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Prevalence and distribution of enamel defects and dental caries in a region with different concentrations of fluoride in drinking water in Sri Lanka.

AIMS: To assess the prevalence and distribution of developmental defects of enamel and caries in 14-year-old children who had been lifetime residents in a region with different concentrations of fluoride in drinking water in Sri Lanka. DESIGN: A cross-sectional survey. SETTING: Uda Walawe--a rural area in southern Sri Lanka where fluoride concentration in ground water is reported to be within the range of 0.05-6.10 mg/l. METHOD: A total of 518 children from six representative schools from this area were examined for developmental defects of enamel and dental caries using the modified DDE index and WHO criteria. The present analysis is limited to 486 children from whom drinking water samples were collected. RESULTS: Based on the fluoride concentration of the drinking water source the children were categorised into four groups: <0.3, 0.31-0.49, 0.5-0.7 and >0.7 mg/l. The prevalence of enamel defects ranged from 29-57% whilst 27-55% of children were affected by diffuse opacities in the four groups. Of the ten teeth examined, between 1.6-3.6 teeth per child were affected by enamel defects. Maxillary first premolars were the most commonly affected by diffuse opacities followed by the maxillary canines. Caries prevalence varied between 18-25% whilst the mean DMFT and DMFS values ranged from 0.29-0.54 and 0.45-0.67 respectively. Occlusal surfaces were the most affected by caries. CONCLUSIONS: The wide differences observed in the prevalence and severity of enamel defects indicate that there are variations in individual response to high fluoride levels in drinking water. It also demonstrates the need to ascertain the factors that could contribute to the prevalence and severity of enamel defects other than high fluoride levels in drinking water.

Adolescent↗

Prevalence of dental caries and dental fluorosis in students, 11-17 years of age, in fluoridated and non-fluoridated cities in Quebec.

The purpose of this study was to evaluate the difference in dental caries and fluorosis prevalence in 936 randomly selected life-long residents selected from public and private schools in Trois-Rivières (1.0 ppm F in 1987) and Sherbrooke (less than 0.1 ppm F), Que., Canada. Students, 11-17 years of age, were examined for dental caries using the National Institute for Dental Research criteria and for dental fluorosis using the Tooth Surface Index of Fluorosis. Because of an inconsistent fluoridation history in Trois-Rivières, comparisons were carried out between two age strata: students 11-14 years of age who consumed for a longer duration suboptimally fluoridated water than those in the second stratum: students 15-17 years of age. Only public school students, 15-17 years of age, from Trois-Rivières had significantly lower mean filled surface and decayed, missing, and filled tooth surface (DMFS) scores (28 and 24%, respectively) than similar students in Sherbrooke. Among private school students, differences were not found, except in the youngest age group in Sherbrooke who had significantly lower mean DMFS than similar students from Trois-Rivières. The prevalence of fluorosis was 45.6% and 58.0% in Trois-Rivières public and private schools, respectively, and 31.1% and 30.1% in Sherbrooke public and private schools, respectively. The use of fluoride tablets was significantly associated with fluorosis. This study showed that water fluoridation benefitted students from public schools and that the risk factors for dental fluorosis were the use of fluoridated water and fluoride tablets.

Adolescent↗

Relationship of dental caries and fluorosis to fluoride supplement history in a non-fluoridated sample of schoolchildren.

A random sample of 206 Michigan children, aged from 9 to 13, were examined for fluorosis from a larger group of 2038 children participating in a dental project. Clinical examinations included caries data (DMFS) and assessment of fluorosis by use of the Tooth Surface Index of Fluorosis (TSIF). Separate examiners were used for each index. The response rate of a questionnaire mailed to parents to gather information on residence histories, use of fluoride supplements, and antibiotics was 78%. The prevalence of fluorosis was about 20% among the respondents. Of the 4868 tooth surfaces examined, 9.2% were affected by fluorosis. In all cases, dental fluorosis was judged as mild, with most occurrences on the posterior teeth. No instances of moderate or severe fluorosis were found. The caries experience of respondents was 1.69 +/- 2.73 DMFS. Caries experience does not appear to be significantly related to income, education, or fluoride supplement use. Approximately 52% of respondents were reported to have taken fluoride supplements with various degrees of consistency. Parents' education was positively related to both prevalence of fluorosis (odds ratio = 2.2) and use of fluoride supplements (odds ratio = 2.7). No significant relation was revealed with evidence of fluorosis and use of supplements. This study shows a relatively mild level of dental fluorosis in a sample of children from a non-fluoridated area. Dental fluorosis in this group does not appear to be related to use of fluoride supplements or differences in caries experience.

