Can type of school be used as an alternative indicator of socioeconomic status in dental caries studies? A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Despite the importance of collecting individual data of socioeconomic status (SES) in epidemiological oral health surveys with children, this procedure relies on the parents as respondents. Therefore, type of school (public or private schools) could be used as an alternative indicator of SES, instead of collecting data individually. The aim of this study was to evaluate the use of the variable type of school as an indicator of socioeconomic status as a substitute of individual data in an epidemiological survey about dental caries in Brazilian preschool children.</p> <p>Methods</p> <p>This study followed a cross-sectional design, with a random sample of 411 preschool children aged 1 to 5 years, representative of Catalão, Brazil. A calibrated examiner evaluated the prevalence of dental caries and parents or guardians provided information about several individual socioeconomic indicators by means of a semi-structured questionnaire. A multilevel approach was used to investigate the association among individual socioeconomic variables, as well as the type of school, and the outcome.</p> <p>Results</p> <p>When all significant variables in the univariate analysis were used in the multiple model, only mother's schooling and household income (individual socioeconomic variables) presented significant associations with presence of dental caries, and the type of school was not significantly associated. However, when the type of school was used alone, children of public school presented significantly higher prevalence of dental caries than those enrolled in private schools.</p> <p>Conclusions</p> <p>The type of school used as an alternative indicator for socioeconomic status is a feasible predictor for caries experience in epidemiological dental caries studies involving preschool children in Brazilian context.</p

Socio-demographic and behavioural correlates of oral hygiene status and oral health related quality of life, the Limpopo - Arusha school health project (LASH): A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Promoting oral health of adolescents is important for improvement of oral health globally. This study used baseline-data from LASH-project targeting secondary students to; 1) assess frequency of poor oral hygiene status and oral impacts on daily performances, OIDP, by socio-demographic and behavioural characteristics, 2) examine whether socio-economic and behavioural correlates of oral hygiene status and OIDP differed by gender and 3) examine whether socio-demographic disparity in oral health was explained by oral health-related behaviours.</p> <p>Methods</p> <p>Cross-sectional study was conducted in 2009 using one-stage cluster sampling design. Total of 2412 students (mean age 15.2 yr) completed self-administered questionnaires, whereas 1077 (mean age 14.9 yr) underwent dental-examination. Bivariate analyses were conducted using cross-tabulations and chi-square statistics. Multiple variable analyses were conducted using stepwise standardized logistic regression (SLR) with odds ratios and 95% Confidence intervals (CI).</p> <p>Results</p> <p>44.8% presented with fair to poor OHIS and 48.2% reported any OIDP. Older students, those from low socio-economic status families, had parents who couldn't afford dental care and had low educational-level reported oral impacts, poor oral hygiene, irregular toothbrushing, less dental attendance and fewer intakes of sugar-sweetened drinks more frequently than their counterparts. Stepwise logistic regression revealed that reporting any OIDP was independently associated with; older age-groups, parents do not afford dental care, smoking experience, no dental visits and fewer intakes of sugar-sweetened soft drinks. Behavioural factors accounted partly for association between low family SES and OIDP. Low family SES, no dental attendance and smoking experience were most important in males. Low family SES and fewer intakes of sugar-sweetened soft drinks were the most important correlates in females.</p> <p>Socio-behavioural factors associated with higher odds ratios for poor OHIS were; older age, belonging to the poorest household category and having parents who did not afford dental care across both genders.</p> <p>Conclusion</p> <p>Disparities in oral hygiene status and OIDP existed in relation to age, affording dental care, smoking and intake of sugar sweetened soft drinks. Gender differences should be considered in intervention studies, and modifiable behaviours have some relevance in reducing social disparity in oral health.</p

