Contextual and Individual Factors Influencing Periodontal Treatment Needs by Elderly Brazilians: A Multilevel Analysis
Identifieur interne : 000942 ( Main/Exploration ); précédent : 000941; suivant : 000943Contextual and Individual Factors Influencing Periodontal Treatment Needs by Elderly Brazilians: A Multilevel Analysis
Auteurs : Chaiane Emilia Dalazen [Brésil] ; Alessandro Diogo De Carli [Brésil] ; Rafael Aiello Bomfim [Brésil] ; Mara Lisiane Moraes Dos Santos [Brésil]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
To assess the relationship between periodontal treatment needs by elderly Brazilians and contextual as well as individual variables.
A cross-sectional study was carried out to assess the need for clinical periodontal treatment, based on National Oral Health Survey (SB Brasil 2010) data on the presence of dental calculus, shallow (3–5 mm) and deep (≥ 6 mm) periodontal pockets, and gingival bleeding in elderly people (n = 7,619). The contextual variables included the Municipal Human Development Index (MHDI), income inequality (Gini Index) and coverage of the municipal population by the Family Health Strategy (FHS) program oral health teams.<0} The individual variables were sex, income, education level and self-reported skin color. Multilevel logistic regression models were used to calculate the odds ratio (OR) and 95% confidence intervals (CI95%) between periodontal treatment needs and the contextual as well as individual variables.
Gingival bleeding was found in 20.7% of the elderly analyzed (n = 1,577), dental calculus in 34% (n = 2,590), shallow periodontal pockets in 15.6% (n = 1,189), and deep periodontal pockets in 4.2% (n = 320). Individual factors were correlated with all the outcomes assessed. Sex was a protective factor in regard to gingival bleeding (OR = 0.87; CI95% 0.76–1.00), dental calculus (OR = 0.86; CI95% 0.75–0.99), shallow periodontal pockets (OR = 0.69; CI95% 0.60–0.80) and deep periodontal pockets (OR = 0.58; CI95% 0.45–0.74). It was found that fewer women needed treatment. Elderly people who self-reported having nonwhite skin had higher chances of needing periodontal treatment. Skin color was a risk factor for gingival bleeding (OR = 1.32; CI95% 1.14–1.53), dental calculus (OR = 1.32; CI95%1.14–1.54) and shallow periodontal pockets (OR = 1.27; CI95% 1.09–1.49). Education level was associated with the presence of dental calculus (OR = 0.77; CI95% 0.66–0.89), shallow periodontal pockets (OR = 0.86; CI95% 0.73–1.00) and deep periodontal pockets (OR = 0.74; CI95% 0.57–0.97), thus acting as a risk factor for undereducated elderly people. There was a correlation between population coverage by the Family Health Strategy (FHS) program oral health teams and the presence of gingival bleeding (OR = 0.67; CI95% 0.52–0.88), shallow periodontal pockets (OR = 0.76; CI95% 0.58–0.98) and deep periodontal pockets (OR = 0.62; CI95% 0.44–0.89), making these teams act as a protective factor.
This study showed evidence of the sociocontextual as well as individual sociodemographic characteristics influencing periodontal treatment needed by elderly Brazilians, based on the clinical features of periodontal disease. The results suggest the existence of inequality related to periodontal treatment needs among elderly Brazilians, especially in regard to sex and ethnicity, in addition to a potentially positive impact from the expansion of the Family Health Strategy (FHS) program oral health teams.
