Revista brasileira de epidemiologia = Brazilian journal of epidemiology最新文献

{"title":"Factors associated with dental service use in Brazil according to Andersen's Behavioral Model: analysis of the 2023 Brazilian National Oral Health Survey.","authors":"Debora Lana Alves Monteiro, Juliana Pereira da Silva Faquim, Rênnis Oliveira da Silva, Edson Hilan Gomes de Lucena, Yuri Wanderley Cavalcanti","doi":"10.1590/1980-549720260016.supl.1","DOIUrl":"10.1590/1980-549720260016.supl.1","url":null,"abstract":"<p><strong>Objective: </strong>To analyze factors associated with the time since the last dental visit among Brazilians aged 15-19, 35-44, and 65-74 years, according to Andersen's Behavioral Model.</p><p><strong>Methods: </strong>This cross-sectional analytical study used microdata from a nationally representative oral health survey. Data from 21,385 individuals were analyzed. The outcome was the time since the last dental visit (≤1 year vs. >1 year). The independent variables were grouped into predisposing, facilitating, and perceived need factors according to Andersen's Behavioral Model. Analyses accounted for the complex sampling design and were performed using multilevel logistic regression with random intercepts at the municipality level, estimating odds ratios (OR) and 95% confidence intervals (95%CI).</p><p><strong>Results: </strong>Older adults (OR 1.436; 95%CI 1.242-1.660), Black (OR 1.161; 95%CI 1.011-1.334) and Brown individuals (OR 1.096; 95%CI 1.005-1.196) were more likely to report a dental visit more than one year prior. Higher education was strongly associated with lower odds of delayed visits (OR 0.383; 95%CI 0.318-0.461). Poor self-rated oral health (OR 2.486; 95%CI 2.041-3.028) increased the likelihood of delayed visits, whereas dental pain was associated with more recent use (OR 0.413; 95%CI 0.382-0.448). Use of private services was associated with lower odds of delayed visits (OR 0.820; 95%CI 0.732-0.919). Municipal coverage and the presence of specialized centers were not significantly associated.</p><p><strong>Conclusion: </strong>Sociodemographic characteristics and perceived need factors remain central determinants of recent dental service utilization patterns in Brazil.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29Suppl 1 Suppl 1","pages":"e260016supl1"},"PeriodicalIF":2.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Race/skin color and educational inequalities in toothache and access to dental care among adults in Brazil: National Oral Health Survey2023.","authors":"Jonatan da Rosa Pereira da Silva, Rafael Amaral Oliveira, Cleidiane Aparecida de Quadra, Afonso Valau de Lima Junior, Gisele Silveira Coelho Lopes, Luciane Bisognin Ceretta","doi":"10.1590/1980-549720260012.supl.1","DOIUrl":"10.1590/1980-549720260012.supl.1","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between race/skin color and educational level with toothache and access to dental care among adults aged 35-44 years in Brazil.</p><p><strong>Methods: </strong>This cross-sectional study included 8,597 adults who participated in the Brazilian National Oral Health Survey 2023 (SB 2023). Two outcomes were evaluated: the prevalence of toothache in the previous six months and access to dental care among adults who reported toothache. Crude and adjusted Poisson regression models with robust variance were used to estimate the associations of race/skin color, educational level, and the intersection of these two social markers with the outcomes.</p><p><strong>Results: </strong>The prevalence of toothache in the previous six months was 23.7%. Among adults who reported toothache, 34.1% did not access dental care. Black adults (adjusted prevalence ratio [PRa]=1.32; 95%CI 1.1-1.7; p=0.034) and those with low educational attainment (aPR=2.1; 95%CI 1.4-2.9; p<0.0001) showed a higher prevalence of toothache. In the intersectional analysis, Black adults with low educational attainment had a higher prevalence of toothache (aPR=3.5; 95%CI 2.0-6.0; p<0.0001) and of not having consulted a dentist despite experiencing pain (PRa=2.5; 95%CI 1.3-4.0; p=0.006) compared with White adults with high educational attainment.</p><p><strong>Conclusion: </strong>Black adults with low educational attainment showed a higher prevalence of toothache and lack of access to dental care even when experiencing pain, indicating that race/skin color and educational level are important determinants of oral health inequalities in Brazil.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29Suppl 1 Suppl 1","pages":"e260012supl1"},"PeriodicalIF":2.