[Prevalence of cavities among adolescents in public and private schools in João Pessoa, Paraíba State, Brazil]

School type and oral conditions associated with school performance and absenteeism in adolescents: A multilevel analysis

BACKGROUND

Investigations assessing how oral health status affects school performance and attendance considering individual and community variables are lacking.

AIM

To analyze the association of school contextual factors and oral conditions with school performance and absenteeism in early adolescence.

DESIGN

This cross-sectional study was carried out with 593 12-year-old students from 20 schools in Passo Fundo, a southern city in Brazil. The caregivers provided sociodemographic information by means of a questionnaire. Oral health status was clinically examined for dental caries and gingival bleeding. Students answered the CPQ11-14 questionnaire to assess the oral health-related quality of life (OHRQoL). Information on contextual factors was obtained from the schools' administrators. "School performance" was measured by Portuguese and Mathematic tests' scores, and "school absenteeism" by the number of school days missed. Descriptive statistics was conducted, followed by unadjusted and adjusted multilevel linear regression.

RESULTS

At the individual level, low OHRQoL was associated with lower school performance and higher absenteeism. At the contextual level, students from private schools had higher school performance and lower mean of school days missed.

CONCLUSIONS

The type of school and OHRQoL were associated with school performance and attendance of adolescents.

[Access to information about how to prevent oral problems among school children in the public school network]

The scope of this study is to identify the prevalence of access to information about how to prevent oral problems among schoolchildren in the public school network, as well as the factors associated with such access. This is a cross-sectional and analytical study conducted among 12-year-old schoolchildren in a Brazilian municipality with a large population. The examinations were performed by 24 trained dentists and calibrated with the aid of 24 recorders. Data collection occurred in 36 public schools selected from the 89 public schools of the city. Descriptive, univariate and multiple analyses were conducted. Of the 2510 schoolchildren included in the study, 2211 reported having received information about how to prevent oral problems. Access to such information was greater among those who used private dental services; and lower among those who used the service for treatment, who evaluated the service as regular or bad/awful. The latter use toothbrush only or toothbrush and tongue scrubbing as a means of oral hygiene and who reported not being satisfied with the appearance of their teeth. The conclusion drawn is that the majority of schoolchildren had access to information about how to prevent oral problems, though access was associated with the characteristics of health services, health behavior and outcomes.

Acesso a orientações de higiene bucal entre escolares da rede pública de ensino

Introdução: O acesso à educação em saúde bucal é considerado um importante preditor para avaliação das condições e dos comportamentos em saúde bucal. Crianças com 12 anos estão, em sua maioria, inseridas no ambiente escolar, sendo a escola um ambiente educacional e social propício para que conhecimentos e mudanças de comportamento sejam trabalhados. Objetivo: Propõe-se identificar a prevalência do acesso a orientações de higiene bucal entre escolares da Rede Pública de Ensino e os fatores associados a esse acesso. Metodologia: Trata-se de um estudo transversal, analítico, conduzido entre escolares de 12 anos de idade de um município brasileiro de grande porte populacional. Os exames foram realizados por 24 Cirurgiões-Dentistas treinados e calibrados com auxílio de 24 anotadores. A coleta de dados ocorreu em 36 escolas públicas, sorteadas dentre as 89 escolas do município. Foram conduzidas análises descritivas, univariadas e múltiplas (OR/IC95%). Resultado: Dos 2.755 escolares avaliados, 2.510 foram incluídos. Destes, 2.173 (86,6%) receberam orientações de higiene bucal. O acesso a orientações de higiene bucal foi maior entre escolares do sexo masculino e dentre os que utilizaram serviços odontológicos privados ou por convênio. Foi menor entre os que usaram o serviço odontológico para tratamento e há mais de um ano, dentre os que não recebiam assistência odontológica na escola e entre aqueles que relataram uma frequência de higiene bucal de uma vez por dia. Conclusão: A maioria dos escolares teve acesso a orientações de higiene bucal, estando este acesso associado a variáveis referentes aos determinantes pessoais, ao serviço de saúde e aos comportamentos.

The prevalence of inhalant use and associated factors among adolescents in Belo Horizonte, Brazil

The scope of this study was to establish the prevalence of inhalant use among adolescents and its association with marijuana use, alcohol consumption, socioeconomic status and gender. A cross-sectional study was performed with a representative sample of 891 adolescents from public and private schools in the city of Belo Horizonte, Brazil. Data were collected using two self-administered questionnaires: the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Alcohol Use Disorders Identification Test (AUDIT C). The socioeconomic status was evaluated using the Social Vulnerability Index, mother's education level and type of school (public or private). The data were analyzed using the chi-square test (p < 0.05) and logistic regression analysis. The prevalence of inhalant use was 7.9%. No significant association was found between the use of inhalants and socioeconomic status after the logistic regression analysis. Inhalant use among adolescents was associated with marijuana use (OR: 4.61; 95% CI: 2.27 - 9.36) and with binge drinking (OR: 5.02; 95% CI: 2.57 - 9.81).

