Caries prevalence and associated factors in children from public versus private schools: Cross-sectional study
DOI:
https://doi.org/10.21527/2176-7114.2024.48.14841Keywords:
dental caries, pediatric dentistry, preventive dentistry, public health practiceAbstract
Introduction: Childhood caries remains a major public health issue in Brazil’s impoverished communities. Although government-sponsored programs have targeted improvement of oral health in children from public schools, more information is needed on the effectiveness of these programs. Objective: The objective was to analyze the prevalence and factors associated with caries in children aged 5 and 12 years in public versus private schools. Methods: This cross-sectional study included 857 children aged 5 (n=509) and 12 years (n=348) who attended public (n=416) or private (n=441) schools in Patos, PB-Brazil. Between March–September 2018 we examined caries from this study population using the DMFT/dmft index and obtained data on its demographics, toothbrushing frequency, socioeconomic status and schools’ oral health program and services via questionnaires. Statistical analyses were performed using multiple logistic regression (p<0.05). Results: Among 5-years-old children from public vs private schools, untreated caries prevalence was 51.5% (n=117) vs 28.4% (n=80) and dmft index, 2.34 vs 1.04. In 12-years-old children, untreated caries prevalence of 41.3% (n=78) and DMFT index=0.99 in public and of 22% (n=35) and DMFT index=0.50 in private schools were observed. Public school children showed 2.19 (5-years-old) and 2.41 (12-years-old) higher caries odds than private school children (p<0.01). Among 5-years-old children, caries odds were 3.6 higher in low-income households (p=0.025) and 42% lower in children who received periodical dental visits at schools (p=0.011). Conclusion: Children aged 5 and 12 from public schools had higher caries odds than children from private schools. At 5 years old, households with higher incomes and access to dental care in public schools can decrease the odds of dental caries.
References
Kassebaum NJ, Smith AGC, Bernabe E, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990-2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res. 2017;96(4):380–87.
Petersen P. The World Oral Health Report 2003: continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol. 2003;31(1):3–24.
Wen PYF, Chen MX, Zhong YJ, Dong QQ, Wong HM. Global burden and inequality of dental caries, 1990 to 2019. J Dent Res. 2021:220345211056247.
Figueiredo MJ, de Amorim RG, Leal SC, Mulder J, Frencken JE. Prevalence and severity of clinical consequences of untreated dentine carious lesions in children from a deprived area of Brazil. Caries Res. 2011;45(5):435–42.
Li YJ, Gao YH, Zhang Y. The impact of oral health status on the oral health-related quality of life (OHRQoL) of 12-year-olds from children's and parents' perspectives. Community Dent Health. 2014;31(4):240–4.
Martins MT, Sardenberg F, Vale MP, Paiva SM, Pordeus IA. Dental caries and social factors: impact on quality of life in Brazilian children. Braz Oral Res. 2015;29(1):S1806-83242015000100310.
Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Global epidemiology of dental caries and severe periodontitis - a comprehensive review. J Clin Periodontol. 2017;44 Suppl 18:S94–S105.
Roncalli AG, Sheiham A, Tsakos G, Araujo-Souza GC, Watt RG. Social Factors Associated with the Decline in Caries in Brazilian Children between 1996 and 2010. Caries Res. 2016;50(6):551–59.
Pucca GA, Jr., Gabriel M, de Araujo ME, de Almeida FC. Ten Years of a National Oral Health Policy in Brazil: Innovation, Boldness, and Numerous Challenges. J Dent Res. 2015;94(10):1333–7.
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Secretaria de Vigilância em Saúde. Pesquisa Nacional de Saúde Bucal: resultados principais. Brasília. 2012.
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Coordenação Nacional de Saúde Bucal. Diretrizes da Política Nacional de Saúde Bucal. Brasília. 2004.
Brasil. Ministério da Educação e Ministério da Saúde. Programa Saúde na Escola. Decreto n. 6289. Brasília. 2007
Ferreira HS, Lúcio GM, Assunção ML, et al. High blood pressure among students in public and private schools in maceió, Brazil. PLoS One. 2015;10(11):e0142982.
Frazao JB, Machado LG, Ferreira MC. Dental erosion in schoolchildren and associated factors: A cross-sectional study. J Indian Soc Pedod Prev Dent. 2018;36(2):113–119.
Galvão MHR, Medeiros AA, Roncalli AG. Using Andersen’s behavioural model to examine individual and contextual factors associated with dental service utilization in Brazil. Community Dent Oral Epidemiol. 2023;51(5):746-754
Galvão MHR, Souza ACO de, Morais HG de F, Roncalli AG. Desigualdades no perfil de utilização de serviços odontológicos no Brasil. Inequalities in the profile of using dental services in Brazil. Cien Saude Colet. 2022;27(6):2437-2448.
Dutra LC, de Lima LCM, Neves ETB, et al. Adolescents with worse levels of oral health literacy have more cavitated carious lesions. PLoS ONE. 2019;14(11):e0225176.
Firmino RT, Martins CC, Faria LS, et al. Association of oral health literacy with oral health behaviors, perception, knowledge, and dental treatment related outcomes: a systematic review and meta-analysis. J Public Health Dent. 2018;78(3):31-245.
Neves ETB, Granville-Garcia AF, Dutra LDC, et al. Association of oral health literacy and school factors with untreated dental caries among 12-year-olds: a multilevel approach. Caries Res. 2021;55(2):144–52.
Dutra LC, Neves ETB, Lima LCM, et al. Degree of family cohesion and social class are associated with the number of cavitated dental caries in adolescents. Braz Oral Res. 2020;34;1-9.
Neves ETB, de Lima LCM, Dutra LC, et al. Oral health literacy, sociodemographic, family and clinical predictors of dental visits among Brazilian early adolescents. Int J Paediatr Dent. 2021;31(2):204-211.