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequalities oral health between beneficiaries and non-beneficiaries of the Bolsa Família Program in Brazil: evidence from SB Brasil 2023.","authors":"Marcos Pascoal Pattussi, Adriana Vieira Macedo Brugnoli, Francine Lorencetti da Silva Campioni, Renato Canevari Dutra da Silva","doi":"10.1590/1980-549720260021.supl.1","DOIUrl":"10.1590/1980-549720260021.supl.1","url":null,"abstract":"<p><strong>Objective: </strong>To investigate inequalities in oral health between beneficiaries and non-beneficiaries of the Bolsa Família Program (PBF) in Brazil.</p><p><strong>Methods: </strong>This was a cross-sectional household study using data from the 2023 National Oral Health Survey (SB Brasil). Clinical indicators (caries, tooth loss, need for treatment and prosthesis) and subjective indicators (self-perception and dental pain) were evaluated. Associations between beneficiary status and outcomes were estimated using Poisson regression and multinomial logistic regression adjusted for sex, skin color, and dental visit in the last year.</p><p><strong>Results: </strong>Beneficiaries reported worse self-perception of oral health (PR 1.87; 95%CI 1.19-2.94 to PR 2.30; 95%CI 1.48-2.28) and a higher prevalence of caries, pain, and need for treatment. 12-year-old children reported more dental pain (PR 1.47; 95%CI 1.10-1.95). In adolescents, the greatest inequities occurred in caries severity (PR 2.03; 95%CI 1.45-2.83), need for urgent care (PR 2.29; 95%CI 1.54-3.39), and partial dentures (PR 2.66; 95%CI 1.65-4.29). Among adults, the need for partial (OR 2.11; 95%CI 1.56-2.85) and total (OR 3.38; 95%CI 1.65-3.42) prostheses was more frequent, a pattern that was maintained in the elderly (OR 1.61; 95%CI 1.05-2.47 and OR 2.06; 95%CI 1.36-3.13).</p><p><strong>Conclusion: </strong>Significant inequalities in oral health are observed between beneficiaries and non-beneficiaries of the Bolsa Família Program. Overcoming these inequities requires integration between income transfer policies, primary care, and specialized dental services, guided by the principles of equity and social justice.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29Suppl 1 Suppl 1","pages":"e260021supl1"},"PeriodicalIF":2.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequalities in negative maternal perception of oral health among Brazilian children: findings from the 2023 National Oral Health Survey (SB Brasil 2023).","authors":"Rafaela Zazyki, Nathalia Ribeiro Jorge da Silva-Garcia, Sarah Arangurem Karam, Francine Dos Santos Costa","doi":"10.1590/1980-549720260013.supl.1","DOIUrl":"10.1590/1980-549720260013.supl.1","url":null,"abstract":"<p><strong>Objective: </strong>To analyze socioeconomic inequalities in negative maternal perception of children's oral health in Brazil using data from the 2023 National Oral Health Survey (SB Brasil 2023).</p><p><strong>Methods: </strong>This cross-sectional study included 6,970 five-year-old children. Our outcome was a negative maternal perception of child oral health. Inequalities were assessed by sex, race/skin color, maternal education, region of the country and wealth index. Complex measures of inequality, Slope Index of Inequality (SII) and Concentration Index (CIX) were estimated using ordered stratification. For interpretation, the estimates were multiplied by 100.</p><p><strong>Results: </strong>The prevalence of a negative maternal perception of child oral health was 30.4% (95% confidence interval - 95%CI 27.1-33.9). It was higher among children whose mothers had ≤8 years of schooling (35.6%), were in the poorest wealth quintile (42.5%), and had caries experience (51.8%). The SII and CIX indicated marked inequalities for wealth quintiles (SII: -28.0; 95%CI -39.2; -16.7/ CIX: -10.3; 95%CI -17.4; -3.1) and maternal education (SII: -22.1; 95%CI -33.0; -11.2/ CIX: -7.9; 95%CI -14.5; -1.4). Higher prevalences were found in the North and Northeast regions and among Black and Brown children.</p><p><strong>Conclusion: </strong>Substantial socioeconomic inequalities persist in maternal perception of children's oral health in Brazil. The findings highlight the need for equity-oriented oral health policies and actions to address social and racial disparities.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29Suppl 1 Suppl 1","pages":"e260013supl1"},"PeriodicalIF":2.