Url:
DOI: 10.1371/journal.pone.0156231
PubMed: 27249677
PubMed Central: 4889082
Affiliations:
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type="wicri:Area/Main/Curation">000942</idno><idno type="wicri:Area/Main/Exploration">000942</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Contextual and Individual Factors Influencing Periodontal Treatment Needs by Elderly Brazilians: A Multilevel Analysis</title><author><name sortKey="Dalazen, Chaiane Emilia" sort="Dalazen, Chaiane Emilia" uniqKey="Dalazen C" first="Chaiane Emilia" last="Dalazen">Chaiane Emilia Dalazen</name><affiliation wicri:level="2"><nlm:aff id="aff001"><addr-line>Faculdade de Odontologia “Prof Albino Coimbra Filho”, Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Faculdade de Odontologia “Prof Albino Coimbra Filho”, Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS</wicri:regionArea><placeName><region type="state">Mato Grosso do Sul</region></placeName></affiliation></author><author><name sortKey="De Carli, Alessandro Diogo" sort="De Carli, Alessandro Diogo" uniqKey="De Carli A" first="Alessandro Diogo" last="De Carli">Alessandro Diogo De Carli</name><affiliation wicri:level="2"><nlm:aff id="aff001"><addr-line>Faculdade de Odontologia “Prof Albino Coimbra Filho”, Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Faculdade de Odontologia “Prof Albino Coimbra Filho”, Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS</wicri:regionArea><placeName><region type="state">Mato Grosso do Sul</region></placeName></affiliation></author><author><name sortKey="Bomfim, Rafael Aiello" sort="Bomfim, Rafael Aiello" uniqKey="Bomfim R" first="Rafael Aiello" last="Bomfim">Rafael Aiello Bomfim</name><affiliation wicri:level="2"><nlm:aff id="aff001"><addr-line>Faculdade de Odontologia “Prof Albino Coimbra Filho”, Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Faculdade de Odontologia “Prof Albino Coimbra Filho”, Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS</wicri:regionArea><placeName><region type="state">Mato Grosso do Sul</region></placeName></affiliation></author><author><name sortKey="Dos Santos, Mara Lisiane Moraes" sort="Dos Santos, Mara Lisiane Moraes" uniqKey="Dos Santos M" first="Mara Lisiane Moraes" last="Dos Santos">Mara Lisiane Moraes Dos Santos</name><affiliation wicri:level="2"><nlm:aff id="aff002"><addr-line>Departamento de Tecnologia de Alimentos e Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Departamento de Tecnologia de Alimentos e Saúde Coletiva, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS</wicri:regionArea><placeName><region type="state">Mato Grosso do Sul</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Objective</title><p>To assess the relationship between periodontal treatment needs by elderly Brazilians and contextual as well as individual variables.</p></sec><sec id="sec002"><title>Methods</title><p>A cross-sectional study was carried out to assess the need for clinical periodontal treatment, based on National Oral Health Survey (SB Brasil 2010) data on the presence of dental calculus, shallow (3–5 mm) and deep (≥ 6 mm) periodontal pockets, and gingival bleeding in elderly people (n = 7,619). The contextual variables included the Municipal Human Development Index (MHDI), income inequality (Gini Index) and coverage of the municipal population by the Family Health Strategy (FHS) program oral health teams.<0} The individual variables were sex, income, education level and self-reported skin color. Multilevel logistic regression models were used to calculate the odds ratio (OR) and 95% confidence intervals (CI95%) between periodontal treatment needs and the contextual as well as individual variables.</p></sec><sec id="sec003"><title>Results</title><p>Gingival bleeding was found in 20.7% of the elderly analyzed (n = 1,577), dental calculus in 34% (n = 2,590), shallow periodontal pockets in 15.6% (n = 1,189), and deep periodontal pockets in 4.2% (n = 320). Individual factors were correlated with all the outcomes assessed. Sex was a protective factor in regard to gingival bleeding (OR = 0.87; CI95% 0.76–1.00), dental calculus (OR = 0.86; CI95% 0.75–0.99), shallow periodontal pockets (OR = 0.69; CI95% 0.60–0.80) and deep periodontal pockets (OR = 0.58; CI95% 0.45–0.74). It was found that fewer women needed treatment. Elderly people who self-reported having nonwhite skin had higher chances of needing periodontal treatment. Skin color was a