Social determinants of health and dental caries in Brazil: a systematic review of the literature between 1999 and 2010

OBJECTIVE: To review epidemiological studies conducted in Brazil that investigated the distribution of dental caries according to socioeconomic status and demographic characteristics. METHODS: The systematic review included articles published between 1999 and 2010 available in six bibliographic sources, without any other restriction. We analyzed the bibliometric and methodological characteristics of the studies, and the direction and statistical significance of associations tested. RESULTS: Of the 1,128 references identified, 67 were incorporated into this study. There was a higher percentage of publications in the last two years and most of the studies were conducted in the South and Southeast of the country with a young population. The cross-sectional design, using a complex sampling procedure, was the most commonly adopted. The DMFT and dmft indexes were the most commonly used to measure dental caries, while sex/gender, income, education, race/skin color and type of school were the most common socioeconomic exposures. CONCLUSIONS: Most studies identified a high rates of dental caries among the poorest, least educated, black and brown and female individuals. A more detailed methodological and theoretically sound study of the relationship between dental caries and socioeconomic conditions is needed.

Association between binge drinking, type of friends and gender: a cross-sectional study among Brazilian adolescents

BACKGROUND

Hazardous drinking among adolescents is a major public health concern. The purpose of this study was to examine the prevalence of binge drinking/alcohol consumption and its association with different types of friendship networks, gender and socioeconomic status among students in Belo Horizonte, Minas Gerais, Brazil.

METHODS

We conducted a cross-sectional study on a representative random sample of 891 adolescents (41% male, aged 15-19 years) from public and private schools in 2009-2010. Information on friendship networks and binge drinking was collected using two validated self-administered questionnaires: the Integrated Questionnaire for the Measurement of Social Capital and the first 3 items in the Alcohol Use Disorders Identification Test (AUDIT C). We used the area-based Social Vulnerability Index (SVI), mother and father's educational background, and the type of school to assess socioeconomic status. The chi-squared test was used to examine the associations between sample characteristics or the type of friends and binge drinking (p-values <0.05 were considered statistically significant). Ordinal logistic regression was used to estimate the association between binge drinking and the independent variables.

RESULTS

A total of 321 (36%) adolescents reported binge drinking (5 or more drinks in one occasion), and among them, 233 (26.2%) adolescents reported binge drinking less than monthly to monthly, and 88 (9.9%) weekly to daily. Binge drinking was associated with being male (OR = 1.52, 95% CI 1.01-2.28) and with living in a low vulnerability area (having the best housing conditions, schooling, income, jobs, legal assistance and health) (OR = 1.66, 95% CI 1.05-2.62). Students who reported that their closest friends were from school (as opposed to friends from church) had an increased risk of binge drinking (OR = 3.55, 95% CI 1.91-5.87). In analyses stratified by gender, the association was significant only among the female students.

CONCLUSIONS

The prevalence of binge drinking was high in this sample of Brazilian adolescents, and gender, low social vulnerability and friendship network were associated with binge drinking.

Fatores associados à experiência de cárie em escolares de um município com baixa prevalência de cárie dentária

A literatura tem mostrado que piores níveis de saúde bucal estão mais frequentemente relacionados a baixos níveis socioeconômicos, assim este estudo transversal de caráter exploratório investigou a associação entre experiência de cárie e fatores socioeconômicos, acesso a serviços, autopercepção e hábitos em 266 escolares de 12 anos de idade de uma localidade com baixa prevalência de cárie dentária em 2003. Utilizou-se critérios de diagnóstico para cárie dentária da Organização Mundial da Saúde e aplicou-se questionário socioecômico e comportamental. Para a identificação dos fatores associados à experiência de cárie utilizou-se a análise de regressão logística multivariada. A variável dependente foi dicotomizada em CPOD=O e CPOD>0. Considerando as limitações de um estudo transversal, não gostar da aparência dos dentes, procurar atendimento odontológico por dor, estudar em escola pública e o responsável da família ser trabalhador manual foram independentemente associados à experiência de cárie. Mesmo em um município com baixa prevalência de cárie os fatores socioeconômicos, o acesso a serviço odontológico e a autopercepção da saúde bucal foram importantes para a ocorrência da cárie, recomendando-se que diversos fatores sejam investigados dentro do contexto biopsicossocial da sua multifatoriedade.

Can type of school be used as an alternative indicator of socioeconomic status in dental caries studies? A cross-sectional study

Background

Despite the importance of collecting individual data of socioeconomic status (SES) in epidemiological oral health surveys with children, this procedure relies on the parents as respondents. Therefore, type of school (public or private schools) could be used as an alternative indicator of SES, instead of collecting data individually. The aim of this study was to evaluate the use of the variable type of school as an indicator of socioeconomic status as a substitute of individual data in an epidemiological survey about dental caries in Brazilian preschool children.

Methods

This study followed a cross-sectional design, with a random sample of 411 preschool children aged 1 to 5 years, representative of Catalão, Brazil. A calibrated examiner evaluated the prevalence of dental caries and parents or guardians provided information about several individual socioeconomic indicators by means of a semi-structured questionnaire. A multilevel approach was used to investigate the association among individual socioeconomic variables, as well as the type of school, and the outcome.

Results

When all significant variables in the univariate analysis were used in the multiple model, only mother's schooling and household income (individual socioeconomic variables) presented significant associations with presence of dental caries, and the type of school was not significantly associated. However, when the type of school was used alone, children of public school presented significantly higher prevalence of dental caries than those enrolled in private schools.

Conclusions

The type of school used as an alternative indicator for socioeconomic status is a feasible predictor for caries experience in epidemiological dental caries studies involving preschool children in Brazilian context.