Adolescent↗

Dental status of rural school children in a sub-optimal fluoride area.

Past investigations by us have shown high levels of caries experience in rural coloured school children of the Western Cape. These studies were all undertaken in fluoride poor areas. In contrast studies of children in areas with optimal and higher concentrations of fluoride in their drinking water have shown lower DMFT scores. On a previous visit to the town of Fraserburg in the North Western Cape we observed fluorosis in children, although the fluoride content of the municipal drinking water was sub-optimal (0.68-0.78 ppm F-). The purpose of this study was therefore to measure the dental status of 6, 12 and 15 year old school children using the dmft, DMFT and Dean's Fluorosis Index according to the 1987 WHO guidelines. The examinations were done by two calibrated examiners using portable equipment. Results showed low mean dmft values of 3.31 +/- 3.90 and 0.22 +/- 0.86 for the 6 and 12 year olds respectively. The corresponding DMFT scores including that for 15 year olds were 0.08 +/- 0.35; 1.45 +/- 1.81 and 1.00 +/- 1.60 respectively and no significant statistical gender differences were observed (p>0.05). The mean fluorosis scores for 6, 12 and 15 year olds were 1.68 +/- 1.05; 2.78 +/- 1.34 and 2.90 +/- 1.58 respectively. For both the 12 and 15 year olds the severity of fluorosis ranged from no fluorosis to severe mottling and corrosion. It can be concluded that the results even at a sub-optimal fluoride level show a high similarity to the dental status of children in rural fluoride rich areas. Defluoridation of the Fraserburg municipal drinking water therefore becomes imperative and a concentration of 0.4 ppm F- is suggested. Furthermore the children have no access to dental services and this has led to accumulated needs which demand urgent addressing.

Adolescent↗

[Oral health of school children in Ceuta. Influences of age, sex, ethnic background and socioeconomic level].

BACKGROUND: The objective of this study is that of gauging the prevalence of dental caries, periodontal disease and malocclusion among the school-age population of Ceuta and the spread thereof by age, sex, ethnic background and father's occupation. METHODS: Prevalence survey of a multistage, stratified, random sample of schoolchildren 7, 12 and 14 years of age (n = 347) in order to calculate DMFT and dmft indexes--permanent and deciduous dentition--, CPITN and malocclusion. Assessment of the statistical significance of the differences encountered according to age, sex, ethnic background and socioeconomic status using the Chi-Square, Student T and Snedecor F tests. To calculate, among schoolchildren ages 12 and 14, the odds ratios of showing a DMFT index over 4 and their 95% confidence intervals by gender, ethnic background and the socioeconomic status. RESULTS: Dmft (decayed, filled and missing teeth) was 3.02 at 7 and DMFT was 3.91 at 12 and 4.46 at 14. Odds ratios of DMFT > 4 were 2.26 by gender (95% CI = 1.27-4.05), 2.17 by ethnic group (95% CI = 1.18-3.99) and 1.8 by SES (95% CI = 0.85-3.81). In schoolchildren of low SES--unemployed father's--OR by ethnic group was 1.37 (95% CI = 0.28-7.0). No statistically significant differences were found in the distribution of malocclusion and periodontal disease--except by age. CONCLUSIONS: Dmft and DMFT values are in Ceuta higher than the mean national values and the proposed value of the WHO for the year 2000. Risk of DMFT higher than the median is 2.3 in girls compared with boys, 2.17 in Moslem compared with non Moslem and 1.8 in low SES schoolchildren--unemployed father's--compared to other SES schoolchildren. The increased risk related to ethnic background is influenced by SES.

Adolescent↗

[Study of caries polarization in 2-5 year-old children of Shenyang, China].

