O papel de fatores socioeconômicos, psicossociais e comportamentais relacionados à saúde na incidência da cárie dentária em crianças aos 12 anos de idade

Abstract

The objective of the present study was to evaluate the role of socioeconomic, psychosocial and behavioral factors related to health in the incidence of dental caries, based on the conceptual model of Social Determinants of Health of the WHO. This is a longitudinal study conducted in 312 children aged 12 years over a year, in public schools, from a socioeconomically disadvantaged region in the city of Manaus, Amazonas, Brazil. Demographic characteristics, socioeconomic status, health-related behaviors, sense of coherence (SOC-13) and social support appraisals were obtained through questionnaires answered by participants. Clinical data on dental caries were collected by five calibrated examiners to evaluate the incidence of dental caries using the DMFT index. The statistical analysis was conducted in three phases: descriptive data analysis, Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM). The incidence of dental caries in the study population was 25.6%. Factorial Confirmatory Analysis supported the presence of latent variables socioeconomic level and social support. The direct effects showed that the socioeconomic condition is a predictor of behaviors such as daily sucrose and sedentarism, which in turn predict a higher incidence of caries. Better socioeconomic status was associated with a lower frequency of sucrose intake (β = -0.243 p <0.05) and a higher level of sedentary lifestyle (β = 0.227 p <0.05). Health-related behaviors such as higher frequency of sucrose intake (β = 0.103 p <0.05) and greater sedentary lifestyle (β = 0.102, p <0.05) were predictors of a higher incidence of dental caries. The sense of coherence was associated with higher tooth brushing frequency (β = 0.148 p <0.05). Thus, socioeconomic, psychosocial and behavioral factors related to health have been predictors of the incidence of dental caries and should be considered in oral health care policies.