Dental caries in 12-year-old schoolchildren: multilevel analysis of individual and school environment factors in Goiânia

Association between bullying at school and tooth loss among 15-19-year-olds from southern Brazil

This study aimed to investigate the association between bullying at school and tooth loss in southern Brazilian adolescents. This population-based cross-sectional study included a representative sample of 15-19-year-old students attending high schools in Santa Maria, southern Brazil. Data on sociodemographic and behavioral variables were collected through questionnaires. Contextual data on bullying at school was provided by educational institutions (bullying episodes in the previous year: 'no,' 'sometimes,' or 'often'). Tooth loss was clinically assessed by the M component of the DMFT index, modeled as a discrete variable. Multilevel Poisson regression was used, and rate ratios (RR) and 95% confidence intervals (CI) were estimated. The prevalence of tooth loss was 9.2% (95%CI = 7.5-10.8). Adolescents who attended the schools where bullying events often occurred had 0.39 (95%CI = 0.33-0.45) missing teeth, on average, in contrast to an average of 0.14 (95%CI = 0.08-0.19) among those whose schools did not experience bullying in the previous year. After adjusting for important cofactors, the contextual variable of bullying at school remained significantly associated with the study outcome. Adolescents who attended schools where bullying frequently occurred were 2.49-fold more likely to have an additional missing tooth than those whose school did not experience bullying in the previous year (RR = 2.49, 95%CI = 1.37-4.51, p = 0.003). In conclusion, the frequent bullying episodes at school were associated with more permanent teeth lost due to caries in this population. Hence, improving the school environment may improve the oral health of adolescents.

School type and oral conditions associated with school performance and absenteeism in adolescents: A multilevel analysis

BACKGROUND

Investigations assessing how oral health status affects school performance and attendance considering individual and community variables are lacking.

AIM

To analyze the association of school contextual factors and oral conditions with school performance and absenteeism in early adolescence.

DESIGN

This cross-sectional study was carried out with 593 12-year-old students from 20 schools in Passo Fundo, a southern city in Brazil. The caregivers provided sociodemographic information by means of a questionnaire. Oral health status was clinically examined for dental caries and gingival bleeding. Students answered the CPQ11-14 questionnaire to assess the oral health-related quality of life (OHRQoL). Information on contextual factors was obtained from the schools' administrators. "School performance" was measured by Portuguese and Mathematic tests' scores, and "school absenteeism" by the number of school days missed. Descriptive statistics was conducted, followed by unadjusted and adjusted multilevel linear regression.

RESULTS

At the individual level, low OHRQoL was associated with lower school performance and higher absenteeism. At the contextual level, students from private schools had higher school performance and lower mean of school days missed.

CONCLUSIONS

The type of school and OHRQoL were associated with school performance and attendance of adolescents.

Contributions of school context to caries on anterior teeth: a multilevel analysis

OBJECTIVE

To investigate whether oral health literacy (OHL) and school context are associated with untreated dental caries on the anterior teeth of adolescents.

METHODS

A representative cross-sectional study was conducted with 746 students aging 15 to 19 in the city of Campina Grande, Brazil. The guardians answered a questionnaire addressing sociodemographic data and the absence/presence of private health insurance. Two examiners were trained for the diagnosis of dental caries using the Nyvad criteria and the measurement of OHL using the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) (Kappa > 0.80). Contextual aspects of the schools were obtained from the 2017 National School Census. Descriptive statistics were conducted, followed by unadjusted and adjusted robust negative binomial regression for complex samples (p < 0.05).

RESULTS

The average number of anterior teeth with untreated caries was 0.95 (SD = 1.77). Among individual factors, the male sex (RR = 1.64; 95%CI: 1.24–2.16), inadequate level of OHL (RR = 2.03; 95%CI: 1.13–1.63), marginal level of OHL (RR = 1.87; 95%CI: 1.05–3.33) and not having private health insurance (RR = 1.34; 95%CI: 1.07–1.68) were associated with untreated caries on anterior teeth. Among school contextual factors, the number of students in the classroom (RR = 2.64; 95%CI: 1.78–3.93), number of public oral health services in the district (RR = 0.14; 95%CI: 0.05–0.39) and average income of the district in which the school is located (RR = 0.99; 95%CI: 0.98–0.99) were associated with the outcome.