Lima LJS, da Consolação Soares ME, Moreira LV, et al. Family income modifies the association between frequent sugar intake and dental caries. Int J Paediatr Dent. 2023;33(6):535-542.
von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453–7.
Pinheiro SAA, Rodrigues HB, Santos JTL, et al. Association of dental caries morbidity stages with oral health-related quality of life in children and adolescents. Int J Paediatr Dent. 2020;30(3):293–302.
Lwanga SK, Lemeshow S. Sample size determination in health studies: a practical manual. Geneva; World Health Organization; 1991.
World Health Organization (WHO). Oral health surveys: basic methods 5th edition. Geneva: WHO; 2013.
Warren JJ, Levy SM, Hand JS. The accuracy of tooth loss data collected by nurses. Spec Care Dentist. 1999;19(2):75–8.
Oliveira LB, Sheiham A, Bonecker M. Exploring the association of dental caries with social factors and nutritional status in Brazilian preschool children. Eur J Oral Sci. 2008;116(1):37–43.
Piovesan C, Tomazoni F, Del Fabro J, et al. Inequality in dental caries distribution at noncavitated and cavitated thresholds in preschool children. J Public Health Dent. 2014;74(2):120–6.
Schwendicke F, Dorfer CE, Schlattmann P, Foster Page L, Thomson WM, Paris S. Socioeconomic inequality and caries: a systematic review and meta-analysis. J Dent Res. 2015;94(1):10–8.
Gargano L, Mason MK, Northridge ME. Advancing oral health equity through school-based oral health programs: an ecological model and review. Front Public Health. 2019;7:359.
Chen J, Duangthip D, Gao SS, et al. Oral health policies to tackle the burden of early childhood caries: a review of 14 countries/regions. Front Oral Health. 2021;2:670154.
Duangthip D, Chu CH. Challenges in oral hygiene and oral health policy. Front Oral Health. 2020;1:575428.
Marmot M, Allen J, Bell R, et al. WHO European review of social determinants of health and the health divide. Lancet. 2012;380(9846):1011–29.
Peres MA, Macpherson LMD, Weyant RJ, et al. Oral diseases: a global public health challenge. Lancet. 2019;394(10194):249–60.
Meira GF, Knorst JK, Maroneze MC, Ortiz FR, Ardenghi TM. Effect of dental caries and socioeconomic status on social capital throughout adolescence: a 6-year follow-up. Braz Oral Res. 2020;34:e104.
Moynihan PJ, Kelly SA. Effect on caries of restricting sugars intake: systematic review to inform WHO guidelines. J Dent Res. 2014;93(1):8–18.
Kassebaum NJ, Bernabe E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of untreated caries: a systematic review and metaregression. J Dent Res. 2015;94(5):650–8.
Gabriel M, Cayetano MH, Chagas MM, et al. Admission of dentist in Brazilian Universal Health System (SUS): a priority agenda for the strengthening of Smiling Brazil. Cien Saude Colet. 2020;25(3):859–868.
Castro R de A, Portela MC, Leão AT, de Vasconcellos MT. Oral health-related quality of life of 11- and 12-year-old public school children in Rio de Janeiro. Community Dent Oral Epidemiol. 2011;39(4):336–44.
Borges TS, Schwanke NL, Reuter CP, et al. Factors associated with caries: a survey of students from southern Brazil. Rev Paul Pediatr. 2016;34(4):489–94.
Piovesan C, Pádua MC, Ardenghi TM, Mendes FM, Bonini GC. Can type of school be used as an alternative indicator of socioeconomic status in dental caries studies? A cross-sectional study. BMC Med Res Methodol. 2011;11:37.
Monteiro CN, Beenackers MA, Goldbaum M, et al. Socioeconomic inequalities in dental health services in Sao Paulo, Brazil, 2003-2008. BMC Health Serv Res. 2016;16(1):683.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Revista Contexto & Saúde
This work is licensed under a Creative Commons Attribution 4.0 International License.
Autores que publicam na Revista Contexto & Saúde concordam com os seguintes termos:
a) A submissão de trabalho(s) científico(s) original(is) pelos autores, na qualidade de titulares do direito de autor do(s) texto(s) enviado(s) ao periódico, nos termos da Lei 9.610/98, implica na cessão de direitos autorais de publicação na Revista Contexto e Saúde do(s) artigo(s) aceitos para publicação à Universidade Regional do Noroeste do Estado do Rio Grande do Sul, autorizando-se, ainda, que o(s) trabalho(s) científico(s) aprovado(s) seja(m) divulgado(s) gratuitamente, sem qualquer tipo de ressarcimento a título de direitos autorais, por meio do site da revista e suas bases de dados de indexação e repositórios, para fins de leitura, impressão e/ou download do arquivo do texto, a partir da data de aceitação para fins de publicação. Isto significa que, ao procederem a submissão do(s) artigo(s) à Revista Contexto e Saúde e, por conseguinte, a cessão gratuita dos direitos autorais relacionados ao trabalho científico enviado, os autores têm plena ciência de que não serão remunerados pela publicação do(s) artigo(s) no periódico.
b). Autores mantém os direitos autorais e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial nesta revista.
c). Autores têm autorização para assumir contratos adicionais separadamente, para distribuição não-exclusiva da versão do trabalho publicada nesta revista (ex.: publicar em repositório institucional ou como capítulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.
d). Autores têm permissão e são estimulados a publicar e distribuir seu trabalho online (ex.: em repositórios institucionais ou na sua página pessoal) a qualquer ponto antes ou durante o processo editorial, já que isso pode gerar alterações produtivas, bem como aumentar o impacto e a citação do trabalho publicado (Veja O Efeito do Acesso Livre).