Prospective Association Between Brazilian Primary Oral Health Care Models and Preventive Dental Visits and Risk Behaviours: A 5-Year Cohort Study Among Young Adults

IF 2.9 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology Pub Date : 2026-07-31 Epub Date: 2026-05-22 DOI:10.1111/cdoe.70075

Jocelaine Vieira Vione, Letícia Donato Comim, Nathália Costa de Castro, Julio Eduardo do Amaral Zenkner, Orlando Luiz do Amaral Júnior, Luana Severo Alves

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引用次数: 0

Abstract

Objective

To evaluate the prospective association between the absence and different models of primary oral health care in Brazil (traditional units and Family Health Strategy [FHS] teams) and preventive dental visits and risk behaviours (smoking initiation and increase in alcohol consumption) among young individuals.

Methods

This 5-year prospective cohort study derived from a population-based cross-sectional survey conducted in 2018 that evaluated the oral health conditions of 1197 15- to 19-year-old adolescents from southern Brazil. In 2022–2024, follow-up assessments were conducted (mean time interval 5 ± 0.5 years). Socio-demographic characteristics, the use of dental services (including the reason for the last dental visit), behavioural habits (smoking and alcohol consumption) and participants' address were collected at baseline and follow-up. The outcomes were last dental visit for prevention, smoking initiation and increase in alcohol consumption. The main predictor variable was public dental services coverage in the neighbourhood (absent, primary health care or FHS including a dental team) obtained from official data. Unadjusted and adjusted multilevel Poisson regression models were performed to estimate relative risk (RR) and 95% confidence intervals (CI).

Results

Five hundred and seventy individuals were re-evaluated (47.6% retention). After adjusting for individual-level variables, participants residing in neighbourhoods with FHS including a dental team were more likely to visit a dentist for preventive purposes (RR: 1.59; 95% CI: 1.29–1.97), and had a lower risk for smoking initiation (RR: 0.45; 95% CI: 0.21–0.97), and an increase in alcohol consumption (RR: 0.80; 95% CI: 0.67–0.97) compared to areas without coverage. Coverage by traditional primary health care showed no significant association with the study outcomes.

Conclusion

Brazil's FHS model with integrated oral health teams outperforms traditional dental services in promoting preventive care and reducing risk behaviours among young adults.

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巴西初级口腔保健模式与预防性牙科就诊和危险行为之间的前瞻性关联：一项针对年轻人的5年队列研究。

目的：评估巴西初级口腔卫生保健的缺失和不同模式（传统单位和家庭卫生战略[FHS]团队）与年轻人预防性牙科就诊和风险行为（开始吸烟和增加饮酒）之间的前瞻性关联。方法：这项为期5年的前瞻性队列研究源自2018年进行的一项基于人群的横断面调查，该调查评估了巴西南部1197名15至19岁青少年的口腔健康状况。2022-2024年随访评估（平均时间间隔5±0.5年）。在基线和随访时收集了社会人口特征、牙科服务的使用（包括最后一次牙科就诊的原因）、行为习惯（吸烟和饮酒）和参与者的地址。结果是预防的最后一次牙科检查，吸烟的开始和饮酒的增加。主要预测变量是从官方数据中获得的社区公共牙科服务覆盖率（缺位、初级卫生保健或FHS，包括牙科小组）。采用未调整和调整的多水平泊松回归模型来估计相对风险（RR）和95%置信区间（CI）。结果：570人被重新评估，留用率为47.6%。在调整了个人水平的变量后，与没有覆盖的地区相比，居住在有FHS包括牙科团队的社区的参与者更有可能出于预防目的去看牙医（RR: 1.59; 95% CI: 1.29-1.97），并且开始吸烟的风险更低（RR: 0.45; 95% CI: 0.21-0.97），酒精消费增加（RR: 0.80; 95% CI: 0.67-0.97）。传统初级卫生保健的覆盖率与研究结果无显著关联。结论：在促进预防保健和减少年轻人的危险行为方面，巴西的FHS综合口腔保健团队模式优于传统牙科服务。

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来源期刊

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

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.