Vazquez Fabiana de Lima, Cortellazzi Karine Laura, Kaieda Armando Koichiro, Bulgareli Jaqueline Vilela, Mialhe Fabio Luiz, Ambrosano Glaucia Maria Bovi, da Silva Tagliaferro Elaine Pereira, Guerra Luciane Miranda, de Castro Meneghim Marcelo, Pereira Antonio Carlos
Department of Community Dentistry, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil, Av, Limeira 901, P,O, BOX 52, CEP: 13414-903 Piracicaba, SP, Brazil.
BMC Oral Health. 2015 Jan 20;15:6. doi: 10.1186/1472-6831-15-6.
Investigate the individual and contextual variables related to caries in underprivileged adolescents, and the disparity in distribution of the disease.
Cross-sectional analytical study, conducted in the city of Piracicaba, SP, Brazil, in 2012. The probabilistic sample was composed of 1,179 adolescents from 15-19 years of age, randomly selected from 21 state schools and 34 Primary Health Units--Family Health (PHU-FH). The dependent variables studied were number of decayed teeth and caries experience (DMFT). The independent variables were classified into individual (clinical, sociodemographic, psychosocial, self-perception, impact on oral health, access to services, and quality of life) and contextual (social exclusion index, total number of residents in suburb, literacy rate, and the following variables given in percentages: residences in the home ownership category, provision of domestic sewerage, trash collection, families with income of over 1 minimum wage per month, and families without monthly income) variables. The multilevel regression model was estimated by the PROC GLIMMIX (Generalized Linear Models-Mixed) procedure, considering the individual variables as Level 1 and the contextual variables of the suburbs as Level 2. Adjustment of the model was evaluated by -2 Res Log Likelihood with α = 0.05.
As regards the individual variables, adolescents who declared having a prison inmate in the Family and resided in homes with a larger number of persons, showed a higher number of decayed teeth. There were a larger number of decayed teeth, a higher DMFT value, and worse self-perception as regards the health of their teeth and mouth. Other variables, such as being of the female gender, age and time since last visit to the dentist were related to the DMFT index. As regards the contextual variables, the DMFT was lower in suburbs with greater access to domestic sewage, and the number of decayed teeth was higher in suburbs with the worst social exclusion indices.
Individual and contextual variables were associated with the presence of caries and DMFT index in underprivileged adolescents, indicating that they must be taken into consideration in the formulation of policies directed towards oral health promotion and prevention activities in this group.
调查贫困青少年中与龋齿相关的个体及环境变量，以及该疾病分布的差异。
2012年在巴西圣保罗州皮拉西卡巴市开展的横断面分析研究。概率样本由1179名15至19岁的青少年组成，从21所公立学校和34个初级卫生保健单位——家庭健康中心（PHU-FH）中随机选取。所研究的因变量为龋齿数和龋病经历（DMFT）。自变量分为个体变量（临床、社会人口学、心理社会、自我认知、对口腔健康的影响、获得服务的情况及生活质量）和环境变量（社会排斥指数、郊区居民总数、识字率，以及以下以百分比表示的变量：自有住房类别中的居住情况、生活污水排放、垃圾收集、月收入超过1个最低工资标准的家庭，以及无月收入的家庭）。采用PROC GLIMMIX（广义线性模型 - 混合模型）程序估计多水平回归模型，将个体变量视为第1层，郊区的环境变量视为第2层。通过 -2残差对数似然法（α = 0.05）评估模型的拟合度。
关于个体变量，宣称家中有服刑人员且居住人数较多的青少年，龋齿数较多。他们的龋齿数更多、DMFT值更高，并且对牙齿和口腔健康的自我认知更差。其他变量，如女性性别、年龄以及上次看牙医以来的时间，与DMFT指数相关。关于环境变量，生活污水排放条件较好的郊区DMFT较低，社会排斥指数最差的郊区龋齿数较高。
个体和环境变量与贫困青少年龋齿的存在及DMFT指数相关，这表明在制定针对该群体的口腔健康促进和预防活动政策时，必须考虑这些因素。