OBJECTIVE: To investigate dental caries polarization in 2-5 year-old children. METHODS: 3 799 random samples of 2-5 year-old children from attending kindergarten in Shenyang were selected. Means of dmft index and SiC index for each age group were calculated by WHO Collaborating Center. The subjects of each age group were further divided into subgroups of different level of dmft: the dmft of subgroup I was 0, the dmft of subgroup II was 1, the dmft of subgroup III was 2, the dmft of sub-group IV was equal to or more than 3. The obtained data were analyzed statistically with SPSS 10.0. RESULTS: 4.5% of 2-year-old children were carriers of 60.0% of the total dmft in that age group, 13.2% of 3-year-old children were carriers of 69.4% of the total dmft in that age group, 34.4% of 4-year-old children were carriers of 86.6% of the total dmft in that age group, and 47.8% of 5-year-old children were carriers of 89.8% of the total dmft of that age group. CONCLUSION: This study supports the assertion that a small percentage of persons with high dental caries rate and a large percentage of caries-free persons of early childhood caries.

Child↗

[Relationship of dental treatment and oral hygiene to caries prevalence and need for periodontal treatment].

The aim of this study was to examine the relationship between differences in dental attendance and oral hygiene patterns and dental caries and periodontal treatment needs. 1469 young people, aged 7, 12 and 15-19 years, and representing the urban (60%) and rural (40%) population from Spain were evaluated. Dental caries and periodontal treatment needs were registered according to the index D.M.F.T. and C.P.I.T.N., following the criteria of W.H.O. Regular dental attendance was observed in 16.6% of subjects examined, and only 9.4 saw a dentist regularly for dental prophylaxis. Statistical analyses showed that while the more frequent the dental visits, the lower the rate of caries, and periodontal treatment needs, the higher, however, the average number of fillings and the D.M.F.T. scores. These individuals had the higher number of functioning teeth, restored or sound, but they also had the disadvantage of having higher levels of disease experience. By the other way the individuals who saw the dentist regularly for dental prophylaxis presented the lower caries rate and periodontal treatment needs, the fewer tooth loss, and also an important reduction in the D.M.F.T. scores. Similar observations had been made in the individuals who brush their teeth frequently or with a correct technique. The results suggested that while frequent dental visits do not apparently help to prevent the onset of further dental disease, we can achieve this goal with regular preventive oriented dental therapy.

Adolescent↗

Stimulated salivary flow rate and composition in asthmatic and non-asthmatic adults.

The number of decayed, missed and filled permanent teeth (DMFT), the degree of periodontal inflammation (Periodontal Status Index, PSI), stimulated salivary flow rate and the concentrations of total protein, lactoferrin, lysozyme, myeloperoxidase, salivary peroxidase, calcium, potassium, sodium and thiocyanate in whole saliva of 26 adult asthma patients were compared with those of 33 non-asthmatic controls. The saliva was also analysed for mutans streptococci, lactobacilli, total anaerobic flora and Candida spp. The mean PSI (p < 0.05; 95% confidence interval for the difference between means (95% CI) 2.47-25.30) was higher and the mean stimulated salivary flow rate (p < or = 0.05; 95% CI 0.57-0.55) was lower in the asthmatic group than in the control group. No differences were found between the groups in non-immune defense factors, except for myeloperoxidase. The myeloperoxidase concentrations were higher in asthmatics than in non-asthmatics (p < 0.05; 95% CI 4.4-134.0 ng/ml). No differences in microbial counts were found. It was concluded that stimulated salivary flow rates decrease while myeloperoxidase concentrations increase in adult asthmatic patients compared with non-asthmatic adults. The higher concentrations of myeloperoxidase are explained by a higher PSI in asthmatics.

Adult↗

Relationship between gingival health and dental caries in children aged 7-12 years.

The purpose of this study was to investigate the relationship between gingival health and dental caries in elementary school children in Japan. The subjects were 474 children aged 7 to 12 years who attended dental check-ups at an elementary school. The Oral Rating Index for Children, which consists of five categories (+2, +1, 0, -1, -2), was used to rate the findings of the gingival health examination. The dental examination was performed using the WHO caries diagnostic criteria for DMFT. Children were divided into three groups: a healthier group (H-group) made up of those scoring +2 (excellent) or +1 (good), an equivocal group (E-group) made up of those scoring 0, and a gingival less-healthy group (L-group) made up of those scoring -2 (very poor) or -1 (poor). Overall percentages for the H-group, E-group and L-group were 48.3%, 21.5% and 30.2%, respectively. The number in the L-group increased with increasing age. The mean scores of the DT and DMFT in the H-group were significantly lower than those in the L-group (p < 0.01 and p < 0.05, respectively). The results suggest that oral hygiene instruction should be given to children in order to motivate self-care, not only to avoid dental caries but also to prevent gingivitis.