CONCLUSIONS

Sociodemographic factors, having private health insurance, OHL, and school context exerted an influence on the occurrence of untreated dental caries on anterior teeth in adolescents aging 15 to 19.

Association of Oral Health Literacy and School Factors with Untreated Dental Caries among 12-Year-Olds: A Multilevel Approach

Dental caries are a global health problem that affects all age groups and must be considered a public health priority due to its significant financial costs and impact on the quality of life. This study evaluated the association between oral health literacy (OHL), school factors, and untreated dental caries in 12-year-old Brazilian adolescents using a multilevel approach. A population-based cross-sectional study was carried out with 740 adolescents randomly selected from private and public schools in Campina Grande, Brazil. Two dentists were trained and calibrated to diagnose dental caries using the Nyvad index and OHL using the Brazilian Rapid Estimate of Literacy in Dentistry (BREALD-30). The caregivers of the adolescents reported demographic data (sex, skin color, and socioeconomic status). Data of school factors such as the type of school and the school grade retention rate were classified through a 2-step hierarchical cluster analysis to obtain the school environment. A robust multilevel log-linear negative binomial regression for complex samples was performed (p < 0.05). In the analysis, adjusted by individual determinants, nonwhite skin color (RR = 2.20; 95% CI 1.56-3.12), a low socioeconomic status (RR = 1.60; 95% CI 1.09-2.34), a low OHL score (RR = 0.94; 95% CI 0.91-0.98), and low satisfaction with the last dental appointment (RR = 2.25; 95% CI 1.67-3.04) were associated with untreated dental caries. The following factors remained associated with untreated dental caries in the final model: students from an unfavorable learning environment (RR = 2.20; 95% CI 1.27-3.80), nonwhite skin color (RR = 1.92; 95% CI 1.27-2.91), a low socioeconomic status (RR = 1.82; 95% CI 1.12-2.94), a low OHL score (RR = 0.95; 95% CI 0.91-0.98), and low satisfaction with the last dental appointment (RR = 2.07; 95% CI 1.47-2.91). Untreated dental caries in early adolescence were impacted by the school environment, the socioeconomic status, OHL, and the adolescent's satisfaction with the last dental appointment.

Oral health literacy, sociodemographic, family, and clinical predictors of dental visits among Brazilian early adolescents

BACKGROUND

The prevalence of dental caries is high in adolescents worldwide, and a large percentage have never been to a dentist or have not had regular dental appointments.

AIM

To evaluate the influence of oral health literacy and sociodemographic, clinical, and family factors on dental visits among early adolescents.

DESIGN

A cross-sectional study was conducted with 740 12-year-old students in Campina Grande, Brazil. Students answered about their level of oral health literacy (BREALD-30), levels of family adaptability and cohesion (FACES III), and visits to the dentist sometime in life. Dental caries experience was evaluated using Nyvad criteria. Robust Poisson regression for complex samples was performed.

RESULTS

A higher level of oral health literacy (PR = 1.01; 95% CI: 1.01-1.03), high social class (PR = 1.28; 95% CI: 1.09-1.50), higher mother's schooling (PR = 1.58; 95% CI: 1.37-1.83), family cohesion classified as enmeshed (PR = 1.55; 95% CI: 1.19-2.02) and connected (PR = 1.22; 95% CI: 1.02-1.44), and the absence of toothache (PR = 1.18; 95% CI: 1.01-1.38) remained associated with having visited a dentist.

CONCLUSIONS

Oral health literacy and sociodemographic, family, and clinical factors were predictors of having visited a dentist among early adolescents.

Dental Caries in Relation to Socioeconomic Factors of 6 and 12-year-old Schoolchildren of Paonta Sahib, Himachal Pradesh, India: An Epidemiological Study

Aims and objectives

Determination of prevalence of dental caries in 6 and 12-year-old schoolchildren, dental caries prevalence between government and private schoolchildren, and the influence of socioeconomic factors on dental caries on children of Paonta Sahib, Himachal Pradesh, India.

