Factors associated with dental caries in adolescents: a cross-sectional study, São Paulo State, Brazil, 2015

Corrêa, Lívia Litsue Gushi; Sousa, Maria da Luz Rosário de; Frias, Antônio Carlos; Antunes, José Leopoldo Ferreira

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Epidemiologia e Serviços de Saúde

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 29 (5) • 2020 • https://doi.org/10.1590/S1679-49742020000500007 copy

Factors associated with dental caries in adolescents: a cross-sectional study, São Paulo State, Brazil, 2015^* * Article derived from the Ph.D. thesis entitled ‘Fators associated with dental caries and dental impact on the everyday activities of 15-19-year-old adolescentes, São Paulo State, 2015’, defended by Lívia Litsue Gushi Corrêa at the University of São Paulo Public Health Faculty Epidemiology Postgraduate Program (FSP/USP) in 2019.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To analyze association between prevalence and severity of dental caries and demographic, socioeconomic, behavioral and oral health status in adolescents.

Methods:

This was a cross-sectional study with secondary data on 5,558 adolescents examined in the São Paulo State Oral Health Survey in 2015. The zero-inflated negative binomial regression model was used, considering sample weights. Prevalence ratios (PR), ratios of mean (RM) and confidence intervals (CI) were estimated.

Results:

Caries prevalence was 71.7%, and was higher in females (PR=1.09 - 95%CI 1.04;1.15), associated with being behind at school (PR=1.11 - 95%CI 1.03;1.18), dental calculus (PR=1.10 - 95%CI 1.01;1.20) and no access to fluoridated water (PR=1.21 - 95%CI 1.01;1.45).

Conclusion:

Identification of factors associated with dental caries can instruct the programming of health services aimed at controlling the disease.

Keywords:
Dental Caries; Adolescents; Oral Health; Socioeconomic Factors, Cross-Sectional Study

Variables	n	Percentage in the weighted sample	Caries prevalence (%)	DMFT^a (95% CI)^b
Demographic characteristics
Gender
Male	2,405	43.27	67.43	3.22 (2.91;3.52)
Female	3,153	56.73	73.79	3.84 (3.45;4.23)
Age (years)
15	1,546	27.81	62.03	2.76 (2.47;3.05)
16	1,081	19.45	67.41	2.99 (2.59;3.40)
17	908	16.34	76.07	4.21 (3.64;4.78)
18	918	16.52	73.28	3.73 (3.14;4.31)
19	1,105	19.88	76.99	4.61 (4.03;5.10)
Race/skin color
White	3,357	60.41	69.09	3.38 (3.09;3.67)
Black	412	7.42	72.63	3.65 (3.08;4.22)
Yellow	57	1.02	80.95	6.46 (2.41;10.52)
Brown	1,722	30.98	74.20	3.83 (3.39;4.27)
Indigenous	10	0.17	55.59	2.55 (0.30;4.80)
Socioeconomic status
Household crowding
Up to 2 people	3,891	70.00	69.15	3.48 (3.17;3.79)
2 or more	1,667	30.00	75.45	3.78 (3.32;4.24)
Family income
Up to BRL 1500	1,964	35.34	72.47	3.90 (3.54;4.26)
BRL 1501 to BRL 2500	1,484	26.71	69.03	3.34 (2.90;3.78)
BRL 2501 or more	2,110	37.95	71.12	3.43 (2.94;3.91)
Number of durable goods in the household
Up to 8	3,157	56.81	73.97	3.92 (3.57;4.28)
9 or more	2,401	43.19	67.19	3.11 (2.75;3.47)
Behavioral status
Behind at school
No	4,300	77.38	68.45	3.28 (2.96;3.59)
Yes	1,258	22.62	79.90	4.58 (3.88;5.28)
Oral health status
Gum bleeding on probing
No	3,696	66.51	69.25	3.25 (2.97;3.52)
Yes	1,862	33.49	74.59	4.21 (3.70;4.72)
Dental calculus
No	3,810	68.55	68.16	3.25 (2.94;3.56)
Yes	1,748	31.45	77.31	4.27 (3.87;4.67)
Access to fluoridated water
Yes	5,478	99.40	70.95	3.55 (3.24;3.86)
No	80	0.60	85.12	7.10 (4.41;9.78)
Total	5,558	100.00	71.04	3.57 (3.26;3.88)

