Community and individual socioeconomic inequalities and dental caries from childhood to adolescence: A 10-year cohort study

IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
Bruna Brondani, Jessica K. Knorst, Thiago M. Ardenghi, Fausto M. Mendes, Mário A. Brondani
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Abstract

Purpose

To evaluate the effect of individual and contextual socioeconomic inequalities in the occurrence of untreated dental caries during the transition from childhood to adolescence.

Methods

This 10-year prospective cohort study followed up an initial sample of 639 1–5 years old schoolchildren from southern Brazil. After 7 and 10 years from the baseline (T1), two other reassessments were conducted (T2 and T3), respectively. Untreated dental caries was measured through the International Caries Detection and Assessment System (ICDAS- scores 3, 5 and 6) at T1 and T3. Socioeconomic status (SES) at the contextual and individual level was assessed at T1. At T2, socioeconomic, behavioural and psychosocial characteristics were evaluated as possible pathways of explanation. Structural equation modelling was used to estimate the direct and indirect effects among the variables over 10 years.

Results

A total of 429 adolescents were reevaluated at 10-year follow-up (cohort retention rate of 67.1%). About 30.6% presented untreated dental caries at T3. Low individual SES at T1 directly impacted a higher occurrence of dental caries at T3. Non-white skin colour at T1 also indirectly impacted a higher occurrence of dental caries at T3 through low individual SES at T1 and lower household income at T2. Contextual SES did not predict, directly or indirectly, dental caries at T3.

Conclusion

There is strong evidence that socioeconomic inequalities at the individual level play an important role on the occurrence of dental caries from childhood to adolescence. On the other hand, there was no evidence that contextual SES influences the occurrence of dental caries over time.

Abstract Image

社区和个人社会经济不平等与儿童至青少年时期的龋齿:一项为期 10 年的队列研究。
目的:评估在从儿童期向青少年期过渡的过程中,个人和环境的社会经济不平等对未经治疗的龋齿发生率的影响:这项为期 10 年的前瞻性队列研究对巴西南部 639 名 1-5 岁学龄儿童的初始样本进行了跟踪调查。从基线(T1)开始的 7 年和 10 年后,分别进行了两次重新评估(T2 和 T3)。在 T1 和 T3 阶段,通过国际龋齿检测和评估系统(ICDAS--评分 3、5 和 6)对未经治疗的龋齿进行了测量。在 T1 阶段,对环境和个人层面的社会经济地位(SES)进行了评估。在 T2 阶段,对社会经济、行为和社会心理特征进行了评估,将其作为可能的解释途径。采用结构方程模型估算了 10 年间各变量之间的直接和间接影响:共有 429 名青少年在 10 年的随访中接受了重新评估(队列保留率为 67.1%)。约30.6%的青少年在T3时出现了未经治疗的龋齿。T1时个人社会经济地位较低直接影响了T3时龋齿发生率的升高。通过 T1 的低个人社会经济地位和 T2 的较低家庭收入,T1 的非白色肤色也间接影响了 T3 的较高龋齿发生率。环境社会经济地位并不能直接或间接地预测 T3 的龋齿情况:结论:有确凿证据表明,个人层面的社会经济不平等对儿童到青少年时期的龋齿发生率起着重要作用。另一方面,没有证据表明社会经济背景会随着时间的推移影响龋齿的发生。
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来源期刊
Community dentistry and oral epidemiology
Community dentistry and oral epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.40
自引率
8.70%
发文量
82
审稿时长
6 months
期刊介绍: The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome. The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry. The journal is published bimonthly.
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