Materials and methods

In the government and private schools at Paonta Sahib of Sirmour district, Himachal Pradesh, India, a cross-sectional study was carried out. The study population comprised schoolchildren of 6 and 12 years. A total of 1,004 children of both genders were surveyed for dental caries status. The decayed, missing, filled teeth (DMFT) index was used for clinical examination of caries. Prior collection of sociodemographic information was done in addition to information on oral health behavior by personal interview.

Results

In the present study, dental caries prevalence was found to be higher in children of 6 years of age (63.6%) than that of 12 years (53.6%) (p = 0.001). The mean DMFT was 2.47 ± 2.75 for 6–year-old children and 1.18 ± 1.33 for 12–year-old children. No significant difference was observed in dental caries prevalence among children of government and private school (p = 0.167). Moreover, dental caries frequency was highest in children belonging to upper-middle (38.14%) class followed by lower-middle (32.32%), upper-lower (25.42%), and upper class (4.12%). The obtained data were analyzed using the chi-square test and one-way ANOVA test.

Conclusion

Dental caries prevalence was high in children of 6 years of age in the study. The dental caries frequency was more in upper-middle-class children. These results suggest that emphasis should be given to scientific monitoring, effective implementation, and evaluation of school-based oral health promotion and preventive programs to increase the dental awareness and oral hygiene practices, in Paonta Sahib, Sirmour district.

How to cite this article

Jindal L, Dua P, Mangla R, et al. Dental Caries in Relation to Socioeconomic Factors of 6 and 12-year-old Schoolchildren of Paonta Sahib, Himachal Pradesh, India: An Epidemiological Study. Int J Clin Pediatr Dent 2020;13(4):395–398.

Can the school environment influence oral health-related behaviours? A multilevel analysis of the Brazilian National Adolescent School-Based Health Survey 2015

OBJECTIVE

To investigate the association between the potential support of schools for oral health promotion and a set of oral health-related behaviours among adolescent students in Brazilian state capitals.

METHODS

A cross-sectional study using individual and school environment data from the 2015 Brazilian National Adolescent School-Based Health Survey (PeNSE) was conducted. The sample consisted of 51 192 students from 1339 public and private schools in the 27 Brazilian State Capitals, aged 11-19 years old. The outcomes were six oral health-related behaviours: dental visits; toothbrushing frequency; soft drink and sweets consumption; smoking and alcohol consumption. The explanatory variable was the Oral Health Promotion School Environment index (OHPSE). Covariates were the adolescents' sociodemographic characteristics and organizational aspects of the schools. A two-level multilevel mixed-effects Poisson regression analysis with fixed slopes and random intercepts was performed, considering the complex sample design.

RESULTS

The prevalence of risk behaviours was 28.0% for 'low frequency of annual dental visits', 6.9% for 'low daily toothbrushing frequency', 28.8% for 'high weekly soft drink consumption', 41.7% for 'high weekly sweet consumption', 18.9% for 'cigarette experimentation' and 52.6% for 'alcoholic beverage experimentation'. The schools were classified as low (36.3%), intermediate (30.4%) and high (33.3%) OHPSE. In the adjusted model, schools with 'high OHPSE' had lower prevalence of 'low frequency of annual dental visits' (PR = 0.94 [95% CI 0.90; 0.99]), 'high weekly frequency of soft drink consumption' (PR = 0.94 [95% CI 0.89; 0.99]) and 'sweet consumption' (PR = 0.96 [95% CI 0.93; 1.00]) than those with 'low OHPSE'. In addition, schools with 'intermediate OHPSE' had higher prevalence's of 'low daily toothbrushing frequency' (PR = 1.12 [95% CI 1.03; 1.23]) and 'cigarette experimentation' (PR = 1.08 [95% CI 1.01; 1.16]) than those with 'low OHPSE'. 'Alcoholic beverage experimentation' was not associated with OHPSE.

CONCLUSIONS

The potential support of schools for oral health promotion was associated with most of the oral health-related behaviours among adolescent students. Those attending schools with higher OHPSE scores reported a higher annual frequency of dental visits and a lower weekly frequency of soft drink and sweet consumption, while those in schools with intermediate OHPSE had a lower daily toothbrushing frequency and a higher rate of cigarette experimentation.