Importance of contextual variables related to cavitated lesions in 5-year-old children
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Universidade Federal de Minas Gerais
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Artigo de periódico
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Background: Dental caries have a high prevalence in children and need to evaluate their individual and contextual determinants. Aim: To evaluate the importance of individual and contextual determinants on the occurrence of cavitated lesions in 5-year-old children. Design: A cross-sectional study was conducted with 769 preschoolers in a city in northeastern Brazil. Parents/caregivers answered questionnaires addressing psychological aspects, socio-demographic characteristics and the child's oral health. The diagnosis of dental caries (cavitated lesion) was performed using the ICDAS-II. Variables related to the context were collected at the preschools and official municipal publications. Unadjusted and adjusted multilevel Poisson regression models with robust variance correction were used. Results: The prevalence of cavitated lesions was 58.8%. In the analysis adjusted by individual determinants, low household income (PR = 1.61; 95%CI:1.27–2.05), lower parent's/caregiver's schooling (PR = 1.57; 95%CI:1.20–2.05), not visited to the dentist (PR = 0.77; 95%CI:0.62–0.94), brushing frequency under 2 times per day (PR = 2.17; 95%CI:1.35–3.51) and weak parent's/caregiver's SOC (PR = 1.30; 95%CI:1.09–1.56) were associated with cavitated lesions. However, after the incorporation of the contextual determinants, parent's/caregiver's schooling and SOC lost their association. Considering contextual factors, children attending public preschools (PR = 1.66; 95%CI:1.34–2.05) and/or smaller preschools (PR = 1.001; 95%CI:1.001–1.002) had a greater probability of exhibiting cavitated lesions. Conclusion: Contextual variables were more important to the occurrence cavitated lesions than individual socioeconomic variables.
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Social determinants of health, Dental caries, Oral health, Child
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https://onlinelibrary.wiley.com/doi/10.1111/ipd.12400