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Untreated dental caries in Brazilian adolescents: analysis by the PUFA index.","authors":"Lívia Natália Sales Brito, Gustavo Gomes Agripino, Sandra Aparecida Marinho, Helene Soares Moura, Robeci Alves Macêdo Filho, Pierre Andrade Pereira de Oliveira","doi":"10.1590/1980-549720260010.supl.1","DOIUrl":"10.1590/1980-549720260010.supl.1","url":null,"abstract":"<p><strong>Objective: </strong>To describe the distribution profile of untreated dental caries in Brazilian adolescents, using the PUFA index, and identify the main associated factors.</p><p><strong>Methods: </strong>This is a cross-sectional study based on data from the 2023 National Survey of Oral Health. The sample consisted of 8,053 adolescents aged 15 to 19 years. The dependent variable was the presence of untreated caries, measured by the PUFA index. Independent variables included sociodemographic and oral health-related factors such as impacts on quality of life and access to dental services. Descriptive and bivariate analyses were performed using the Rao-Scott test and multiple logistic regression, considering a significance level of 5% (p<0.05).</p><p><strong>Results: </strong>We verified that 12.5% of Brazilian adolescents had at least one tooth affected by some repercussion of untreated caries. There were statistically significant associations between PUFA≥1 and the adolescents' socioeconomic conditions, such as lower level of education, low family income, being beneficiary of government cash transfer programs, in addition to Black skin color/race. We observed a negative impact on the quality of life of 22.4% of adolescents with PUFA index ≥1, and 19.1% had never had a dental appointment. Low family income, presence of pain in the last six months, and self-perceived need for dental treatment were factors strongly associated with PUFA≥1.</p><p><strong>Conclusion: </strong>Social determinants influenced the progression of dental caries in adolescents. Therefore, social policies targeting Black adolescents and expanded access to dental services are essential to reduce oral health problems in this more vulnerable population.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 suppl 1","pages":"e260010.supl1"},"PeriodicalIF":2.0,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social inequalities and untreated dental caries in 5-year-old children: an intersectional analysis based on SB Brasil 2023.","authors":"Monarko Nunes de Azevedo, João Victor Alves Alencar, Mary Anne de Souza Alves França, Marcos Vinicius Rodrigues de Melo, Matheus Ribeiro Dos Santos, Gustavo Adolfo Martins Mendes, Edsaura Maria Pereira","doi":"10.1590/1980-549720260014.supl.1","DOIUrl":"10.1590/1980-549720260014.supl.1","url":null,"abstract":"<p><strong>Objective: </strong>To identify intersectional vulnerability profiles among 5-year-old children with untreated dental caries and to analyze associated social inequalities in Brazil.</p><p><strong>Methods: </strong>This is a population-based, cross-sectional study using data from the National Survey of Oral Health (SB Brasil 2023). Five-year-old children examined in the survey were included. The variables used to identify profiles were: race/skin color, household income, maternal level of education, beneficiaries of social welfare programs, and region of residence. For profile comparison, the variables \"last dental appointment\" and \"presence of piped water at home\" were used. Descriptive, bivariate (χ²), Two-Step Cluster, and binary and multinomial logistic regression analyses were performed.</p><p><strong>Results: </strong>A total of 7,185 children were analyzed, of whom 44.8% presented untreated dental caries. Higher prevalence values were observed among children with low maternal education (51.9%), Black (49.9%) and Indigenous (75.0%), low income (54.1%), living in the North (56.3%) region, and beneficiaries of social welfare programs (53.0%) (p<0.001). Three profiles were identified: Profile A (boys, Black, from the Northeast, low income, and high dependence on social welfare programs) showed lower probability of dental appointment in the past 2 years (OR 0.59; 95%CI 0.48-0.73; p<0.001); Profile B (boys, White, from the Northeast, low income, and beneficiaries of social welfare programs) showed worse conditions regarding the presence of piped water at home (OR 0.38; 95%CI 0.19-0.76; p=0.006); and Profile C (girls, Black, from the North, higher income, and lower dependence on social welfare programs) concentrated the best conditions for dental appointment and piped water (p<0.001).</p><p><strong>Conclusion: </strong>Untreated dental caries among 5-year-old children reflects structural inequities combining racial, socioeconomic, territorial, and income-related inequalities.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29Suppl 1 Suppl 1","pages":"e260014supl1"},"PeriodicalIF":2.