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| Author(s): |
Stela Márcia Pereira Dourado
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | Piracicaba, SP. |
| Institution: | Universidade Estadual de Campinas (UNICAMP). Faculdade de Odontologia de Piracicaba |
| Defense date: | 2008-09-12 |
| Examining board members: |
Antonio Carlos Pereira;
Sílvia Helena de Carvalho Sales Peres;
Maria Ercília de Araujo;
Marcelo de Castro Meneghim;
Francisco Haiter Neto
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| Advisor: | Carlos Alberto Vettorazzi; Gláucia Maria Bovi Ambrosano; Antonio Carlos Pereira |
| Abstract | |
The present study was composed by 2 articles which aims were evaluate the distribution profile of oral health problems and its associations with areas of social deprivation at two levels, individual and contextual, by means of Geographic Information Systems (GIS) and multilevel analysis. The cluster sample consisted of 1002 12-year-old schoolchildren attending 25 public and private schools in Piracicaba, SP, Brazil in 2005-06. The examinations were carried out by a single calibrated examiner in outdoor settings, under natural light, using mirror and ball point probe. The examinations were executed after tooth-brushing and followed the recommendations of WHO. A semi-structured questionnaire was sent to the parents to collect information on socioeconomic level and behavior variables related to dental health (first level). The contexts variables "the percentage of heads of families without income" and "the percentage of illiterate heads of families" were used in the contextual level (second level). A GIS was elaborated for mapping the distribution of the oral health condition, using the ArcView software Article 1: The DMFT and Care Index (CI) were considered as dependent variables. At individual level, students with lower income (OR=1.8; CI=1.0-3.6), more people living in the household (OR=1.4;CI=1.0-1.8), lower visits to the dentist (OR=1.8;CI=1.3-2.4), lower father's (OR=1.7;CI=1.0-3.3) and mother's (OR=1.7;CI=1.0-3.3) educational level were more likely to present a higher DMFT. The individuals with higher income (OR=3.9; CI=0.8-17.9) and more visits to the dentist (OR=4.7;CI=2.9-7.7) showed best Care Index. At conglomerate level, areas with social deprivation were not associated with the DMFT and the CI indexes, however, by means of the maps, it is possible to visualize that the central districts have the best social and oral conditions than the outlying deprived districts. At individual level, social and economic variables were associated with a higher prevalence of the disease, however, this relationship was not observed at territorial level. Article 2 Initials lesions and Community Periodontal Index were included. Variables can be visually distinguished in the maps, which show a upward tendency of oral health (less scores of initials lesions and gingival bleeding) in the central regions of the city, that are recognized as a privileged area. However, in the second level (contextual level) of the multilevel analysis, only the percentage of illiterate heads of families was statistically significant associated to both outcomes, while the variable "income" was not associated to these oral health problems. The individuals from areas where the heads of family do not have income were not associated to a higher prevalence of oral health problems. This fact suggests that these individuals are reasonably protected of the impact of the social deprivation due to the actions of the health public services of the municipality regarding prevention and treatment of the oral health problems. (AU) | |