitation, Interuniversity Center for Healthy Aging, Universidad de La Frontera, Temuco 4811230, Chile
| | - Marco Flores
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco 4811230, Chile
- Postgraduate Program in Oral Rehabilitation, Interuniversity Center for Healthy Aging, Universidad de La Frontera, Temuco 4811230, Chile
| | - Cristina Sanzana
- Postgraduate Program in Oral Rehabilitation, Interuniversity Center for Healthy Aging, Universidad de La Frontera, Temuco 4811230, Chile
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago 8380544, Chile
| | - Fernanda Muñoz-Sepúlveda
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco 4811230, Chile
- Program of Master in Dental Sciences, Dental School, Universidad de La Frontera, Temuco 4811230, Chile
| | - Eloy Alvarado
- Department of Industrial Engineering, Universidad Técnica Federico Santa María, Santiago 7630000, Chile
| | - Bernardo Venegas
- Carlos Van Buren Hospital of Valparaíso, Valparaíso 2340000, Chile
| | | | - Sandra Rueda-Velásquez
- Department of Oral Pathology, Faculty of Dentistry, Universidad Santo Tomás, Bucaramanga 680001, Colombia
| | - Alfredo von Marttens
- Department of Prosthesis, Faculty of Dentistry, Interuniversity Center for Healthy Aging, University of Chile, Santiago 8380000, Chile
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Menegazzo GR, Cunha ARD, Fagundes MLB, Amaral Júnior OLD, Giordani JMDA, Hilgert JB, Abreu LG, Hugo FN. Pathways that explain racial differences on edentulism among older adults: 2019 Brazil National Health Survey. Braz Oral Res 2023; 37:e40. [PMID: 37132727 DOI: 10.1590/1807-3107bor-2023.vol37.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/04/2022] [Indexed: 05/04/2023] Open
Abstract
This study aimed to evaluate the pathways that explain the association between race/skin color and edentulism in elderly Brazilians. This was a cross-sectional study using data from participants aged 60 years or older from the 2019 Brazilian National Health Survey, a nationally representative population-based sample. Data were obtained by a structured interview and participants were classified as edentulous if they reported having lost all natural teeth. Information on race, socioeconomic level, behavioral aspects, psychosocial aspects, and access to dental care was collected by interviewers using a questionnaire. The pathways between race/skin color and edentulism were analyzed using structural equation modeling. The final sample of the study included 22,357 participants. Most participants were white (51.5%; 95% confidence interval [CI]: 50.3-52.6), and 36.8% (95%CI: 35.7-37.9) were edentulous. Race/skin color was indirectly associated with edentulism via enabling factors. These findings suggest that socioeconomic inequalities are key in explaining racial inequalities in edentulism among Brazilian older adults.
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Affiliation(s)
| | - Amanda Ramos da Cunha
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
| | | | | | | | - Juliana Balbinot Hilgert
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
| | - Lucas Guimarães Abreu
- Universidade Federal de Minas Gerais - UFMG - School of Dentistry , Department of Child's and Adolescent's Oral Health , Belo Horizonte , MG , Brazil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
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Pitchika V, Jordan RA, Norderyd O, Rolander B, Welk A, Völzke H, Holtfreter B, Kocher T. Factors influencing tooth loss in European populations. J Clin Periodontol 2022; 49:642-653. [PMID: 35569026 DOI: 10.1111/jcpe.13642] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 03/19/2022] [Accepted: 04/26/2022] [Indexed: 11/27/2022]
Abstract
AIM This study aimed to identify the factors influencing the changes in the number of teeth present and the number of healthy or filled surfaces between two time points. MATERIALS AND METHODS Repeated cross-sectional data from population-based studies, namely the German Oral Health Studies (DMS-III vs. DMS-V), the Studies of Health in Pomerania (SHIP-START-0 vs. SHIP-TREND-0), and the Jönköping study (2003 vs. 2013), were analysed. Oaxaca decomposition models were constructed for the outcomes (number of teeth, number of healthy surfaces, and number of filled surfaces). RESULTS The number of teeth increased between examinations (DMS: +2.26 [adults], +4.92 [seniors], SHIP: +1.67, Jönköping: +0.96). Improvements in education and dental awareness brought a positive change in all outcomes. An increase in powered toothbrushing and inter-dental cleaning had a great impact in DMS (adults: +0.25 tooth, +0.78 healthy surface, +0.38 filled surface; seniors: +1.19 teeth, 5.79 healthy surfaces, +0.48 filled surface). Inter-dental cleaning decreased by 4% between SHIP-START-0 and SHIP-TREND-0, which negatively affected the outcomes. CONCLUSIONS From this study, it can be concluded that education may be the most important factor having a direct and indirect effect on the outcomes. However, for better oral health, powered toothbrushing and inter-dental cleaning should not be neglected.