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13325560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of clinical consequences of untreated caries in early childhood with oral health-related quality of life.","authors":"Renato Canevari Dutra da Silva, Francine Lorencetti da Silva Campioni, Heloísa Silva Guerra, Fernanda Oliveira Meller, Cleidiane Aparecida de Quadra, Elton Brás Camargo Júnior, Antônio Augusto Schäfer","doi":"10.1590/1980-549720260018.supl.1","DOIUrl":"10.1590/1980-549720260018.supl.1","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between the pulp involvement, ulceration, fistula, abscess (PUFA) index and oral health-related quality of life (OHRQoL) of 5-year-old Brazilian children.</p><p><strong>Methods: </strong>This was a cross-sectional, population-based study using data from the oral health survey SB Brasil 2023. A total of 7,198 children examined by trained teams were included. The exposure variable was the presence of clinical consequences of untreated caries in primary teeth, assessed by PUFA. OHRQoL was assessed using the SOHO-5 instrument for 5-year-olds. The analysis considered a complex sampling design, using Poisson regression to estimate prevalence ratios (PR) and linear regression.</p><p><strong>Results: </strong>The prevalence of clinical consequences of untreated caries (PUFA≥1) was 41.1%, with a higher prevalence among Black, Brown, Asian, and Indigenous children compared to White children. Attending school (PR 0.69; 95%CI 0.53-0.90) and a family income above R$ 4,000.00 (PR 0.59; 95%CI 0.42-0.84) showed a protective effect. The North and Central-West regions had higher prevalence rates than the Southeast. and OHRQoL was worse among children of mixed race and indigenous descent compared to those of white skin color. Furthermore, children with dental caries had a 1.44-point higher OHRQoL score (β=1.44; 95%CI 1.01-1.86), which indicates a worse OHRQoL.</p><p><strong>Conclusion: </strong>The clinical consequences of untreated dental caries have a negative impact on the OHRQoL of Brazilian children, influenced by social and racial determinants. These findings reinforce the need for public policies aimed at reducing regional inequalities and expanding oral health promotion and prevention actions.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29Suppl 1 Suppl 1","pages":"e260018supl1"},"PeriodicalIF":2.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13325561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Greater municipal oral healthcare coverage is associated with lower odds of poor oral health among 5-year-old children in Brazil.","authors":"Érica Torres de Almeida Piovesan, Luiza de Marilac Meireles Barbosa, Patrícia Maria Fonseca Escalda, Eduardo Bernabe","doi":"10.1590/1980-549720260002.supl.1","DOIUrl":"10.1590/1980-549720260002.supl.1","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between municipal oral healthcare coverage and poor oral health among pre-school children.</p><p><strong>Methods: </strong>Individual-level data from 5-year-old children who participated in the National Oral Health Survey - SB Brasil 2023 were merged with municipal-level data on oral healthcare coverage, retrieved from the e-Gestor Atenção Primária à Saúde (e-Gestor APS). Poor oral health was determined by the presence of primary teeth with pulp involvement, ulceration, fistula and abscess (pufa prevalence) and the need for urgent dental care according to the World Health Organization (WHO) criteria. Four trajectories of municipal oral health coverage were identified using group-based trajectory modelling, namely always-low (reference group), medium-low, medium-high and always-high coverage. Multilevel logistic regression models were used to estimate associations adjusting for municipality and individual-level covariates.</p><p><strong>Results: </strong>The variance partition coefficient of the empty model (no predictors) indicated that 18.3 and 18.0% of the total individual variance in pufa prevalence and urgent dental care need, respectively, was due to differences between municipalities. Compared to children in municipalities with always-low coverage, those in municipalities with medium-high (odds ratio: 0.59, 95% confidence interval - 95%CI 0.35-0.98) and medium-low (0.63, 95%CI 0.40-0.99) coverage had lower odds of experiencing clinical consequences of untreated dental caries. Likewise, children in municipalities with always-high coverage (OR 0.49; 95%CI 0.27-0.89) had lower odds of needing urgent dental care than those in municipalities with always-low coverage.