Determinants Of Adherence To Dental Treatment Of Socially Vulnerable Adolescents In Primary Health Care: A Cohort Study

Abstract

Background: Different studies with adolescents address the difficulty they have to adhere to oral dental treatments. Therefore, better understanding the processes involved in adherence to treatment in this population is necessary. The aim of this study was to investigate the factors that influence adherence to dental treatment in socially underprivileged adolescents in primary care. Methods: A longitudinal analytical study was conducted in Piracicaba, São Paulo, Brazil, between 2014 and 2015. The sample consisted of 1179 adolescents examined in family health units; of these, 474 were referred to treatment (40.2%) and 325 (68.6%) were reevaluated after 18 months. Adherence to dental treatment was the dependent variable. Independent variables were: individual (clinical, sociodemographic, access to the service, reporting pain, oral impacts on daily performance, family cohesion) and contextual (percentage of families in the neighborhood with income of 0.5 to 1 minimum wage). Results: Non-adherence to treatment showed high rate in the studied sample (49.5%). Family income (p=0.039) and number of individuals in the family (p=0.003) were associated with non-adherence to dental treatment. Conclusions: It is concluded that the adolescents’ social vulnerability condition resulted in situations that are incompatible with adherence, which hinders dental treatment and health service planning.