Dalazen Chaiane Emilia, De Carli Alessandro Diogo, Bomfim Rafael Aiello, Dos Santos Mara Lisiane Moraes
Faculdade de Odontologia "Prof Albino Coimbra Filho", Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil.
Departamento de Tecnologia de Alimentos e Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil.
PLoS One. 2016 Jun 1;11(6):e0156231. doi: 10.1371/journal.pone.0156231. eCollection 2016.
To assess the relationship between periodontal treatment needs by elderly Brazilians and contextual as well as individual variables.
A cross-sectional study was carried out to assess the need for clinical periodontal treatment, based on National Oral Health Survey (SB Brasil 2010) data on the presence of dental calculus, shallow (3-5 mm) and deep (≥ 6 mm) periodontal pockets, and gingival bleeding in elderly people (n = 7,619). The contextual variables included the Municipal Human Development Index (MHDI), income inequality (Gini Index) and coverage of the municipal population by the Family Health Strategy (FHS) program oral health teams.<0} The individual variables were sex, income, education level and self-reported skin color. Multilevel logistic regression models were used to calculate the odds ratio (OR) and 95% confidence intervals (CI95%) between periodontal treatment needs and the contextual as well as individual variables.
Gingival bleeding was found in 20.7% of the elderly analyzed (n = 1,577), dental calculus in 34% (n = 2,590), shallow periodontal pockets in 15.6% (n = 1,189), and deep periodontal pockets in 4.2% (n = 320). Individual factors were correlated with all the outcomes assessed. Sex was a protective factor in regard to gingival bleeding (OR = 0.87; CI95% 0.76-1.00), dental calculus (OR = 0.86; CI95% 0.75-0.99), shallow periodontal pockets (OR = 0.69; CI95% 0.60-0.80) and deep periodontal pockets (OR = 0.58; CI95% 0.45-0.74). It was found that fewer women needed treatment. Elderly people who self-reported having nonwhite skin had higher chances of needing periodontal treatment. Skin color was a risk factor for gingival bleeding (OR = 1.32; CI95% 1.14-1.53), dental calculus (OR = 1.32; CI95%1.14-1.54) and shallow periodontal pockets (OR = 1.27; CI95% 1.09-1.49). Education level was associated with the presence of dental calculus (OR = 0.77; CI95% 0.66-0.89), shallow periodontal pockets (OR = 0.86; CI95% 0.73-1.00) and deep periodontal pockets (OR = 0.74; CI95% 0.57-0.97), thus acting as a risk factor for undereducated elderly people. There was a correlation between population coverage by the Family Health Strategy (FHS) program oral health teams and the presence of gingival bleeding (OR = 0.67; CI95% 0.52-0.88), shallow periodontal pockets (OR = 0.76; CI95% 0.58-0.98) and deep periodontal pockets (OR = 0.62; CI95% 0.44-0.89), making these teams act as a protective factor.
This study showed evidence of the sociocontextual as well as individual sociodemographic characteristics influencing periodontal treatment needed by elderly Brazilians, based on the clinical features of periodontal disease. The results suggest the existence of inequality related to periodontal treatment needs among elderly Brazilians, especially in regard to sex and ethnicity, in addition to a potentially positive impact from the expansion of the Family Health Strategy (FHS) program oral health teams.
评估巴西老年人的牙周治疗需求与环境及个体变量之间的关系。
基于全国口腔健康调查（2010年巴西口腔健康调查）中有关老年人（n = 7619）牙石、浅牙周袋（3 - 5毫米）、深牙周袋（≥6毫米）及牙龈出血的数据，开展了一项横断面研究，以评估临床牙周治疗需求。环境变量包括市人类发展指数（MHDI）、收入不平等（基尼指数）以及家庭健康战略（FHS）项目口腔健康团队覆盖的市人口比例。个体变量为性别、收入、教育水平及自我报告的肤色。采用多水平逻辑回归模型计算牙周治疗需求与环境及个体变量之间的比值比（OR）和95%置信区间（CI95%）。
在接受分析的老年人中，20.7%（n = 1577）有牙龈出血，34%（n = 2590）有牙石，15.6%（n = 1189）有浅牙周袋，4.2%（n = 320）有深牙周袋。个体因素与所有评估结果相关。性别是牙龈出血（OR = 0.87；CI95% 0.76 - 1.00）、牙石（OR = 0.86；CI95% 0.75 - 0.99）、浅牙周袋（OR = 0.69；CI95% 0.60 - 0.80）和深牙周袋（OR = 0.