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Affiliation(s)
- Vinay Pitchika
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | | | - Ola Norderyd
- Department of Periodontology, The Institute for Postgraduate Dental Education, Region Jönköping County, Jönköping, Sweden.,Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Bo Rolander
- Futurum, Academy for Health and Care, Region Jönköping County and Department of Social Work, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Alexander Welk
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Lima-Costa MF, de Melo Mambrini JV, Bof de Andrade F, de Souza PRB, de Vasconcellos MTL, Neri AL, Castro-Costa E, Macinko J, de Oliveira C. Cohort Profile: The Brazilian Longitudinal Study of Ageing (ELSI-Brazil). Int J Epidemiol 2022; 52:e57-e65. [PMID: 35748356 PMCID: PMC9908056 DOI: 10.1093/ije/dyac132] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/07/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Maria Fernanda Lima-Costa
- Corresponding author. Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz, Av. Augusto de Lima 1715, 6º andar, sala 614, Belo Horizonte, 30190-003, Brasil. E-mail:
| | | | | | - Paulo Roberto Borges de Souza
- Instituto de Comunicação e Informação Científica e Tecnológica e Tecnologia em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | - Erico Castro-Costa
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - James Macinko
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK
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Galvão MHR, Souza ACOD, Morais HGDF, Roncalli AG. Inequalities in the profile of using dental services in Brazil. CIENCIA & SAUDE COLETIVA 2022; 27:2437-2448. [PMID: 35649030 DOI: 10.1590/1413-81232022276.17352021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/22/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to examine the influence of socioeconomic factors on inequality in the use of dental services within the Brazilian population. The methodology was based on a sectional study, using secondary data from the 2013 National Health Survey (PNS, in Portuguese). The database contains information on 60,202 individuals over 18 years of age. The dependent variables were "frequency of dental appointments" and "type of dental treatment performed in the last appointment". The independent variables were sex, age group, education, social class measured using the Brazil criterion, and geographic region. The odds-ratio of outcomes were evaluated in the multivariate analysis using a multinomial logistic regression model. It was noticed that the population subgroups comprising Blacks and those residing in the North/Northeast, with lower social class and education, had a greater chance of having irregular follow-up and never having been to the dentist. In addition, this population stratum also had a greater chance of undergoing surgical or emergency dental procedures in the last dental appointment. Data from the 2013 PNS reveal a picture of social inequality in access to dental services in Brazil.
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Affiliation(s)
- Maria Helena Rodrigues Galvão
- Departamento de Odontologia, Universidade Federal do Rio Grande do Norte. Av. Sen. Salgado Filho 1787, Lagoa Nova. 59056-000 Natal RN Brasil.
| | - Ava Conceição Oliveira de Souza
- Departamento de Odontologia, Universidade Federal do Rio Grande do Norte. Av. Sen. Salgado Filho 1787, Lagoa Nova. 59056-000 Natal RN Brasil.
| | - Hannah Gil de Farias Morais
- Departamento de Odontologia, Universidade Federal do Rio Grande do Norte. Av. Sen. Salgado Filho 1787, Lagoa Nova. 59056-000 Natal RN Brasil.
| | - Angelo Giuseppe Roncalli
- Departamento de Odontologia, Universidade Federal do Rio Grande do Norte. Av. Sen. Salgado Filho 1787, Lagoa Nova. 59056-000 Natal RN Brasil.
