Factors associated with the needs of specialised dental treatment among adults aged 35-44 years old in the state of Minas Gerais, Brazil: a multilevel cross-sectional study

Azevedo, Mônica Baltazar de; Pinto, Rafaela da Silveira; Abreu, Mauro Henrique Nogueira Guimarães de; Lucas, Simone Dutra

doi:10.1590/1413-81232020257.29852018

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

FREE THEMES • Ciênc. saúde coletiva 25 (7) • July 2020 • https://doi.org/10.1590/1413-81232020257.29852018 copy

Factors associated with the needs of specialised dental treatment among adults aged 35-44 years old in the state of Minas Gerais, Brazil: a multilevel cross-sectional study

Fatores associados às necessidades de tratamento odontológico entre adultos com idade entre 35 e 44 anos na atenção secundária no estado de Minas Gerais, Brasil: estudo transversal multinível

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study evaluated the individual and contextual factors associated with the specialised dental treatment needs of a population of adults aged 35 to 44 years old in the state of Minas Gerais. The individual variables were obtained from the database of the SB Minas Gerais project - a survey of oral health status of the population of Minas Gerais, Brazil. The variables at the municipal level were derived from any available public databases related to oral health services. A multilevel analysis was performed to evaluate the association of independent individuals and contextual variables with or without dental treatment needs in the secondary care of the oral health network. Individuals with a higher income (OR 0.53; CI95% 0.31-0.93) and with greater access to oral health care (OR 0.94; CI95% 0.90-0.99) had less secondary care treatment needs. Income and access to oral health care are related to the needs of specialised dental treatment in Minas Gerais.

Key words
Dental care; Primary Health Care; Dental Health Services; Health Services Accessibility; Social Determinants of Health

Variable	Description	Categorization	Source
Dependent Variable
Dental treatment needs	Consisting of caries treatment, periodontal disease and prosthesis needs.	Does not require or only requires PHC Requires PHC + specialized care or only specialized care	SBMG2012
Independent Variables
Individual level
Gender	Self-reported gender	Female Male	SBMG2012
Household income	Total income received by all family members in the month preceding the survey, in Brazilian reais (R$). R$1.00 = U$ 0.50 dollars in 29/06/2012	Under R$1,500.00 Above R$1,500.00	SBMG2012
Schooling	Years of formal education. The variable was expressed as mean of years of study.	Continuous variable	SBMG2012
Numbers of residents at home	Number of people residing at home.	Continuous variable	SBMG2012
Ethnicity/skin color	Self-reported skin color.	White Non-white	SBMG2012
Time elapsed since the patient's last dentist appointment	Refers to the frequency of use of dental services, i.e. if individuals had never used a dental service, used it in the last year or less frequently than in the last year.	Never used More than one year Less than one year	SBMG2012
Type of service used	Type of service used at the last dental appointment. The non-public service encompassed all private services such as covenants, health plans and others.	Never used Public Non-public	SBMG2012
Main reason for consultation	Reason why the individual sought care at the last dental appointment.	Never used Curative procedures Check-up/preventive procedures	SBMG2012
Independent Variables
Contextual level
Allocation factor	Calculated based on the index of health needs and economic size. It measures the municipal relative need of financial resources so that the municipality bears with its own resources the necessary health treatments for its population.	Continuous variable	FJP
Access to individual dental care	Proportion of people who received a first dental appointment programmed in the SUS to diagnose and elaborate a preventive / therapeutic plan to meet the detected needs. Calculated as a percentage of population.	Continuous variable	DATASUS
Frequency of Oral Health Team (OHT) with an Oral Health Technician (TSB)	Number of OHT with TSB in relation to the total of oral health teams of the Family Health Strategy.	Continuous variable	DAB/MS
Mean supervised dental brushing	Number of supervised individual dental brushing performed divided by the population. This total is divided by the 12 months of the year. It measures access to preventive procedures.	Continuous variable	DATASUS
Dental extraction frequency	Proportion of permanent tooth extraction compared to other primary care dental clinical. It measures the quality of service with regard to whether or not it is a mutilating service.	Continuous variable	DATASUS
Emergency dental care frequency	Average number of urgent care per 100 inhabitants in Minas Gerais in the year 2012.	Continuous variable	DATASUS
Prosthesis laboratory availability	Characterizes whether the municipality has a dental prosthesis laboratory.	No Yes	SESMG
SDC Availability	Characterizes whether the municipality has a dental specialties center (specialized oral health care).	No Yes	SESMG

