The associations of socioeconomic status and social capital with gingival bleeding among schoolchildren

Abstract

Objective: The aim of this study was to assess the associations of gingival bleeding with individual and community social variables among schoolchildren. Methods: This cross-sectional study evaluated a representative, multistage, random sample of 1,134 12-year-old schoolchildren from Santa Maria, a city in southern Brazil. The participants were examined clinically, and full-mouth gingival bleeding was recorded according to the Community Periodontal Index criteria (scored as healthy or bleeding). The children's parents or guardians answered questions regarding their socioeconomic status and social capital, and an assessment of the associations was performed using multilevel Poisson regression models. Results: The prevalence of gingival bleeding was 96.21 percent. The multilevel adjusted assessment revealed that socioeconomic, clinical, and social capital variables at the individual level were associated with higher levels of gingival bleeding. Children whose fathers had a low educational level, children who had dental plaque and dental crowding, and children who never/almost never attended religious meetings exhibited significantly higher levels of gingival bleeding than their counterparts. This social gradient remained significant even after adjusting for contextual-level covariates. Conclusion:The results indicate that the socioeconomic status and features of social capital are associated with the levels of gingival bleeding among schoolchildren.

The Effect of Parenting Practices on the Severity of Gingival Bleeding in Children

“…A limitation of the present study was that data collected on oral health–related practices were not comprehensive. Although there was an attempt to include the most important family demographic factors in the model, several psychosocial variables, such as stress and coping that have been found to operate at various SES levels 34 and have an impact on gingivitis in children, could not be considered 30 , 35 . Nevertheless, the present study demonstrates that, apart from SES disparities which have been widely understood and studied, parenting practices are also important in predicting gingival disease in children.…”

Pathways of socioeconomic inequalities in gingival bleeding among adolescents

“…Parents’ religious practice was used as a proxy of social capital (psychosocial characteristic) and it was measured by the following five questions: “How often do you go to a church, temple or another religious meeting: 1—more than once a week, 2—about once a week, 3—two or three times a month, 4—a few times a year, 5—once a year or less, or 6—never?”, “How often do you devote your time to religious activities such as praying, meditation, Bible reading or reading another religious text: 1—more than once a day, 2—daily, 3—two or more times a week, 4—about once a week, 5—a few times a month, or 6—never/almost never?”, “In your life, do you feel the presence of God (or the Holy Spirit)?”, “Does your religious beliefs determines your day‐to‐day life?”, and “Do you live your religion in all aspects of life?” The options for these questions were: “1—totally true to me, 2—in general it is true, 3—I am not sure, 4—in general, it is not true, or 4—it is not true.” These variables were used according to original categories. Religiosity questions were adapted from previous studies . Religious practice can be considered as an individual attribute related to social capital (social network) reflecting the reciprocal exchange of social support among members and the encouragement of good health behaviours…”

The role of socioeconomic status and psychosocial factors on gingivitis in socially disadvantaged adolescents

“…Nonetheless, low socioeconomic status was a meaningful predictor of gingivitis. The role of socioeconomic circumstances on gingival bleeding in children and adolescents was demonstrated using single measures of socioeconomic position, including parental education, family income, house overcrowding and housing conditions . However, studies investigating the association between similar socioeconomic indicators and gingivitis have reported contradictory findings.…”

“…However, studies investigating the association between similar socioeconomic indicators and gingivitis have reported contradictory findings. For instance, although adolescents from low family income were more likely to have gingivitis than those from better off families, other studies did not find an association between family income and gingivitis . There is no gold standard to measure socioeconomic status.…”

“…The current knowledge of the relationship between worse social conditions and gingivitis is supported by studies using different measures of socioeconomic position . On the other hand, investigations on the impact of psychological well‐being on gingivitis in children and adolescents are scarce .…”