Social Intersectional Differences in Pulpal Clinical Consequences of Untreated Dental Caries among Brazilian Adolescents: Analysis of the SB Brasil 2023 Survey.
Gabriela Scortegagna de Souza, Maria Laura Braccini Fagundes, Fernando Neves Hugo, Juliana Balbinot Hilgert, Jessye Melgarejo do Amaral Giordani, Orlando Luiz do Amaral Júnior
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Abstract
Introduction: The aim of the study was to examine differences in the occurrence of consequences of untreated dental caries (pulpal involvement, ulceration, fistula, and abscess-PUFA) across intersectional social positions defined by sex, skin color, and household income among adolescents.
Methods: This study analyzed data from the Brazilian National Oral Health Survey (SB Brasil 2023), using a multistage stratified probability sampling design to represent adolescents aged 15-19 years. Social variables were combined into 8 intersectional groups based on sex, skin color, and family income. Outcomes included PUFA prevalence ≥1 and counts of its components. Survey-adjusted Poisson regression with robust variance and a three-way interaction term was applied.
Results: The sample comprised 4,892 adolescents. Compared to high-income White males, prevalence was higher among low-income Black males (PR = 5.93; 95% CI: 2.60-13.51) and low-income Black females (PR = 4.06; 95% CI: 1.85-8.90). The predicted prevalence of PUFA ≥1 ranged from 4.0% (95% CI: 2.0-7.0) among high-income White males to 21.0% (95% CI: 11.0-32.0) among low-income Black males. Among females, prevalence estimates were 15.0% (95% CI: 9.0-20.0) in high-income Black, 16.0% (95% CI: 5.0-28.0) in low-income White, and 18.0% (95% CI: 12.0-24.0) in low-income Black individuals.
Conclusion: Marked differences in PUFA occurrence were observed across intersectional social positions, with the highest burden observed among low-income Black adolescents, particularly males for prevalence ratios, although females also presented high absolute prevalence. These findings reinforce the need for policies addressing structural social inequalities in oral health.
期刊介绍：
''Caries Research'' publishes epidemiological, clinical and laboratory studies in dental caries, erosion and related dental diseases. Some studies build on the considerable advances already made in caries prevention, e.g. through fluoride application. Some aim to improve understanding of the increasingly important problem of dental erosion and the associated tooth wear process. Others monitor the changing pattern of caries in different populations, explore improved methods of diagnosis or evaluate methods of prevention or treatment. The broad coverage of current research has given the journal an international reputation as an indispensable source for both basic scientists and clinicians engaged in understanding, investigating and preventing dental disease.
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