School of Dentistry, Federal University of Goiás, Goiânia-GO, Brazil.
Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast-QLD, Queensland, Australia.
Community Dent Oral Epidemiol. 2019 Dec;47(6):454-460. doi: 10.1111/cdoe.12483. Epub 2019 Jul 1.
To analyse trends in dental pain prevalence among Brazilian adolescent students over 6 years, focusing on inequalities by maternal education.
Data from the National Adolescent School-Based Health Survey (PeNSE) carried out in 2009 (n = 45 239), 2012 (n = 46 482) and 2015 (n = 35 592) were analysed, including ninth grade students from the 27 state capitals in Brazil who were of ages 11-17 years or older. Variables analysed were dental pain within the last 6 months (yes/no) and the following sociodemographic factors: age, sex, race, type of school and maternal schooling (years of study: ≤8; 9-11; ≥12). The prevalence of dental pain in the 3 years was compared using the Rao-Scott test. Relative and absolute measures of socioeconomic (maternal education) inequalities in dental pain were applied using the slope index of inequality (SII) and the relative concentration index (RCI).
The prevalence of dental pain increased from 17.5% (95% CI = 16.9-18.2) in 2009 to 20.4% (95% CI = 19.7-21.1) in 2012, then to 21.8% (95% CI = 21.1-22.5) in 2015. All sociodemographic factors investigated were associated with dental pain in all survey years. There was an increasing proportion of the outcome in all categories of maternal education over the years studied. Absolute (SII) and relative (RCI) inequalities regarding of maternal education were found; these indicate higher levels of dental pain in the lower socioeconomic group in each study year. However, no significant changes in inequalities were found from 2009 to 2015.
The prevalence of dental pain increased in the 2009-2012 and 2012-2015 periods, and social inequalities were found. Higher levels of dental pain persisted in the lower maternal education group. Inequalities remained stable over time. Broader actions to reduce the existing inequalities are needed and should be a priority for public policies.
分析过去 6 年巴西青少年学生中牙科疼痛患病率的变化趋势，重点关注母亲教育水平方面的差异。
对 2009 年（n=45239）、2012 年（n=46482）和 2015 年（n=35592）全国青少年学校健康调查（PeNSE）的数据进行分析，调查对象为巴西 27 个州首府的 9 年级学生，年龄在 11-17 岁及以上。分析的变量包括过去 6 个月内的牙科疼痛（有/无）和以下社会人口因素：年龄、性别、种族、学校类型和母亲教育程度（受教育年限：≤8 年；9-11 年；≥12 年）。使用 Rao-Scott 检验比较 3 年的牙科疼痛患病率。使用不平等斜率指数（SII）和相对集中指数（RCI）评估牙科疼痛的社会经济（母亲教育）不平等的相对和绝对程度。
2009 年至 2012 年，牙科疼痛的患病率从 17.5%（95%CI=16.9-18.2）上升至 20.4%（95%CI=19.7-21.1），然后在 2015 年上升至 21.8%（95%CI=21.1-22.5）。所有调查年份的所有社会人口因素均与牙科疼痛有关。在所研究的所有年份中，母亲教育的各个类别中，结果的比例都在增加。发现了母亲教育的绝对（SII）和相对（RCI）不平等；这表明在每个研究年度，社会经济地位较低的群体中牙科疼痛的水平更高。然而，2009 年至 2015 年期间，不平等情况没有明显变化。
2009-2012 年和 2012-2015 年期间，牙科疼痛的患病率有所上升，并发现了社会不平等现象。在母亲教育水平较低的群体中，牙科疼痛的水平持续较高。不平等状况随时间保持稳定。需要采取更广泛的行动来减少现有的不平等现象，这应成为公共政策的优先事项。
