Inequalities in Oral Health among Older Brazilians: A Cross-Sectional Analysis of a National Survey

Abstract

Objective: To investigate the association of tooth loss and periodontal disease with socioeconomic and demographic factors, the need for and use of health services, and the effect of oral health on the daily lives of older Brazilians. Material and Methods: We abstracted data from a nation-wide, representative, cross-sectional survey of 7619 Brazilians aged between 65 to 74 years. Poisson regression models were created to investigate associations between oral diseases and income, education level, gender, ethnicity, region of residence, and use of dental services; statistical significance was set at 5%. Results: The mean age of the 7619 subjects studied was 69 years (95% Confidence Interval, 68.9-69.1); 61.9% were women. Regarding ethnicity, 46.95% were White, 38.90% were Brown, 11.54% were Black and 2.53% belonged to other ethnic groups. Bleeding on probing or dental calculus was present in 26.67% of subjects, whereas LOA was present in 87.27%. The loss of at least one tooth was observed in 48.90% of subjects, while 47.03% were completely edentulous. Low educational status increased the prevalence ratio (PR) of all diseases (loss of attachment, PR=5.54; bleeding on probing, PR=3.93; tooth loss, PR=2.24; edentulousness, PR=3.34). The prevalence of tooth loss was 2.58 times higher in subjects who reported a monthly income of less than 301 USD. The effect on daily life was occasionally a protective factor and occasionally increased the likelihoods of diseases. Conclusion: These findings substantiate the association of socioeconomic conditions, demographic features, and use of dental services with bleeding on probing, presence of dental calculus, loss of periodontal attachment, tooth loss, and edentulousness among older Brazilian subjects.

Fatores associados ao uso dos serviços de saúde bucal entre idosos no Brasil: scoping review

“…O uso por rotina foi associado com ausência de dor . Os fatores de diagnóstico de condições normativas de saúde bucal estiveram associados ao uso dos serviços de saúde bucal (Sória et al, 2019;Silva et al, 2018;Prado et al, 2018;Fonseca et al, 2017;Langlois & Feldens, 2013;Ferreira et al, 2013;Martins et al, 2007). Sangramento gengival, presença de cálculo, bolsa periodontal e edentulismo foram associados ao uso há mais de um ano (Prado et al, 2018;Silva et al, 2013).…”

“…Os fatores de diagnóstico de condições normativas de saúde bucal estiveram associados ao uso dos serviços de saúde bucal (Sória et al, 2019;Silva et al, 2018;Prado et al, 2018;Fonseca et al, 2017;Langlois & Feldens, 2013;Ferreira et al, 2013;Martins et al, 2007). Sangramento gengival, presença de cálculo, bolsa periodontal e edentulismo foram associados ao uso há mais de um ano (Prado et al, 2018;Silva et al, 2013). A condição periodontal saudável, não ter necessidade de próteses, de tratamento odontológico e menor número de dentes extraídos estiveram associados ao uso recente (Sória et al, 2019;Fonseca et al, 2017;Ferreira et al, 2013;Martins et al, 2007), regular (Silva et al, 2018) ou por rotina dos serviços de saúde bucal.…”

“…O delineamento transversal foi adotado em todos os estudos. A análise estatística múltipla se deu através da técnica de regressão de Poisson (50,0%) ( (Sória et al, 2019;Silva et al, 2018;Prado et al, 2018;(Sória et al, 2019;Silva et al, 2018;Silva et al, 2013;Prado et al, 2018; e os demais 50,0%, pela regressão logística (Fonseca et al, 2017;Oliveira et al, 2016;Souza et al, 2012;Martins et al, 2007;Matos & Lima-Costa, 2007) (Tabela 1).…”

“…Referências para avaliação do texto completo (n=25) As variáveis desfecho relacionadas ao uso de serviços de saúde bucal foram: tempo da última consulta odontológica, uso regular dos serviços, uso dos serviços por rotina e uso de serviços públicos. Os estudos que analisaram 'última consulta odontológica' adotaram diferentes recortes de tempo para análise dos fatores associados: uso há menos de um ano (Sória et al, 2019;Souza et al, 2012;Martins et al, 2007), entre um a dois anos (Prado et al, 2018;Ferreira et al 2013;Matos & Lima-Costa, 2007) e maior que três anos (Silva et al, 2013), bem como nunca utilizou (Matos & Lima-Costa, 2007).…”

Reducing social inequalities in the oral health of an adult population

“…Studies on inequalities have increased, especially in developed countries; 13,14 however, most of them are cross-sectional analyses 14,15,16,17 of young people, 13,16 adults 14,15,16 or older adults, 14,17 or else assess certain oral health conditions, such as healthcare service use and health behaviors, 13,14,18 as well as some clinical conditions, like dental caries. 16 A cohort study of an adult population is a relevant tool that can be used to identify what oral conditions may be more susceptible to social inequalities.…”