Skip to main content

Advertisement

SpringerLink
Log in

Is neighborhood income associated with untreated dental caries irrespective of family income?

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objective

To assess the status of untreated dental caries in adolescents exposed to different conditions of family and neighborhood income.

Materials and methods

This cross-sectional study included a representative sample of 1197 15–19-year-old adolescents attending high schools from Santa Maria, southern Brazil. Data collection included a questionnaire and clinical examination (DMFT index). Neighborhood mean income was collected from official sources. The main predictor variable was a combination of household income and neighborhood mean income resulting in four categories: low household income/low neighborhood income, low household income/high neighborhood income, high household income/low neighborhood income, or high household income/high neighborhood income. The outcome was untreated caries (number of teeth with dentin cavities or residual roots). Multilevel Poisson regression analysis was used to assess the association between predictors and untreated caries. Rate ratio (RR) and 95% confidence intervals (CI) were estimated.

Results

The prevalence of untreated dental caries was 26% (n = 312), with a mean (± standard deviation) of 0.47 (± 1.05) teeth. Adolescents with low household income living in areas with low neighborhood income had the worse caries scenario. Compared with them, those classified as low-income households residing in high-income neighborhoods had 37% lower rate of untreated dental caries (adjusted RR = 0.63; 95%CI = 0.44–0.89). No neighborhood effect was detected among adolescents of more affluent families.

Conclusions

Neighborhood income contributed to the rate of untreated dental caries over and above household income among adolescents with low household income only.

Clinical relevance

Improving living conditions in disadvantaged neighborhoods may positively impact the oral health of residents, thus reducing oral health inequalities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, Listl S, Celeste RK, Guarnizo-Herreño CC, Kearns C, Benzian H, Allison P, Watt RG (2019) Oral diseases: a global public health challenge. Lancet 394(10194):249–260

    Article  Google Scholar 

  2. Kassebaum NJ, Smith AGC, Bernabé E, Fleming TD, Reynolds AE, Vos T, Murray CJL, Marcenes W, GBD (2015) Oral Health Collaborators (2017) Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res 96(4):380–387

    Article  Google Scholar 

  3. Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C (2005) The global burden of oral diseases and risks to oral health. Bull World Health Organ 83(9):661–669

    PubMed  PubMed Central  Google Scholar 

  4. Sisson KL (2007) Theoretical explanations for social inequalities in oral health. Community Dent Oral Epidemiol 35(2):81–8

    Article  Google Scholar 

  5. Diez-Roux AV (1988) Bringing context back into epidemiology: variables and fallacies in multilevel analysis. Am J Public Health 88(2):216–222

    Article  Google Scholar 

  6. Pattussi MP, Marcenes W, Croucher R, Sheiham A (2001) Social deprivation, income inequality, social cohesion and dental caries in Brazilian school children. Soc Sci Med 53(7):915–925

    Article  Google Scholar 

  7. Celeste RK, Nadanovsky P, Ponce de Leon A, Fritzell J (2009) The individual and contextual pathways between oral health and income inequality in Brazilian adolescents and adults. Soc Sci Med 69(10):1468–1475

    Article  Google Scholar 

  8. Singh A, Peres MA, Watt RG (2019) The relationship between income and oral health: a critical review. J Dent Res 98(8):853–860

    Article  Google Scholar 

  9. Schwendicke F, Dörfer CE, Schlattmann P, Foster Page L, Thomson WM, Paris S (2015) Socioeconomic inequality and caries: a systematic review and meta-analysis. J Dent Res 94(1):10–18

    Article  Google Scholar 

  10. Yen IH, Kaplan GA (1999) Poverty area residence and changes in depression and perceived health status: evidence from the Alameda County Study. Int J Epidemiol 28(1):90–94

    Article  Google Scholar 

  11. Diez-Roux AV, Merkin SS, Arnett D, Chambless L, Massing M, Nieto FJ, Sorlie P, Szklo M, Tyroler HA, Watson RL (2001) Neighborhood of residence and incidence of coronary heart disease. N Engl J Med 345(2):99–106

    Article  Google Scholar 

  12. Karvonen S, Rimpelä A (1996) Socio-regional context as a determinant of adolescents’ health behaviour in Finland. Soc Sci Med 43(10):1467–1474

    Article  Google Scholar 

  13. IBGE - Instituto Brasileiro de Geografia e Estatística [Internet]. Censo 2010 [cited 2020 Jul 20]. Available from: https://censo2010.ibge.gov.br. Accessed 20 Jul 2020

  14. Petersen PE, Baez RJ, World Health Organization (‎2013) Oral health surveys: basic methods, 5th ed. World Health Organization

  15. World Health Organization (2010) A conceptual framework for action on the social determinants of health. World Health Organization, Geneva

    Google Scholar 

  16. Santos SM, Chor D, Werneck GL, Coutinho ES (2007) Association between contextual factors and self-rated health: a systematic review of multilevel studies. Cad Saúde Pública 23(11):2533–2554

    Article  Google Scholar 

  17. Diez-Roux AV, Mair C (2010) Neighborhoods and health. Ann N Y Acad Sci 1186:125–145

    Article  Google Scholar 

  18. Morris T, Manley D, Van Ham M (2018) Context or composition: how does neighbourhood deprivation impact upon adolescent smoking behaviour? PLoS One 13(2):e0192566

    Article  Google Scholar 

  19. Lynch J, Smith GD, Harper S et al (2004) Is income inequality a determinant of population health? Part 1. A systematic review. Milbank Q 82(1):5–99

    Article  Google Scholar 

  20. Watt RG (2012) Social determinants of oral health inequalities: implications for action. Community Dent Oral Epidemiol 40(Suppl 2):44–48

    Article  Google Scholar 

  21. Solar O, Irwin A (2010) A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion. WHO Press, Geneva, pp 1–65

    Google Scholar 

  22. Stafford M, Marmot M (2003) Neighbourhood deprivation and health: does it affect us all equally? Int J Epidemiol 32(3):357–366

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank all volunteers, their parents/legal guardians, and the schools for their contribution.

Funding

We acknowledge the support of the National Coordination of Post-graduate Education (CAPES), Ministry of Education, Brazil (funding code 001), the Municipal Oral Health Policy of Santa Maria, and the Federal University of Santa Maria.

Author information

Authors and Affiliations

  1. Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil

    Angela Dalla Nora, Jéssica Klöckner Knorst & Julio Eduardo Amaral Zenkner

  2. Department of Restorative Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil

    Leticia Donato Comim, Débora Nunes Oliveira Racki & Luana Severo Alves

Authors
  1. Angela Dalla Nora
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jéssica Klöckner Knorst
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Leticia Donato Comim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Débora Nunes Oliveira Racki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luana Severo Alves
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Julio Eduardo Amaral Zenkner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luana Severo Alves.

Ethics declarations

Ethics approval

The study protocol was approved by the Research Ethics Committee of the Federal University of Santa Maria (CAAE 69901917.5.0000.5346). The research was conducted ethically, in accordance with the World Medical Association Declaration of Helsinki.

Informed consent

All participants and their parents/legal guardians provided written informed consent.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dalla Nora, A., Knorst, J.K., Comim, L.D. et al. Is neighborhood income associated with untreated dental caries irrespective of family income?. Clin Oral Invest 26, 4929–4934 (2022). https://doi.org/10.1007/s00784-022-04461-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-022-04461-6

Keywords

Search

Navigation