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Multimorbidity and tooth loss: the Brazilian National Health Survey, 2019. BMC Public Health 2021; 21:2311. [PMID: 34930189 PMCID: PMC8691078 DOI: 10.1186/s12889-021-12392-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 12/07/2021] [Indexed: 12/26/2022] Open
Abstract
Background Little is known about the presence of two or more chronic conditions (multimorbidity) on tooth loss between adults and older adults. Understanding the mechanisms of multimorbidity on tooth loss is essential to inform policy development. This study aims to investigate the association between multimorbidity and severity of tooth loss in Brazilian adults and older adults. Methods We analysed data from a nationally representative sample of 88,531 Brazilian individuals aged 18 and over who participated in the 2019 Brazilian Health Survey. Tooth loss was the outcome by two different classifications: functional dentition (lost 1–12 teeth) and severe tooth loss (lost 23–32 teeth). The presence of multimorbidity was the main exposure and based on 13 self-reported doctor-diagnosed chronic diseases that were further categorised into two groups, i.e., ≥2 or ≥ 3 comorbidities. Sociodemographic covariates included sex, age, race, income, level of education and tobacco smoking and geographic region of residency. Multivariate logistic regression models estimated the OR (Odds Ratios) and 95%CI of the associations between multimorbidity and tooth loss. Results For 65,803 adults (aged 18 to 59), the presence of multimorbidity (≥2) was associated with 32% higher odds of having severe tooth loss (95% CI, 1.17; 1.49) and 33% lower odds of having functional dentition (95% CI, 0.60; 0.75). For the 22,728 older adults (aged 60 and older), multimorbidity (≥2) was associated with a 17% higher odds of severe tooth loss (95% CI, 1.06; 1.29) and 23% lower odds of having functional dentition (95% CI 0.70; 0.85). The sensitivity analysis, excluding hypertension, confirmed our findings. Conclusions Brazilian adults and older adults with multimorbidity are more likely to have severe tooth loss and less likely to have functional dentition. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12392-2.
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Martinelli DLF, Cascaes AM, Frias AC, Souza LBD, Bomfim RA. Oral health coverage in the Family Health Strategy and use of dental services in adolescents in Mato Grosso do Sul, Brazil, 2019: cross-sectional study. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2021; 30:e20201140. [PMID: 34854464 DOI: 10.1590/s1679-49742021000400010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 07/05/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the association between the coverage by oral health teams in the Family Health Strategy (FHS-OH) and the use of dental services among 12-year-old adolescents in the state of Mato Grosso do Sul, Brazil, 2019. METHODS This is a cross-sectional study involving school-based research, which adopted the use of dental services as its outcome. Structural equation modeling was used to test the association between covariates and the outcome. RESULTS Of the 615 participants, 74.0% used dental services in the last three years. ESF-SB (oral health coverage by family health strategy, acronym in Portuguese) ≥50% was associated with a greater use of public dental services [standardized coefficient (SC) = 0.10 -95%CI 0.01;0.18], a lower use of these services for prevention (SC = -0.07 -95%CI -0.17;0.01) and higher unhealthy food consumption (SC = 0.19 -95%CI 0.11;0.26). CONCLUSION Higher ESF-SB coverage was associated with a lower use of dental services for prevention and higher unhealthy food consumption. Teams must organize the access to oral health service and qualify the work process.
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Affiliation(s)
| | - Andreia Morales Cascaes
- Universidade Federal de Santa Catarina, Departamento de Saúde Pública, Florianópolis, SC, Brasil
| | | | | | - Rafael Aiello Bomfim
- Universidade Federal de Mato Grosso do Sul, Faculdade de Odontologia, Campo Grande, MS, Brasil
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