Variables^* * Frequencies calculated considering the sample weight.	n	% (CI 95%)
Gender
Female	776	65.10 (61.47-68.57)
Male	431	34.89 (31.42-38.52)
Income
Under 1.500 Reais	750	54.62 (48.33-60.76)
Above 1.500 Reais	438	45.37 (39.23-51.66)
Ethnicity/skin color
White	482	44.47 (40.44-48.58)
Non-white	725	55.52 (51.41-59.55)
Time elapsed since the patient's last dentist appointment
Never used	101	5.41 (3.01-9.55)
More than one year	575	49.20 (44.65-53.75)
Less than one year	526	45.38 (41.01-49.83)
Type of service used
Never used	97	5.21 (2.82-9.40)
Public	386	30.24 (25.63-35.29)
Non-public	721	64.54 (59.23-69.51)
Reason for consultation
Never used	97	5.20 (2.89-9.38)
Curative procedures	876	73.97 (69.18-78.26)
Check-up/preventive procedures	231	20.81 (17.16-25.01)

Variables	Mean	Standard Deviation	Minimum	Maximum
Allocation factor	1.41	0.20	1.08	1.80
Access to individual dental care	10.80	9.40	0.00	42.31
Frequency of Oral Health Team (OHT) with an Oral Health Technician (TSB)	25.61	35.79	0.00	100.00
Supervised dental brushing	3.53	3.82	0.00	15.11
Dental extraction frequency	6.32	5.02	0.00	22.55
Emergency dental care frequency	2.47	3.05	0.00	13.53

Variables	Odds Ratio	95% CI	P-value	Reliability estimate
Individual-level variables
Gender
Female	1
Male	1.44	(0.88-2.35)	0.145	0.504
Income
Under R$1.500,00	1
Above R$1.500,00	0.53	(0.31-0.93)	0.026	0.507
Years of schooling	0.92	(0.87-0.98)	0.011	0.509
Numbers of residents at home	0.92	(0.78-1.07)	0.268	0.502
Ethnicity/skin color
White	1
Non-white	1.48	(0.90-2.44)	0.123	0.504
Time elapsed since the patient's last dentist appointment
Never used	1			0.505
More than 1 year	0.87	(0.28-2.72)	0.810
Less than 1 year	0.54	(0.19-1.53)	0.243
Type of service used
Never used	1			0.506
Public	1.20	(0.32-4.48)	0.787
Non-public	0.69	(0.22-2.14)	0.524
Reason for last dental consultation
Never used	1			0.511
Curative procedures	0.98	(0.28-3.41)	0.972
Check-up/preventive procedures	0.26	(0.07-0.98)	0.046
Municipal-level variables
Allocation factor	0.29	(0.06-1.35)	0.113	0.496
Access to individual dental care	0.94	(0.90-0.99)	0.010	0.459
Frequency of oral health teams with oral health technician	1.00	(0.99-1.02)	0.527	0.504
Monthly frequency of supervised dental brushing	0.97	(0.89-1.06)	0.450	0.503
Dental extraction frequency	1.02	(0.94-1.11)	0.598	0.503
Frequency of dental urgency	1.03	(0.93-1.15)	0.549	0.505
Dental prosthesis laboratory available
No	1
Yes	1.33	(0.67-2.66)	0.411	0.504
Dental specialties center available
No	1
Yes	1.90	(0.92-2.95)	0.083	0.484

Variables	Odds Ratio	95% CI	P-Value	Reliability estimate
Individual-level variables				0.465
Income
Under R$1,500.00	1
Above R$1,500.00	0.53	(0.31-0.93)	0.026
Municipal-level variables
Access to individual dental care	0.94	(0.90-0.99)	0.011

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Collaborations

MB Azevedo, RS Pinto, MHNG Abreu and SD Lucas worked on the design, final writing, and methodological research. SD Lucas submitted the article to this journal.