Bomfim Rafael Aiello, Frias Antonio Carlos, Cascaes Andreia Morales, Mazzilli Luiz Eugênio Nigro, Souza Luciana Bronzi de, Carrer Fernanda Campos de Almeida, Araújo Maria Ercília de
Universidade Federal do Mato Grosso do Sul - UFMS, School of Dentistry, Department of Community Health, Campo Grande, MS, Brazil.
Universidade de São Paulo - USP, School of Dentistry, Department of Community Health, São Paulo, SP, Brazil.
Braz Oral Res. 2021 Apr 26;35:e041. doi: 10.1590/1807-3107bor-2021.vol35.0041. eCollection 2021.
This study analyzed the association between sedentary behavior (SB), unhealthy food consumption, and dental caries amongst 12-year-old schoolchildren. An epidemiological survey was carried out in the five largest cities (> 80,000 inhabitants) of the State of Mato Grosso do Sul, Brazil. Data were collected on decayed, missing and filled teeth index (DMFT), sociodemographic characteristics, SB, unhealthy food consumption, and water fluoridation status. The analysis was based on the theoretical framework established by J Sisson. Structural equation models were performed to test the association of dental caries experience with sociodemographic, contextual, and behavioral factors. The mean DMFT index in the five cities was 1.02 (95%CI: 0.39-1.66). Higher sedentary behavior (more than 2 hours/day) [standardized coefficient (SC) = 0.21 95%CI: 0.07-0.39] and higher unhealthy food consumption (more than 4 times/week) [SC = 0.23 (0.10-0.45)] were associated with higher DMFT index than their counterparts. Also, cities with fluoridated water were associated with lower DMFT index [SC = -0.85 (-1.20--0.50)]. Families who had a per capita income above the poverty line had a direct association with unhealthy food consumption [SC = -0.24 (-0.38--0.11)]. Unhealthy food consumption mediated the association of sedentary behavior on DMFT index [SC=0.07 (0.02-0.13)]. Sensitivity analysis confirmed the findings. Sedentary behavior mediated by unhealthy food consumption had a significant association with dental caries experience. Public policies must address transdisciplinary actions to reduce sedentary behavior and unhealthy food consumption and promote water fluoridation.
本研究分析了12岁学童的久坐行为（SB）、不健康食品消费与龋齿之间的关联。在巴西南马托格罗索州五个最大的城市（居民超过8万）开展了一项流行病学调查。收集了龋齿、缺失牙和补牙指数（DMFT）、社会人口学特征、久坐行为、不健康食品消费以及水氟化状态的数据。分析基于J·西森建立的理论框架。进行了结构方程模型分析，以检验龋齿经历与社会人口学、环境和行为因素之间的关联。五个城市的平均DMFT指数为1.02（95%可信区间：0.39 - 1.66）。久坐时间较长（每天超过2小时）[标准化系数（SC）= 0.21，95%可信区间：0.07 - 0.39]以及不健康食品消费频率较高（每周超过4次）[SC = 0.23（0.10 - 0.45）]与较高的DMFT指数相关，相比之下，情况相反的人群DMFT指数较低。此外，饮用氟化水的城市与较低的DMFT指数相关[SC = -0.85（-1.20 - -0.50）]。人均收入高于贫困线的家庭与不健康食品消费存在直接关联[SC = -0.24（-0.38 - -0.11）]。不健康食品消费在久坐行为与DMFT指数之间的关联中起中介作用[SC = 0.07（0.02 - 0.13）]。敏感性分析证实了这些发现。由不健康食品消费介导的久坐行为与龋齿经历存在显著关联。公共政策必须采取跨学科行动，以减少久坐行为和不健康食品消费，并促进水氟化。