Age Factors↗

Therapeutic effects of daily or weekly chlorhexidine rinsing on oral health of a geriatric population.

The effects of a chlorhexidine rinse on salivary Streptococcus mutans, Lactobacillus, and Candida albicans counts and on periodontal conditions (gingival index, plaque index, pocket depths) were studied in 42 elderly subjects. Under supervision, they rinsed either daily or weekly for 6 weeks with a 0.12% chlorhexidine solution (Peridex). Saliva samples were taken for chemical and microbiologic examinations, and periodontal conditions were assessed at baseline, week 6, and 6 weeks after final rinse. Significantly lower S. mutans counts were found at week 6 for both rinsing groups (p less than 0.001). Lactobacillus and Candida counts were also generally lower at week 6, with the clearest improvement among persons with the highest counts of bacteria and yeast. Periodontal conditions were improved at week 6 (p less than 0.001) in both groups. Such improvements were not maintained 6 weeks after the rinsing regimen was completed. At baseline poor oral conditions were noticed, which placed most of the subjects at risk for tooth decay and periodontal disease. Without any other dental procedures but daily or weekly supervised rinsing, oral conditions were improved and this risk was reduced. Daily rinsing was not superior to weekly rinsing with 0.12% chlorhexidine.

Aged↗

Dental health of aboriginal pre-school children in Brisbane, Australia.

This investigation studied the dental health status of a group of 184 Australian Aboriginal children with a mean age of 4.4 +/- 0.8 years, who were attending pre-schools in metropolitan Brisbane, a non-fluoridated state capital city. The DDE (Developmental Defects of Enamel) Index was used to chart enamel hypoplasia and enamel opacities. WHO criteria was used to diagnose dental caries. The results showed that 98% of children had at least one tooth showing developmental enamel defects. Each child had a mean of 3.8 +/- 1.7 teeth affected by enamel hypoplasia and another 1.1 +/- 0.8 teeth affected by enamel opacity. Seventy-eight percent of the children had dental caries. The mean number of decayed, missing, filled teeth (dmft) per child was 3.8 +/- 3.7. The decayed component constituted 3.5 (95%) of the mean dmft, indicating a high unmet restorative need in this group. The mean dmfs (decayed, missing, filled, surfaces) was 5.9 +/- 7.3. Maxillary anterior labial decay of at least one tooth affected 43 (23%) of the children. In this sub-group, the dmft and dmfs was 9.1 +/- 2.8 and 15.4 +/- 7.7 respectively. Oral debris was found in 98% of the children. It is hypothesized that the high levels of underlying developmental enamel defects, compounded by low fluoride exposure, poor oral hygiene and a diet high in refined sugars pose an important caries risk factor in this group of children.

Child, Preschool↗

Oral cleanliness of 12-13-year-old and 15-year-old school children of Sunsari District, Nepal.

The aim of the study was to evaluate the oral cleanliness of school children in the District of Sunsari, Nepal. A multi-stage random sampling oral epidemiological survey was conducted in private and government, urban, rural town and rural village schools in 15 illakas of Sunsari District, Eastern Nepal. A total of 600, 12-13-year-old and 600 15-year-old school children were examined by trained examiners using the simplified oral hygiene index (OHI-S). The average age-group, debris and calculus index scores were combined to obtain the simplified oral hygiene index (OHI-S). The mean OHI-S scores were compared and evaluated using the parametric t-test for two independent samples. The mean OHI-S for urban 12-13-year-old school children was 0.98 compared to 1.34 for school children of rural towns and 1.44 for school children of rural villages and these differences in mean OHI-S were statistically significant (P < 0.005). In the 15-year-old age group, urban school children had a mean OHI-S score of 1.00 compared to 1.37 for rural towns and 1.43 for rural villages. The variance in the mean OHI-S scores were statistically significant (P < 0.005). The overall level of cleanliness in the school children surveyed was good. Children of urban schools had the lowest scores followed by school children from rural towns and then rural villages. When the mean OHI-S scores were compared with the DMFT scores, there was an inverse relationship between oral cleanliness and dental caries. Frequency of sugar consumption and the availability and affordability of fluoridated toothpaste may be important factors in the development of dental caries than oral cleanliness.

Adolescent↗

Dental caries and treatment characteristics in human twins reared apart.

