Department of Dentistry, State University of Paraiba, Campina Grande, Brazil.
Department of Dentistry, State University of Paraiba, Campina Grande, Brazil,
Caries Res. 2021;55(2):144-152. doi: 10.1159/000514501. Epub 2021 Mar 15.
Dental caries are a global health problem that affects all age groups and must be considered a public health priority due to its significant financial costs and impact on the quality of life. This study evaluated the association between oral health literacy (OHL), school factors, and untreated dental caries in 12-year-old Brazilian adolescents using a multilevel approach. A population-based cross-sectional study was carried out with 740 adolescents randomly selected from private and public schools in Campina Grande, Brazil. Two dentists were trained and calibrated to diagnose dental caries using the Nyvad index and OHL using the Brazilian Rapid Estimate of Literacy in Dentistry (BREALD-30). The caregivers of the adolescents reported demographic data (sex, skin color, and socioeconomic status). Data of school factors such as the type of school and the school grade retention rate were classified through a 2-step hierarchical cluster analysis to obtain the school environment. A robust multilevel log-linear negative binomial regression for complex samples was performed (p < 0.05). In the analysis, adjusted by individual determinants, nonwhite skin color (RR = 2.20; 95% CI 1.56-3.12), a low socioeconomic status (RR = 1.60; 95% CI 1.09-2.34), a low OHL score (RR = 0.94; 95% CI 0.91-0.98), and low satisfaction with the last dental appointment (RR = 2.25; 95% CI 1.67-3.04) were associated with untreated dental caries. The following factors remained associated with untreated dental caries in the final model: students from an unfavorable learning environment (RR = 2.20; 95% CI 1.27-3.80), nonwhite skin color (RR = 1.92; 95% CI 1.27-2.91), a low socioeconomic status (RR = 1.82; 95% CI 1.12-2.94), a low OHL score (RR = 0.95; 95% CI 0.91-0.98), and low satisfaction with the last dental appointment (RR = 2.07; 95% CI 1.47-2.91). Untreated dental caries in early adolescence were impacted by the school environment, the socioeconomic status, OHL, and the adolescent's satisfaction with the last dental appointment.
龋齿是一个全球性的健康问题，影响所有年龄段的人群，由于其巨大的经济成本和对生活质量的影响，必须将其视为公共卫生的重点。本研究采用多水平方法评估了巴西 12 岁青少年的口腔健康素养（OHL）、学校因素与未经治疗的龋齿之间的关系。这是一项基于人群的横断面研究，从巴西坎皮纳格兰德的私立和公立学校中随机抽取了 740 名青少年。对两名牙医进行了培训和校准，以使用 Nyvad 指数和巴西快速口腔健康评估量表（BREALD-30）诊断龋齿和 OHL。青少年的看护人报告了人口统计学数据（性别、肤色和社会经济地位）。通过两步分层聚类分析对学校因素的数据（学校类型和学校年级保留率）进行分类，以获得学校环境。对复杂样本进行了稳健的多水平对数线性负二项式回归分析（p<0.05）。在分析中，通过个体决定因素进行调整后，非白色肤色（RR=2.20；95%CI 1.56-3.12）、低社会经济地位（RR=1.60；95%CI 1.09-2.34）、低 OHL 评分（RR=0.94；95%CI 0.91-0.98）和对上一次牙科就诊的低满意度（RR=2.25；95%CI 1.67-3.04）与未经治疗的龋齿有关。在最终模型中，以下因素仍与未经治疗的龋齿有关：来自不利学习环境的学生（RR=2.20；95%CI 1.27-3.80）、非白色肤色（RR=1.92；95%CI 1.27-2.91）、低社会经济地位（RR=1.82；95%CI 1.12-2.94）、低 OHL 评分（RR=0.95；95%CI 0.91-0.98）和对上一次牙科就诊的低满意度（RR=2.07；95%CI 1.47-2.91）。青少年早期未经治疗的龋齿受到学校环境、社会经济地位、OHL 和青少年对上一次牙科就诊的满意度的影响。