Water fluoridation as a marker for sociodental inequalities

Objectives: The aim of this study was to investigate the associations between the Human Development Index at city level (HDI-M) in the state of Parana, Brazil, and the length of time of population exposure to water fluoridation (time span) with the respective mean decayed, missing and filled teeth (DMF-T) of schoolchildren in the state, looking at possible inequalities in these associations. Methods: The HDI-M of 323 cities in the state of Parana, Brazil, was correlated to the duration of exposure to water fluoridation, calculated in number of days. Correlation between the HDI-M and the DMF-T indexes for 12-year-old children was also performed. Results: Correlations were statistically significant, showing that in the cities with a better HDI-M, water fluoridation had been implemented earlier (squared coefficient correlation of 22%). The fluoridation time span accounted for around 11% of the variance in the DMF-T indexes of the cities. The correlation indicated that locations with a better HDI-M had a better DMF-T, owing to the probable mediating effect of receiving fluoridation earlier. Furthermore, the cost of water fluoridation to benefit the population that has access to this public health measure has been estimated at USD 0.15 per capita/year. Conclusions: It is possible to conclude that this low-cost measure is able to improve oral health status in general. Nevertheless, in the Brazilian areas studied, fluoridation seems to reflect existing social development inequalities, as it was first made available in more socially developed areas, thus bearing an influence on their higher DMF-T performance to date.36210310

The promotion of oral health within the Healthy School context in England: a qualitative research study

Background Healthy Schools programmes may assist schools in improving the oral health of children through advocating a common risk factor approach to health promotion and by more explicit consideration of oral health. The objectives of this study were to gain a broad contextual understanding of issues around the delivery of oral health promotion as part of Healthy Schools programmes and to investigate the barriers and drivers to the incorporation of oral health promoting activities in schools taking this holistic approach to health promotion. Methods Semi-structured telephone interviews were carried out with coordinators of Healthy Schools programmes in the Northwest of England. Interview transcripts were coded using a framework derived from themes in the interview schedule. Results All 22 Healthy Schools coordinators participated and all reported some engagement of their Healthy Schools scheme with oral health promotion. The degree of this engagement depended on factors such as historical patterns of working, partnerships, resources and priorities. Primary schools were reported to have engaged more fully with both Healthy Schools programmes and aspects of oral health promotion than secondary schools. Participants identified healthy eating interventions as the most appropriate means to promote oral health in schools. Partners with expertise in oral health were key in supporting Healthy Schools programmes to promote oral health. Conclusion Healthy Schools programmes are supporting the promotion of oral health although the extent to which this is happening is variable. Structures should be put in place to ensure that the engagement of Healthy Schools with oral health is fully supported

A dor e a perda dentária: representações sociais do cuidado à saúde bucal The toothache and toothloss: social representation of oral care

O objetivo do estudo foi apreender as representações sociais do cuidado à saúde bucal, buscando a compreensão desse saber construído na prática vivida por uma população de baixa renda do Nordeste brasileiro. Foram investigados 30 indivíduos moradores do bairro de Cidade da Esperança, Natal (RN) Brasil. A coleta de dados, realizada através de uma entrevista semi-estruturada, foi averiguada pela Análise de Conteúdo Temática (Bardin¹) e pelo software Alceste 4,5. A análise dos dados possibilitou a construção das categorias: Experiência de Dor e Perda Dentária. Se por um lado a Experiência de Dor indica o acesso restrito aos serviços odontológicos, por outro a Perda Dentária denuncia a existência de uma prática mutiladora imposta pelos serviços de saúde pública para solucionar a dor. Nesta categoria está presente ainda a prótese dentária, cujo desejo tem a sua possibilidade limitada pelas condições econômicas. As representações sociais do cuidado à saúde bucal salientam as conseqüências negativas da prática odontológica vigente e aponta para a necessidade de reestruturação dos serviços, levando em conta a percepção da população em relação ao cuidado à saúde bucal.<br>The objective of this study was identify the social representations of the oral care on daily activities to understand how the common sense works with the oral health, we realized the research with Brazilian northeast people. Thirty residents of Cidade da Esperança District, Natal, RN, Brazil were analyzed. The data was obtained from a semi-structured interview. The interviews were analyzed by Technique of Content Analysis (Bardin¹) as well as by Alceste 4.5 software. The categories were Toothache and Tooth Loss. The Toothache shows how the public health service is restrict. The Tooth Loss shows how the dentistry practice resolved the toothache, and how the prosthetics is limited by the social condition. The Social Representations of the oral care on daily activities show the negative consequences of the dentistry practice and the necessity of the new paradigm to the organization of the public health service taking into consideration the common sense about the oral care on daily activities