The 'reared apart' model, eliminating the effect of common environmental factors, is used extensively in twins research. In this study, teeth present (TP), teeth present excluding third molars (TPX3), teeth restored (TR), teeth restored index (TRI), surfaces restored (SR), surfaces restored index (SRI) and surfaces restored or carious (SRCI), were compared in 46 monozygotic (MZ) twin pairs and 22 dizygotic (DZ) twin pairs separated during infancy and raised apart. The dental examination included charting, panoral and bitewing radiographs, study models and a questionnaire. Data were analysed using intraclass correlations (ICC) and analysis of variance (corrected for age and sex). For all characteristics, the MZ pairs showed greater within-pair similarity than DZ pairs. For MZ pairs, the ICC values for the dental characteristics were all statistically significant (p < 0.005): TP, 0.45; TPX3, 0.49; TR, 0.57; TRI, 0.61; SR, 0.46; SRI, 0.67; SRCI, 0.58. For DZ pairs, none of the ICC values reached statistical significance: TP, 0.04; TPX3, 0.11; TR, 0.30; TRI, 0.31; SR, 0.20; SRI, 0.17; SRCI, 0.26. Despite subjects being reared in different environments, receiving different diets and different dental professional care, the MZ findings demonstrated significant genetic variance (45-67%) for the number of teeth present, number of teeth and surfaces restored, and caries present; the DZ data supported this conclusion. These findings provide new evidence for a genetic contribution to dental caries.

Adult↗

A comparison of the effectiveness of two systems for the prevention of radiation caries.

The purpose of this study was to compare the effectiveness of two systems for the prevention of dental caries in patients who have received radiation treatment (mean number of rads; 5672 +/- 1113) for head and neck cancer. The baseline examination of 184 dentulous patients included measures of DMFS and the Root Caries Index (RCI), field of radiation, gingival inflammation, oral hygiene status, pocket depth and attachment loss. The patients were assigned randomly into two treatment groups. One group was instructed to use 0.4% Sn2 gel while toothbrushing everyday, and the other group was instructed to use a 1.1% neutral NaF gel for three months, followed by twice daily rinsing with a remineralizing mouthrinse (Salminsol Solutions, Iowa City, Iowa). One hundred and forty-three patients were re-examined after one-year, and 69, 56 and 18 patients continued in the NaF gel/remineralizing mouthrinse, SnF2 and non-compliant groups, respectively. Inter-group comparisons showed that the incidence of MT, DMFT, and DF surfaced, and the RCI were significantly higher in the non-compliant group compared to either the SnF2 or NaF gel/remineralizing mouthrinse groups (P less than 0.05). Also, the NaF gel/remineralizing mouthrinse group demonstrated a significantly higher incidence of carious root surfaces compared to the SnF2 group (P less than 0.05). Also the incidence of radiation caries was significantly higher when the field of radiation exposed a greater surface area of the major salivary glands.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

Caries incidence in patients with dementia.

One in ten persons over the age of 65 and as many as half the population aged 85 and over have Alzheimer's disease. Review of the literature reveals substantial decrements in oral health in persons with dementia as measured by denture hygiene, coronal decayed, missing and filled teeth, filled teeth (cervical), percentage of the population with caries, Oral Hygiene Index-simplified, and of sites with plaque, gingival bleeding and calculus. A study of caries incidence is described in 23 male veterans with moderate and advanced dementia of the Alzheimer's type, using a comparison group of male veterans from the Department of Veterans Affairs Dental Longitudinal Study, matching 2:1 for age, number of teeth and education. Baseline findings indicate significant differences in the numbers of coronal surfaces with decay, root decayed and/or filled teeth and root decayed and/or filled surfaces. Mean annual increments of coronal caries in the dementia group were 2.29 +/- 4.29 per 100 surfaces at risk, over twice that in the comparison group (0.88 +/- 1.14). For root caries, mean annual increments in the dementia group were 2.38 +/- 5.57 per 100 available surfaces, versus 0.31 +/- 0.69 in the comparison group. Despite these large mean differences, the marked variability in these small samples statistical significance in caries increments between the two groups. The article concludes by suggesting some potential modifications to clinical trials of caries preventive agents and some overall research issues in populations with dementia.

Aged↗

Effects of lifelong consumption of fluoridated water or use of fluoride supplements on dental caries prevalence.

