Dalla Nora Angela, Knorst Jéssica Klöckner, Comim Leticia Donato, Racki Débora Nunes Oliveira, Alves Luana Severo, Zenkner Julio Eduardo Amaral
Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
Department of Restorative Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
Clin Oral Investig. 2022 Jul;26(7):4929-4934. doi: 10.1007/s00784-022-04461-6. Epub 2022 Mar 22.
To assess the status of untreated dental caries in adolescents exposed to different conditions of family and neighborhood income.
This cross-sectional study included a representative sample of 1197 15-19-year-old adolescents attending high schools from Santa Maria, southern Brazil. Data collection included a questionnaire and clinical examination (DMFT index). Neighborhood mean income was collected from official sources. The main predictor variable was a combination of household income and neighborhood mean income resulting in four categories: low household income/low neighborhood income, low household income/high neighborhood income, high household income/low neighborhood income, or high household income/high neighborhood income. The outcome was untreated caries (number of teeth with dentin cavities or residual roots). Multilevel Poisson regression analysis was used to assess the association between predictors and untreated caries. Rate ratio (RR) and 95% confidence intervals (CI) were estimated.
The prevalence of untreated dental caries was 26% (n = 312), with a mean (± standard deviation) of 0.47 (± 1.05) teeth. Adolescents with low household income living in areas with low neighborhood income had the worse caries scenario. Compared with them, those classified as low-income households residing in high-income neighborhoods had 37% lower rate of untreated dental caries (adjusted RR = 0.63; 95%CI = 0.44-0.89). No neighborhood effect was detected among adolescents of more affluent families.
Neighborhood income contributed to the rate of untreated dental caries over and above household income among adolescents with low household income only.
Improving living conditions in disadvantaged neighborhoods may positively impact the oral health of residents, thus reducing oral health inequalities.
评估处于不同家庭和社区收入状况下青少年的未治疗龋齿情况。
这项横断面研究纳入了来自巴西南部圣玛丽亚市高中的1197名15 - 19岁青少年的代表性样本。数据收集包括一份问卷和临床检查（DMFT指数）。社区平均收入从官方来源获取。主要预测变量是家庭收入和社区平均收入的组合，分为四类：低家庭收入/低社区收入、低家庭收入/高社区收入、高家庭收入/低社区收入或高家庭收入/高社区收入。结果变量是未治疗龋齿（有牙本质龋洞或残根的牙齿数量）。采用多水平泊松回归分析来评估预测因素与未治疗龋齿之间的关联。估计率比（RR）和95%置信区间（CI）。
未治疗龋齿的患病率为26%（n = 312），平均（±标准差）为0.47（±1.05）颗牙。家庭收入低且居住在社区收入低的地区的青少年龋齿情况最差。与他们相比，那些被归类为居住在高收入社区的低收入家庭青少年的未治疗龋齿率低37%（调整RR = 0.63；95%CI = 0.44 - 0.89）。在较富裕家庭的青少年中未检测到社区效应。
仅在家庭收入低的青少年中，社区收入对未治疗龋齿率的影响超过家庭收入。
改善弱势社区的生活条件可能对居民的口腔健康产生积极影响，从而减少口腔健康不平等。
