Graduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil.
Graduate Program in Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil.
Community Dent Oral Epidemiol. 2023 Oct;51(5):872-878. doi: 10.1111/cdoe.12779. Epub 2022 Jul 29.
To estimate socioeconomic inequalities in the maternal perception of children's oral health from a birth cohort study in Brazil.
The data from this study were collected through perinatal interviews and at the 48-month follow-up from the 2015 Pelotas Birth Cohort Study. The main outcome was the maternal perception of children's oral health, dichotomized into positive (good/very good) and negative (fair/bad/very bad). The secondary outcome was untreated dental caries (absence and presence, according to the ICDAS index - International Caries Detection and Assessment System). For the statistical analysis, the absolute inequality index (Slope Index of Inequality - SII) and the relative concentration index (Concentration Index - CIX) were used. Analyses were stratified by maternal educational level, family income and wealth index.
The prevalence of outcomes was 19.4% (95% CI 18.2; 20.7) for the negative maternal perception of children's oral health and 15.6% (95% CI 14.4; 16.8) for untreated dental caries. Socioeconomics inequalities were observed in negative maternal perception of children's oral health in both absolute and relative terms. A SII of -16.6 (95% CI -20.8; -12.5) was observed for family income, with higher prevalence in poor families. A higher prevalence of the negative maternal perception of children's oral health was observed in mothers without any educational level or a few years of study (CIX -21.1 [95% CI -24.5; -17.7]).
This study demonstrates socioeconomics disparities in the maternal perception of children's oral health and in the prevalence of untreated caries in children. A higher concentration of negative maternal perception of children's oral health was identified among the most socioeconomically vulnerable individuals. The findings reinforce the presence of socioeconomic inequalities in subjective measures about children's oral health.
从巴西一项出生队列研究中估计儿童口腔健康感知的社会经济不平等情况。
本研究数据来自 2015 年佩洛塔斯出生队列研究的围产期访谈和 48 个月随访。主要结局是母亲对儿童口腔健康的感知，分为积极（良好/非常好）和消极（一般/差/非常差）。次要结局是未经治疗的龋齿（根据 ICDAS 指数-国际龋齿检测和评估系统，缺失和存在）。对于统计分析，使用绝对不平等指数（不平等斜率指数-SII）和相对集中指数（集中指数-CIX）。分析按母亲教育程度、家庭收入和财富指数进行分层。
儿童口腔健康负面感知的发生率为 19.4%（95%CI 18.2%；20.7%），未经治疗的龋齿发生率为 15.6%（95%CI 14.4%；16.8%）。在绝对和相对意义上，社会经济不平等现象均存在于儿童口腔健康负面感知中。家庭收入的 SII 为-16.6（95%CI-20.8；-12.5），表明贫困家庭的患病率较高。未受过任何教育或仅接受过几年教育的母亲对儿童口腔健康的负面感知更为普遍（CIX-21.1[95%CI-24.5；-17.7]）。
本研究表明，儿童口腔健康感知和未经治疗的龋齿患病率存在社会经济差异。在社会经济最脆弱的个体中，对儿童口腔健康的负面感知更为集中。研究结果证实了儿童口腔健康主观测量存在社会经济不平等现象。