This study was undertaken to determine the prevalence of dental caries in children ages 6-14, from fluoridated and non-fluoridated areas in British Columbia, Canada, and the effects of receiving certain fluoride preventive procedures during childhood. Children from two communities were surveyed using a modified Decayed, Missing and Filled Tooth Surface Index (D1D2MFS). Questionnaires on the use of various fluoride preventive practices and residence histories during childhood were collected. Completed questionnaires were returned and exams were performed on 1131 children. Crude caries prevalence scores for the different fluoride exposure groups were tested for differences in dental age and the level of educational attainment of parents and/or guardians. No significant group differences were found. The 110 children with lifelong exposure only to fluoridated water had 35%, or 0.88 (S.D. = 2.91), fewer decayed or filled tooth surfaces per child (P < 0.07) than children with no reported exposure to systemic fluorides. For the 122 children who had taken fluoride supplements for 4 yr or more, 0.67 fewer decayed and filled tooth surfaces (26% reduction) were observed per child when compared to children with no exposure to fluoridated water or supplements. For children who used fluoride supplements for less than 4 yr, no significant benefits were observed. Approximately 75% of the caries prevalence for control and fluoride-exposed groups was on pit and fissured surfaces. Reductions by surface type showed savings on both smooth and pit and fissured surfaces.

Adolescent↗

Socio-economic and behavioural factors related to caries in twelve-year-old Sardinian children.

Our aim was to describe socio-economic and behavioural factors related to caries experience in school children in Sassari, Sardinia (Italy). Four hundred and three 12-year-old schoolchildren were randomly selected and their teeth clinically examined after air drying, under standard light using a plain mirror and WHO community periodontal index for treatment needs (CPITN) ballpoint probe. The clinical DMFS index was recorded following a diagnostic threshold, CPITN following the WHO indications. A questionnaire concerning oral hygiene habits (OHH), the onset of toothbrushing habits (OTH), frequency of dental check-ups (DCU), sweet food and soft drink consumption and socio-economic background factors, i.e. parents' occupational status (SOCFAM) and parents' age, was filled in by children and parent(s)/guardian(s). The caries prevalence was 61.6%. A positive skewness of DMFS was observed. Regarding caries, a significant linear trend (p<0.05) was found among odds ratios at each exposure level in SOCFAM, OHH, OTH and CPITN. A logistic regression model for caries was constructed using related factors. CPITN (gingival conditions) gave a significant contribution in the predictive model (p = 0.01). Gender acted as an effect modifier on CPITN, so logistic regression models were constructed for males and females separately. CPITN was the only statistically significant covariate in males and OHH the only one in females. Our results confirm a high caries prevalence and also a need for preventive and educational programmes for caries in Sardinia.

Age Factors↗

Multilevel assessment of determinants of dental caries experience in Brazil.

OBJECTIVE: To examine contextual and individual determinants of dental caries experience, documenting levels of the disease in Brazil. METHODS: The dental status of 34 550 12-year-old schoolchildren was informed by a country-wide survey of oral health comprising 250 towns and performed in 2002-2003. Indices assessing dental caries experience were compared by sociodemographic characteristics of examined children (gender, ethnic group, localization and type of school), and geographic characteristics of participating towns [the human development index (HDI), and access to fluoridated tap water]. A multilevel model fitted the adjustment of untreated caries to individual and contextual covariates. RESULTS: Better-off Brazilian regions presented an improved profile of dental health, besides having a less unequal distribution of restorative dental treatments between blacks and whites, rural and urban areas, and public and private schools. Girls [odds ratio (OR)=1.1; 95% confidence interval (CI): 1.0-1.1], blacks (OR=1.6; 95% CI: 1.5-1.7), and children studying in rural areas (OR=1.9; 95% CI: 1.7-2.0) and public schools (OR=1.7; 95% CI: 1.6-1.9) presented higher odds of having untreated decayed teeth. The multilevel model identified the fluoride status of tap water (beta=-0.3), the proportion of households linked to the water network (beta=-0.3), and the HDI (beta=-0.2), as town-level variables associated with caries levels. CONCLUSION: Dental caries experience is prone to sociodemographic and geographic inequalities. The monitoring of contrasts in dental health outcomes is relevant for programming socially appropriate interventions aimed both at overall improvements and at the targeting of resources for groups of population presenting higher levels of needs.

Black People↗