Disparidades raciais na saúde bucal em adolescentes brasileiros: uma abordagem multinível

Abstract

The aim of this study was to assess the occurrence and magnitude of racial inequalities in clinical and subjective oral health outcomes in Brazilian adolescents. A survey was conducted in 2012 with a multistage sample of 12 years-old schoolers in the city of Santa Maria, RS, Brazil. Data were collected through oral clinical examinations and structured interviews. The clinical variables evaluated were: dental caries, dental plaque, calculus and gingival bleeding. Participants answered the Brazilian short version of Child Perception Questionnaire (CPQ11-14) for assessing their Oral Health-related Quality of life (OHRQoL). The socioeconomic status and race were colected throug questionnaires answered by parentes. Variables related to the school neighborhood of the adolescentes were obtained by oficial publications of the city. Data were analysed using STATA 12.0 software. Multilevel Poisson Regresson models were performed to assess the associations between race, clinical variables, oral health-related quality of life and use of dental care. A total of 1,134 adolescents were examined. Non-white individuals presented the worst clinical conditions compared to White ones. Non-white adolescentes had the higher number of missed and less filled surfaces (RR 1.92 CI 1.31-2.82 and RR 0.52 CI 0.37-0.71, respectively); they also presented at a higher rate of dental plaque (RR 1.14 CI 1.09-1.18) and gingival bleeding (RR 1.07 CI 1.02-1.12) when comparing to their white counterparts. There are no racialdiferences in the use of dental services. However, the use of dental services due to pain was higher for non-white adolescents (RR 1.36 CI 1.05-1.77). Non-white adolescents had poorer OHRQoL. The most affected domains were Emotional well-being (RR 1.10 CI 1.00-1.20) and Social well-being (RR 1.16 CI 1.03-1.10). There are racial inequalities in clinical and subjective oral health outcomes as well as the reason for use of dental care in the Brazilian adolescents. The results demonstrate the need for public health policies and programm targing minority ethnic / racial groups to reduce these inequities.