Dental caries, periodontal disease and restorative dental care among Indigenous and non‐Indigenous groups in Brazil: A descriptive study

Abstract

Objective: To compare patterns of dental caries, periodontal disease and dental care among Indigenous and non-Indigenous Central-West Brazilian subpopulations. Methods: Data were from two population-based cross-sectional studies involving 5-, 12-, 15-19-and 35-44-year-olds. The first examined were the Guarani, Kaiowá, Terena and Kadiwéu Indigenous groups from Mato Grosso do Sul Brazilian state and the second comprised a non-Indigenous population. Mean numbers of sound teeth, decayed, missing and filled teeth (dmft/DMFT), prevalence of poor oral hygiene for adults (35-44 years) and of periodontal disease were estimated. Restorative dental service utilization was measured using the Care Index. Results: The study populations comprised of 1830 Indigenous and 29 395 non-Indigenous people. The Kaiwoá ethnic group had the lowest DMFT among Indigenous groups for ages 12, 15-19 years; 0.9 (95% CI 0.7-1.1) and 2.4 (95% CI 1.9-2.9), respectively. The highest values were observed among the 12-year-old Terena ethnic group and 15-to 19-year-old Kadiwéo groups; 2.2 (95% CI 1.8-2.5) and 3.7 (95% CI 3.1-4.4), respectively. The mean DMFT values were significantly lower among Indigenous than non-Indigenous people for all age groups. The prevalence of bleeding and calculus was 70.3% (95% CI 64.5%-75.5%) and 80.1% (95% CI 74.8%-84.5%), respectively, for Indigenous people and 43.9% (95% CI 34.4%-50.7%) and 61.5% (95% CI 55.4%-67.2%), respectively, for the non-Indigenous population. Restorative services were higher among 5-year-old non-Indigenous children and adults than for Indigenous groups. Among Indigenous groups, the Terena had the highest level of restored teeth (38.0% at 12 years) and Kadiwéu the lowest level (8.8% at 12 years). Conclusion: In our study, Indigenous people had a lower caries burden, but less access to restorative services than their non-Indigenous counterparts. These disparities likely reflect differences in historical, socioeconomic, cultural, environmental and political determinants that both groups have experienced differently over time.

Dental Health Inequalities among Indigenous Populations: A Systematic Review and Meta-Analysis

“…No studies were excluded based solely on the assessment of methodological quality. Only 13 [Hallett and O'Rourke, 2002;Endean et al, 2004;Australian Institute of Health and Welfare, 2007;Brennan et al, 2007;Lawrence et al, 2008;Kapellas et al, 2014;Arrow, 2016;Jamieson et al, 2016a;Miranda et al, 2018;Shi et al, 2018;Simangwa et al, 2018;Haag et al, 2020;Arantes et al, 2021] studies of 43 answered "yes" for each critical appraisal question, achieving a score of 9 out of 9. The lowest score was 5, observed in studies by Jamieson et al [2007b] and Gowda et al [2009] as these studies failed to mention the sampling frame, methods for sampling participants, and sample size calculation.…”

“…The lowest score was 5, observed in studies by Jamieson et al [2007b] and Gowda et al [2009] as these studies failed to mention the sampling frame, methods for sampling participants, and sample size calculation. Out of 43 studies, only 14 [Hallett and O'Rourke, 2002;Endean et al, 2004;Schroth et al, 2005;Australian Institute of Health and Welfare, 2007;Brennan et al, 2007;Lawrence et al, 2008;John et al, 2015;Arrow, 2016;Jamieson et al, 2016a;Miranda et al, 2018;Shi et al, 2018;Simangwa et al, 2018;Haag et al, 2020;Arantes et al, 2021] reported methods for sample size calculation or whether the sample size was adequate for the population of interest. Most studies described the study setting and participants in detail (95.3%).…”

