Iniquidades e tendência na distribuição de cárie dentária em pré-escolares do sul do Brasil entre 2008 e 2013

Abstract

Inequalities in oral health have been observed in caries experience and distribution among different groups. However, there are few studies evaluating trend and inequalities in the distribution of dental caries associated to psychosocial factors in preschool children in a Brazilian context. Therefore, the aim of this study is to assess the trend of dental caries in preschool children in the period 2008 to 2013 and to evaluate the disparities in dental caries distribution according individuals, socioeconomic and psychological factors in the city of Santa Maria-RS. Data were obtained from cross-sectional studies with representative samples of preschool children in the city in 2008 and 2013 during the National Day of Children s Vaccination, using the criteria of dmft index recommended by World Health Organization (WHO). Caries prevalence (dmft > 0) and severity (dmfs) were calculated using chi-square test for trend. For each survey year, we calculated disparities by individual, socio-economic position and oral health self-perception in standardized caries occurrence (prevalence:dmft > 0; severity: mean dmft) using absolute and relative measures. The results showed a marked and statistically significant decline in the prevalence (P < 0.001) of dental caries between 2008 and 2013. Moreover, although it has been observed a decrease in SiC, the Gini coefficient increased from 0.85 to 0.90 in the years evaluated. The largest reductions ( relative and absolute) in prevalence and dmft mean occurred in non-white preschoolers, families with low household income, mothers with low level of education , unemployed fathers (except for average dmft) and those whose parents rated the child s oral health as "great / good". It was concluded that, in general, there was a significant reduction in the proportion and severity of dental caries in preschool children during the study period. However, inequalities in dental caries distribution remained and increased over the years, i.e., although the overall disease burden has been reduced, the distribution of the disease still occurs unequally among different population groups.