Social Economic Disadvantage and Untreated Dental Caries: Findings from a Cohort Study in Adolescents.

This study aimed to assess the impact of determinants of the individual and contextual level on the untreated dental caries during adolescence. A cohort study was started in 2012 with a random sample of 1,134 12-year-old adolescents in the city of Santa Maria, RS, Brazil. The adolescents were clinically evaluated by calibrated dentists and investigated variables: contextual, demographic, socioeconomic factors, dental service use, toothache, and subjective variables. After 2 years (T2) and 6 years (T3), the same adolescents were reevaluated (retention rate of 67.9% and 67.8%, respectively). Untreated dental caries (component "D" of the DMFT index) was the outcome and was collected at all three times. Multilevel Poisson regression analyses considered repeated measures (level 1 - times), nested to adolescents (level 2), were used to assess the association between predictors (baseline) and untreated dental caries. High neighborhood's mean income was associated with the lowest risk of dental caries. Low household income (incidence rate ratio [IRR] 1.57; confidence interval 95% [CI]: 1.35-1.82), low mother education (IRR 1.19; 95% CI: 1.03-1.38), toothache (IRR 1.73; 95% CI: 1.47-2.03), and poor self-perception of oral health (IRR 1.19; 95% CI: 1.07-1.32) were risk factors for untreated dental caries. In conclusion, our results showed that socioeconomic disadvantages and oral conditions in early adolescence are risk factors for untreated caries among adolescents.