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. 2020 Mar 17;20(1):73.
doi: 10.1186/s12903-020-1057-1.

Contextual and individual determinants of tooth loss in adults: a multilevel study

Luana Leal Roberto  1 , Marise Fagundes Silveira  2 , Alfredo Mauricio Batista de Paula  3 , Efigênia Ferreira E Ferreira  4 , Andréa Maria Eleutério de Barros Lima Martins  3 , Desirée Sant'ana Haikal  3
Affiliations

Contextual and individual determinants of tooth loss in adults: a multilevel study

Luana Leal Roberto et al. BMC Oral Health. .

Abstract

Background: Tooth loss represents a known marker of health inequality. The association between tooth loss and unfavorable socioeconomic conditions is evident when analyzed at an individual level. However, the effects of contextual characteristics on tooth loss need to be better investigated and understood. The objective of this study was to analyze tooth loss among Brazilian adults (35-44 years of age), in accordance with individual and contextual social characteristics.

Methods: This was a multilevel cross-sectional study with data from 9564 adult participants from the Brazilian Oral Health Survey - SBBrasil 2010. The dependent variable was the number of lost teeth and the independent variables were grouped into structural (socioeconomic & political context) and intermediary (socioeconomic position, behavioral & biological factors, and health services) determinants. Multilevel Hierarchical Negative Binomial Regression was conducted and the Mean Ratio (MR) was estimated.

Results: Brazilian adults lost a mean of 7.57 (95% CI 7.1-8.1) teeth. Among the contextual variables, the number of teeth lost was higher among residents of municipalities with high and medium/low Municipal Human Development Index (MHDI) and in municipalities that did not have public water fluoridation. Among the individual variables, dental loss was higher among those who declared themselves yellow/black/brown/indigenous, were older, who had lower income, who had never visited a dentist, who had used dental services for more than a year and those whose most recent visit to the dentist was due to oral health problems. On the other hand, dental loss was lower among adults with higher education levels and males.

Conclusions: The number of missing teeth was associated with unfavorable contextual and individual conditions, which reinforces the need to reduce social inequality and guarantee regular, lifetime access to dental services.

Keywords: Adult; Health inequalities; Multilevel analysis; Tooth loss.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Conceptual model for the inequities of oral health adapted from Watt & Sheiham (2012)
Fig. 2
Fig. 2
The mean number of missing teeth in the residents of Brazilian geopolitical macroregions (n = 9564). SBBrasil Project, 2010
See this image and copyright information in PMC

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References

    1. Sanders AE, Slade GD, Turrell G, Spencer AJ, Marcenes W. Does psychological stress mediate social deprivation in tooth loss? J Dent Res. 2007;86(12):1166–1170. - PubMed
    1. Peres MA, Barbato PR, Reis SCGB, Freitas CHSM, Antunes JLF. Tooth loss in Brazil: analysis of the 2010 Brazilian Oral Health Survey. Rev Saude Publica. 2013;47(Supl 3):1–11. - PubMed
    1. Barbato PR, Nagano HCM, Zanchet FN, Boing AF, Peres MA. Perdas dentárias e fatores sociais, demográficos e de serviços associados em adultos brasileiros: uma análise dos dados do Estudo Epidemiológico Nacional (Projeto SB Brasil 2002-2003) Cad Saude Publica. 2007;23(8):1803–1814. - PubMed
    1. Thomson WM. Social inequality in oral health. Community Dent Oral Epidemiol. 2012;40(Supl 2):28–32. - PubMed
    1. Hamasha AA, Sasa I, Al-Qudah M. Risk indicators associated with tooth loss in Jordanian adults. Community Dent Oral Epidemiol. 2000;28(1):67–72. - PubMed

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