risk factor for gingival bleeding (OR = 1.32; CI95% 1.14–1.53), dental calculus (OR = 1.32; CI95%1.14–1.54) and shallow periodontal pockets (OR = 1.27; CI95% 1.09–1.49). Education level was associated with the presence of dental calculus (OR = 0.77; CI95% 0.66–0.89), shallow periodontal pockets (OR = 0.86; CI95% 0.73–1.00) and deep periodontal pockets (OR = 0.74; CI95% 0.57–0.97), thus acting as a risk factor for undereducated elderly people. There was a correlation between population coverage by the Family Health Strategy (FHS) program oral health teams and the presence of gingival bleeding (OR = 0.67; CI95% 0.52–0.88), shallow periodontal pockets (OR = 0.76; CI95% 0.58–0.98) and deep periodontal pockets (OR = 0.62; CI95% 0.44–0.89), making these teams act as a protective factor.</p></sec><sec id="sec004"><title>Conclusions</title><p>This study showed evidence of the sociocontextual as well as individual sociodemographic characteristics influencing periodontal treatment needed by elderly Brazilians, based on the clinical features of periodontal disease. The results suggest the existence of inequality related to periodontal treatment needs among elderly Brazilians, especially in regard to sex and ethnicity, in addition to a potentially positive impact from the expansion of the Family Health Strategy (FHS) program oral health teams.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Carvalho, Jam" uniqKey="Carvalho J">JAM Carvalho</name></author><author><name sortKey="Garcia, Ra" uniqKey="Garcia R">RA Garcia</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Carvalho, Jam" uniqKey="Carvalho J">JAM Carvalho</name></author><author><name sortKey="Rodriguez Wong, Ll" uniqKey="Rodriguez Wong L">LL Rodríguez-Wong</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vasconcelos, Amn" uniqKey="Vasconcelos A">AMN Vasconcelos</name></author><author><name sortKey="Gomes, Mmf" uniqKey="Gomes M">MMF 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J">JLF Antunes</name></author><author><name sortKey="Andrade, Fb" uniqKey="Andrade F">FB Andrade</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sabbah, W" uniqKey="Sabbah W">W Sabbah</name></author><author><name sortKey="Tsakos, G" uniqKey="Tsakos G">G Tsakos</name></author><author><name sortKey="Chandola, T" uniqKey="Chandola T">T Chandola</name></author><author><name sortKey="Sheiham, A" uniqKey="Sheiham A">A Sheiham</name></author><author><name sortKey="Watt, Rg" uniqKey="Watt R">RG Watt</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Steele, J" uniqKey="Steele J">J Steele</name></author><author><name sortKey="Shen, J" uniqKey="Shen J">J Shen</name></author><author><name sortKey="Tsakos, G" uniqKey="Tsakos G">G Tsakos</name></author><author><name sortKey="Fuller, E" uniqKey="Fuller E">E Fuller</name></author><author><name sortKey="Morris, S" uniqKey="Morris S">S Morris</name></author><author><name sortKey="Watt, R" uniqKey="Watt R">R Watt</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sabbah, W" uniqKey="Sabbah W">W Sabbah</name></author><author><name sortKey="Sheiham, A" uniqKey="Sheiham A">A Sheiham</name></author><author><name sortKey="Bernabe, E" uniqKey="Bernabe E">E Bernabé</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Celeste, Rk" uniqKey="Celeste R">RK Celeste</name></author><author><name sortKey="Fritzell, J" uniqKey="Fritzell J">J Fritzell</name></author><author><name sortKey="Nadanovsky, P" uniqKey="Nadanovsky P">P Nadanovsky</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Brésil</li></country><region><li>Mato Grosso do Sul</li></region></list><tree><country name="Brésil"><region name="Mato Grosso do Sul"><name sortKey="Dalazen, Chaiane Emilia" sort="Dalazen, Chaiane Emilia" uniqKey="Dalazen C" first="Chaiane Emilia" last="Dalazen">Chaiane Emilia Dalazen</name></region><name sortKey="Bomfim, Rafael Aiello" sort="Bomfim, Rafael Aiello" uniqKey="Bomfim R" first="Rafael Aiello" last="Bomfim">Rafael Aiello Bomfim</name><name sortKey="De Carli, Alessandro Diogo" sort="De Carli, Alessandro Diogo" uniqKey="De Carli A" first="Alessandro Diogo" last="De Carli">Alessandro Diogo De Carli</name><name sortKey="Dos Santos, Mara Lisiane Moraes" sort="Dos Santos, Mara Lisiane Moraes" uniqKey="Dos Santos M" first="Mara Lisiane Moraes" last="Dos Santos">Mara Lisiane Moraes Dos Santos</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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