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Brazilian Oral Research
version ISSN 1806-8324
Braz. oral res. vol.25 no.1 São Paulo Jan./Feb. 2011
doi: 10.1590/S1806-83242011000100012 
PEDIATRIC DENTRISTY
 
Inequalities in the distribution of dental caries among 12-year-old Brazilian schoolchildren
 
 
Chaiana PiovesanI; Fausto Medeiros MendesII; José LeopoldoFerreira AntunesI; Thiago Machado ArdenghiIII
IDepartment of Orthodontics and Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
IIDepartment of Epidemiology, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
IIIDepartment of Stomatology, Federal University of Santa Maria, Santa Maria, RS, BrazilCorresponding author
 
 
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ABSTRACT
We assessed the inequality in the distribution of dental caries and the association between indicators of socioeconomic status and caries experience in a representative sample of schoolchildren. This study followed a cross-sectional design, with a sample of 792 schoolchildren aged 12 years, representative of this agegroup in Santa Maria, RS, Brazil. Guardians answered questions on socioeconomic status and a dental examination provided information on the dental caries experience (DMF-T). Inequality in dental caries distribution was measured by the Gini coefficient and the Significant Caries Index (SiC). The assessment of association used Poisson regression models. Socioeconomic factors were associated withprevalence of dental caries for the whole sample and also for individuals with a high-caries level. Children from low-income households had the highest prevalence of dental caries. The Gini coefficient was 0.7 and the SiC Index 2.5. The percentage of caries prevalence was 39.3% (95% CI: 35.8%-42.8%) and the mean for DMF-T was 0.9 (± SD 1.5). Inequalities in the distribution of dental caries were observedand socioeconomic factors were found to be strong predictors of the prevalence of oral disease in children of this age group.
Descriptors: Public Health Dentistry; Epidemiology; Dental Caries; Socioeconomic Factors; Child.
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Introduction
Socioeconomic gradients have been simultaneously associated with both caries experience anddistribution among preschool and schoolchildren.1,2 Despite a global decline in dental caries experience in children, inequalities in oral health exist,3 leading to a high prevalence of disease in some minorities.4,5
An impressive body of scientific evidence demonstrates the underlying influence of psychosocial, economic, environmental, and political determinants on general health inequalities.However, it is now widely acknowledged that a more comprehensive and detailed understanding of oral health inequalities is needed to enable public health agencies to take effective action against this fundamental health problem.6 Therefore, it is important to know the pattern of dental caries distribution among different population groups.
To investigate this problem, Bratthall proposedusing the Significant Caries Index (SiC) to identify individuals with the highest prevalence of caries in each population. The SiC index is the mean DMF/dmf for the one-third of the study group with the highest caries score.7 In a recent Brazilian study using the SiC index, a high polarization in the distribution of dental caries in 12-year-old adolescents was observed.8 In that study, the DMF-Tindex was 2.45, with an SiC index of 5.08, and 30% of the adolescents were shown to be caries-free. It was observed that 70% of caries cases were concentrated among 34% of the adolescents.
Another important measurement of the inequality in caries distribution is the Gini coefficient.9 This coefficient is a well-documented index of inequality used mainly to assess income distribution....