Influence of Socioeconomic Status on Oral Disease Burden: A Population-Based Study

Abstract Background : Dental caries is associated with Biological, behavioral, socioeconomic, and environmental factors; however, socioeconomic status is a distal determinant of dental caries development that modulates exposure to risk and protective factors. This study aimed to analyze the factors associated with the distribution and concentration of oral diseases in a population-based study in Brazil. Methods : This is a quantitative, analytical, cross-sectional study based on secondary data from the SB São Paulo 2015 epidemiological survey. A total of 17,560 subjects were included. The concentration of oral disease in the population was estimated by the oral disease burden (ODB) variable. The ODB consists of four components: dental caries; tooth loss; need for dental prosthesis and periodontal condition. Thus, the total score on the ODB could vary between 0 and 4, with the highest score indicating the worst possible situation. ODB was analyzed in multivariate negative binomial regression, and multivariate binary logistic regression analysis. The following demographic data were included as independent variables: age group, skin color, socioeconomic data, and family income. Results : ODB was present in 86.9% of the sample. Negative multivariate binomial regression showed a statistically significant relationship (p<0.005) between ODB and all variables analyzed (skin color, family income, education, OIDP results and age range). The adjusted multivariate binary logistic regression showed that the individuals most likely to have at least one component of ODB were nonwhite (25.5%), had a family income of up to R$ 1,500.00 / month (19.6%), had only completed primary education (19.1%), and reported that their oral health had an impact on their daily activities (57.6%). Elderly individuals were two times more likely than adolescents to have an ODB component. Conclusions : ODB is associated with factors related to social inequality. Adults and elderly individuals had the highest cumulative number of ODB components.