Postgraduate Program in Health Sciences, State University of Montes Claros (Universidade Estadual de Montes Claros), Montes Claros, Minas Gerais, Brazil.
Department of Mathematics, State University of Montes Claros (Universidade Estadual de Montes Claros), Montes Claros, Minas Gerais, Brazil.
BMC Oral Health. 2020 Mar 17;20(1):73. doi: 10.1186/s12903-020-1057-1.
Tooth loss represents a known marker of health inequality. The association between tooth loss and unfavorable socioeconomic conditions is evident when analyzed at an individual level. However, the effects of contextual characteristics on tooth loss need to be better investigated and understood. The objective of this study was to analyze tooth loss among Brazilian adults (35-44 years of age), in accordance with individual and contextual social characteristics.
This was a multilevel cross-sectional study with data from 9564 adult participants from the Brazilian Oral Health Survey - SBBrasil 2010. The dependent variable was the number of lost teeth and the independent variables were grouped into structural (socioeconomic & political context) and intermediary (socioeconomic position, behavioral & biological factors, and health services) determinants. Multilevel Hierarchical Negative Binomial Regression was conducted and the Mean Ratio (MR) was estimated.
Brazilian adults lost a mean of 7.57 (95% CI 7.1-8.1) teeth. Among the contextual variables, the number of teeth lost was higher among residents of municipalities with high and medium/low Municipal Human Development Index (MHDI) and in municipalities that did not have public water fluoridation. Among the individual variables, dental loss was higher among those who declared themselves yellow/black/brown/indigenous, were older, who had lower income, who had never visited a dentist, who had used dental services for more than a year and those whose most recent visit to the dentist was due to oral health problems. On the other hand, dental loss was lower among adults with higher education levels and males.
The number of missing teeth was associated with unfavorable contextual and individual conditions, which reinforces the need to reduce social inequality and guarantee regular, lifetime access to dental services.
牙齿缺失是健康不平等的已知标志。从个体层面分析时，牙齿缺失与不利的社会经济条件之间存在明显关联。然而，需要更好地研究和理解背景特征对牙齿缺失的影响。本研究的目的是根据个体和背景社会特征分析巴西成年人（35-44 岁）的牙齿缺失情况。
这是一项多水平横断面研究，使用了来自巴西口腔健康调查（SBBrasil 2010）的 9564 名成年参与者的数据。因变量为缺失牙齿数量，自变量分为结构（社会经济和政治背景）和中介（社会经济地位、行为和生物因素以及卫生服务）决定因素。进行了多水平分层负二项回归分析，并估计了平均比（MR）。
巴西成年人平均缺失 7.57 颗牙齿（95%CI 7.1-8.1）。在背景变量中，处于高和中/低城市人类发展指数（MHD）的城市和没有公共水氟化的城市的居民缺失牙齿数量更高。在个体变量中，自我认定为黄/黑/棕/原住民、年龄较大、收入较低、从未看过牙医、使用牙科服务超过一年以及最近看牙医是因为口腔健康问题的人，牙齿缺失的情况更高。另一方面，教育程度较高和男性的牙齿缺失情况较低。
缺失牙齿的数量与不利的背景和个体条件有关，这加强了减少社会不平等和保障终身定期获得牙科服务的必要性。