“…Another reason for exclusion was variations in measurement of den-tal caries prevalence for both the case and control groups. Therefore, a total of 43 articles [Schamschula et al, 1980;de Muñiz, 1985;del Rio Gomez, 1991;Jones et al, 1992;Rao and Bharambe, 1993;Grim et al, 1994;Davies et al, 1997;Hallett and O'Rourke, 2002;Endean et al, 2004;Schroth et al, 2005;Zeng et al, 2005;Jamieson et al, 2006a, b;Australian Institute of Health and Welfare, 2007;Jamieson et al, 2007a, b;Brennan et al, 2007;Lawrence et al, 2008;Medina et al, 2008;Gowda et al, 2009;Lawrence et al, 2009;Phelan et al, 2009;Jamieson et al, 2010a, b;Dogar et al, 2011;Foster Page and Murray Thomson, 2011;Page and Thomson, 2011;Singh et al, 2011;Kumar et al, 2013;Kapellas et al, 2014;Drummond et al, 2015;John et al, 2015 2015; Shen et al, 2015;Arrow, 2016;Jamieson et al, 2016a;Schuch et al, 2017;Miranda et al, 2018;Shi et al, 2018;Simangwa et al, 2018;Haag et al, 2020;Arantes et al, 2021] met the inclusion criteria and were included in this review for descriptive analysis. A total of 34 articles were included for meta-analysis...…”

“…Australia had the highest number of published articles, with a total of 21 articles [Davies et al, 1997;Hallett and O'Rourke, 2002;Endean et al, 2004;Jamieson et al, 2006a, b;Australian Institute of Health and Welfare, 2007;Brennan et al, 2007;Jamieson et al, 2007a, b;Phelan et al, 2009;Jamieson et al, 2010a, b;Dogar et al, 2011;Kapellas et al, 2014;Lalloo et al, 2015;Arrow, 2016;Jamieson et al, 2016a;Schuch et al, 2017;Haag et al, 2020]. While 4 articles were published in India [Rao and Bharambe, 1993;Singh et al, 2011;Kumar et al, 2013;John et al, 2015] and Canada [Schroth et al, 2005;Lawrence et al, 2008Lawrence et al, , 2009Shi et al, 2018], 3 articles were published in New Zealand [Gowda et al, 2009;Foster Page and Murray Thomson, 2011;Page and Thomson, 2011] and Brazil [Drummond et al, 2015;Miranda et al, 2018;Arantes et al, 2021], 2 articles were published each in the USA [Jones et al, 1992;Grim et al, 1994] and China [Takeshima et al, 2014;Shen et al, 2015], while Argentina [de Muñiz, 1985], Ecuador [Medina et al, 2008], Mexico [del Rio Gomez, 1991], and Tan...…”

“…While 4 articles were published in India [Rao and Bharambe, 1993;Singh et al, 2011;Kumar et al, 2013;John et al, 2015] and Canada [Schroth et al, 2005;Lawrence et al, 2008Lawrence et al, , 2009Shi et al, 2018], 3 articles were published in New Zealand [Gowda et al, 2009;Foster Page and Murray Thomson, 2011;Page and Thomson, 2011] and Brazil [Drummond et al, 2015;Miranda et al, 2018;Arantes et al, 2021], 2 articles were published each in the USA [Jones et al, 1992;Grim et al, 1994] and China [Takeshima et al, 2014;Shen et al, 2015], while Argentina [de Muñiz, 1985], Ecuador [Medina et al, 2008], Mexico [del Rio Gomez, 1991], and Tanzania [Simangwa et al, 2018] reported only 1 published report each. Sample size calculation was reported for 13 studies [Hallett and O'Rourke, 2002;Endean et al, 2004;Schroth et al, 2005;Australian Institute of Health and Welfare, 2007;Brennan et al, 2007;Lawrence et al, 2008;Singh et al, 2011;John et al, 2015;Arrow, 2016;Simangwa et al, 2018;Haag et al, 2020;Arantes et al, 2021]. Except for 8 studies [Schamschula et al, 1980;de Muñiz, 1985;Davies et al, 1997;…”