Social deprivation, income inequality, social cohesion and dental caries in Brazilian school children

This ecological study investigated the associations between social deprivation, income inequality and social cohesion and dental caries levels in school children of the Distrito Federal, Brazil. Three sources of data were used: (1) area-based data from a 1997 social survey carried out on 13,000 families, (2) 1995 census data collected for the Government of the Distrito Federal (GDF), and (3) dental caries data from a 1997 oral health survey on 7296 6–12-year-old school children. Results of simple linear regression showed that percent with less than eight years of education (P=0.03) and percent who did not have a maid (P=0.009), were negatively statistically significantly associated with the percent of children free of caries. None of the deprivation measures were statistically significantly associated with mean DMF-T scores (P>0.05). GINI coefficient, an indicator of social inequalities, was negatively statistically significantly associated with both measures of dental caries experience, percent of caries free (P=0.003) and mean DMF-T scores (P=0.01). Per thousand number of homicides or attempted homicides, an indicator of social cohesion was of marginal statistical significance associated with caries experience. Results of multiple linear regression analyses showed that only the Gini coefficient remained statistically significantly associated with both dental clinical measures used, after adjusting for potential confounding. In conclusion, relative rather than absolute levels of income were stronger determinants of the onset of caries in this study.