</p><p><strong>Conclusion: </strong>Greater municipal oral healthcare coverage was associated with lower odds of poor oral health among Brazilian pre-school children.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29Suppl 1 Suppl 1","pages":"e260002supl1"},"PeriodicalIF":2.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population-Based Health Survey in the municipality of São Paulo 2024: methodological and operational aspects.","authors":"Chester Luiz Galvão Cesar, Katia Cristina Bassichetto, Zilda Pereira da Silva, Marilia Cristina Prado Louvison, Regina Mara Fisberg, Maria Cecilia Goi Porto Alves, Maria Mercedes Loureiro Escuder, Gizelton Pereira Alencar, Regina Tomie Ivata Bernal, Edige Felipe de Sousa Santos, Olinda do Carmo Luiz, Moises Goldbaum","doi":"10.1590/1980-549720260022","DOIUrl":"10.1590/1980-549720260022","url":null,"abstract":"<p><p>This paper presents the methodological procedures adopted for the construction and development of the population-based household health survey (ISA Capital-SP 2024), including its planning, sampling, and operational aspects for field feasibility. The data were collected using stratified probability sampling, with two-stage cluster sampling: at the census tract and household level. The strata were formed by the six health regions of the municipality of São Paulo (MSP). Individuals aged 10 or older living in permanent private households in the MSP's urban area were interviewed. The questionnaire consisted of 13 thematic blocks, including: reported morbidity, service use, preventive exams, immunization, medication use, and health behaviors. Health surveys contribute to studies of health trends and the identification of different patterns of health service use by the population, complementing data from official information systems. The ISA constitutes an important instrument for monitoring health conditions, planning, and formulating public policies at the municipal and intra-municipal levels, especially given the need to generate regional indicators for a city with the social and geographic inequalities of the MSP.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260022"},"PeriodicalIF":2.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation between primary and secondary health care coverage with periodontal disease in Brazil: a multilevel study.","authors":"Roger Keller Celeste, Leonardo Vilar Filgueiras, Joao Paulo Steffens, Stefany Duarte Dos Anjos, Rafael Aiello Bomfim, Yuri Wanderley Cavalcanti, Alex Nogueira Haas","doi":"10.1590/1980-549720260008.supl.1","DOIUrl":"10.1590/1980-549720260008.supl.1","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the independent and combined effects of the presence of Dental Specialty Centers (Centros de Especialidades Odontológicas - CEOs) and primary health care coverage on Periodontal Disease (PD) among adults and older adults in Brazil.</p><p><strong>Methods: </strong>Data from the SB Brasil 2023 survey were obtained for 7,851 individuals who used public services. Contextual variables were obtained from health information systems and the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística - IBGE). The outcome variable was PD, defined as having >1 tooth with probing depth >3 mm. The main exposures were the presence of CEOs and the coverage of Primary Oral Health Care (PHC-OH). Multilevel logistic regression analyses were performed.</p><p><strong>Results: </strong>The weighted prevalence of PD was 17.4%; and, respectively, 19.4% and 11.9% (p=0.03) in municipalities with and without CEOs. Municipalities with PHC-OH population coverage of ≤50, 50-74, 75-99%, and 100% showed prevalences of 19.3, 21.1, 18.1, and 7.7%, respectively (p=0.01). Individuals in municipalities with CEOs had higher odds of developing PD [OR 1.12 (95% CI 0.75-1.68)]. Individuals in municipalities with 100% PHC-OH coverage had OR 0.57 (95% CI 0.29-1.12), indicating lower odds of PD compared to municipalities with <50% coverage in the presence of CEOs. In the absence of CEOs, the corresponding OR was 0.43 (95%CI 0.19-0.97), but the interaction between CEO and PHC-OH was not significant (p=0.90).</p><p><strong>Conclusion: </strong>Greater coverage of primary oral health care appears to be independently associated with a lower prevalence of PD in small- and medium-sized cities. Future studies should investigate barriers in the referral system.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29Suppl 1 Suppl 1","pages":"e260008supl1"},"PeriodicalIF":2.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}