Variables	PR^a	95%CI^b	p-value^c	PRa^d	95%CI^b	p-value^c
Demographic characteristics
Gender
Male	1.00			1.00
Female	1.09	1.04;1.16	<0.001	1.09	1.04;1.15	0.001
Age (years)
15	1.00			1.00
16	1.04	0.92;1.16	0.546	1.04	0.93;1.16	0.457
17	1.17	1.06;1.29	0.001	1.13	1.03;1.24	0.006
18	1.13	1.02;1.24	0.014	1.09	0.99;1.19	0.076
19	1.18	1.09;1.28	<0.001	1.13	1.04;1.22	0.003
Race/skin color
White	1.00			1.00
Black	1.05	0.95;1.16	0.341	1.03	0.93;1.14	0.611
Yellow	1.17	0.88;1.55	0.271	1.05	0.88;1.25	0.488
Brown	1.07	0.99;1.16	0.082	1.05	0.98;1.14	0.205
Indigenous	0.80	0.39;1.65	0.550	0.83	0.41;1.66	0.596
Socioeconomic status
Household crowding
Up to 2	1.00			1.00
2 or more	1.11	1.00;1.23	0.002	1.07	1.00;1.14	0.041
Family income
Up to BRL 1500	1.00			1.00
BRL 1501 to BRL 2500	0.95	0.88;1.03	0.236	0.97	0.90;1.05	0.551
BRL 2501 or more	0.98	0.87;1.11	0.760	1.00	0.90;1.12	0.963
Number of durable goods in the household
Up to 8	1.00			1.00
9 or more	0.91	0.85; 0.97	0.005	0.94	0.88;0.99	0.058
Behavioral status
Behind at school
No	1.00			1.00
Yes	1.17	1.09;1.25	<0.001	1.11	1.03;1.18	0.004
Oral health status
Gum bleeding on probing
No	1.00			1.00
Yes	1.08	1.00;1.16	0.04	1.00	0.92;1.09	0.939
Dental calculus
No	1.00			1.00
Yes	1.13	1.06;1.21	<0.001	1.10	1.01;1.20	0.025
Access to fluoridated water
Yes	1.00			1.00
No	1.20	0.96;1.49	<0.001	1.21	1.01;1.45	<0.001

Variables	RM^a	95%CI^b	p-value^c	RMa^d	95%CI^b	p-value^c
Demographic characteristics
Gender
Male	1.00			1.00
Female	1.11	1.01;1.22	0.037	1.07	0.98;1.18	0.138
Age (years)
15	1.00			1.00
16	1.06	0.94;1.18	0.34	1.07	0.95;1.20	0.288
17	1.37	1.20;1.55	<0.001	1.29	1.16;1.43	<0.001
18	1.24	1.07;1.43	0.004	1.20	1.04;1.39	0.012
19	1.49	1.34;1.66	<0.001	1.40	1.23;1.59	<0.001
Race/skin color
White	1.00			1.00
Black	1.03	0.89;1.19	0.667	1.00	0.86;1.15	0.939
Yellow	1.74	1.19;2.54	0.005	1.35	1.01;1.83	0.054
Brown	1.06	0.98;1.16	0.139	1.04	0.95;1.13	0.288
Indigenous	0.92	0.64;1.33	0.673	1.02	0.65;1.60	0.981
Socioeconomic status
Household crowding
Up to 2	1.00			1.00
2 or more	1.08	0.90;1.09	0.896	1.07	0.98;1.17	0.765
Family income
Up to BRL 1500	1.00			1.00
BRL 1501 to BRL 2500	0.88	0.80;0.98	0.016	0.91	0.82;0.99	0.049
BRL 2501 or more	0.88	0.80;0.97	0.008	0.89	0.78;0.99	0.054
Number of durable goods in the household
Up to 8	1.00			1.00
9 or more	0.85	0.77;0.94	0.001	0.91	0.81;1.02	0.136
Behavioral status
Behind at school
No	1.00			1.00
Yes	1.23	1.03;1.47	0.020	1.07	0.92;1.24	0.298
Oral health status
Gum bleeding on probing
No	1.00			1.00
Yes	1.24	1.11;1.39	<0.001	1.15	1.02;1.30	0.018
Dental calculus
No	1.00			1.00
Yes	1.19	1.06;1.33	0.004	1.04	0.91;1.19	0.549
Access to fluoridated water
Yes	1.00			1.00
No	1.77	1.51;2.08	<0.001	1.81	1.56;2.09	<0.001

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[1] Correspondence: José Leopoldo Ferreira Antunes - Universidade de São Paulo, Faculdade de Saúde Pública, Av. Dr. Arnaldo, No. 715, São Paulo, SP, Brazil. Postcode: 01246-904. E-mail: leopoldo@usp.br