Kramer Paulo Floriani, Chaffee Benjamin W, Bertelli Aline Estades, Ferreira Simone Helena, Béria Jorge Umberto, Feldens Carlos Alberto
Department of Pediatric Dentistry, Lutheran University of Brazil, Canoas, Brazil.
Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, CA, USA.
Int J Paediatr Dent. 2015 Nov;25(6):383-92. doi: 10.1111/ipd.12140. Epub 2014 Oct 17.
Oral health inequalities are the measures by which equity in oral health is tracked. Despite widespread improvement in children's dental health globally, substantial socio-economic disparities persist and may be worsening.
Quantify 10-year changes in child caries occurrence by socio-economic position in a Southern Brazilian city and compare oral health inequalities over time.
Representative surveys of dental caries in children (age <6 years) in Canoas, Brazil, were conducted in 2000 and 2010 following standardized methods. For each survey year, we calculated disparities by socio-economic position (maternal education and family income) in age- and sex-standardized caries occurrence (prevalence: dmft > 0; severity: mean dmft) using absolute measures (difference and Slope Index of Inequality) and relative measures (ratio and Relative Index of Inequality).
Comparing 2010 to 2000, caries occurrence was lower in all socio-economic strata. However, reductions were more pronounced among socio-economically advantaged groups, yielding no improvement in children's oral health disparities. Some disparity indicators were consistent with increasing inequality.
Overall, dental caries levels among children in Canoas improved, but inequalities in disease distribution endured. Concerted public health efforts targeting socio-economically disadvantaged groups are needed to achieve greater equity in children's oral health.
口腔健康不平等是追踪口腔健康公平性的指标。尽管全球儿童牙齿健康普遍有所改善，但社会经济方面的巨大差距依然存在，且可能正在加剧。
量化巴西南部一个城市儿童龋齿发生率按社会经济地位划分的10年变化，并比较不同时期的口腔健康不平等情况。
2000年和2010年，按照标准化方法对巴西卡诺阿斯市6岁以下儿童的龋齿情况进行了代表性调查。对于每个调查年份，我们使用绝对指标（差值和不平等斜率指数）和相对指标（比率和不平等相对指数），计算了按社会经济地位（母亲教育程度和家庭收入）划分的年龄和性别标准化龋齿发生率（患病率：dmft>0；严重程度：平均dmft）的差异。
与2000年相比，2010年所有社会经济阶层的龋齿发生率都有所降低。然而，社会经济优势群体的降幅更为明显，儿童口腔健康差距并未得到改善。一些差距指标显示不平等现象在加剧。
总体而言，卡诺阿斯市儿童的龋齿水平有所改善，但疾病分布的不平等现象依然存在。需要针对社会经济弱势群体开展协调一致的公共卫生工作，以在儿童口腔健康方面实现更大的公平性。
