Number of dentists in the neighborhood and incidence of dental caries in the children permanent dentition

Abstract This study aimed to evaluate the influence of the number of dentists in the neighborhood on the incidence of dental caries in the children permanent dentition. This cohort began in 2010 (T1) with a random sample of 639 children (1 to 5 years-old) followed for 7 years, in southern Brazil. The follow-up reassessment (T2) took place in 2017. Untreated dental caries was evaluated at T2 through the Decayed, Missing, and Filled surfaces index (DMF-S). The number of dentists in the neighborhood was obtained from the city’s official database and used as a contextual variable. Socioeconomic, demographic, and oral health variables at the individual level were evaluated at T1. A multilevel Poisson regression was performed to evaluate the influence of the predictor variables in the incidence of untreated dental caries. From 639 children at T1, 449 were reassessed at T2 (a 70.3% retention rate). The mean of decayed surfaces at T2 was 0.92 (SE 0.01). The greater the number of dentists in the neighborhoods where the children lived, the lower the incidence of dental caries. Children with low socioeconomic status, who have not routinely visited the dentist in the last 6 months, who presented a experience of dental caries, and whose parents perceived their oral health as fair/poor showed a higher incidence of surfaces with untreated dental caries. As conclusion, children who live in neighborhoods with fewer dentists have a higher incidence of untreated dental caries in permanent dentition.

摘要 本研究旨在评估社区牙医数量对儿童恒牙列龋病发病率的影响。该队列研究于2010年（基线T1）在巴西南部开展，纳入639名1至5岁儿童的随机样本，随访时长7年。随访复评（T2）于2017年完成。本研究于T2阶段采用龋失补牙面指数（Decayed, Missing, and Filled surfaces index, DMF-S）评估受试者的未治疗龋病情况。社区牙医数量数据取自该市官方数据库，作为背景变量纳入分析。研究于T1阶段收集了个体层面的社会经济地位、人口统计学特征及口腔健康相关变量。本研究采用多层泊松回归模型，分析各预测变量对未治疗龋病发病率的影响。T1阶段纳入的639名儿童中，最终有449名完成T2复评，随访保留率为70.3%。T2阶段的龋面均数为0.92（标准误SE=0.01）。儿童居住社区的牙医数量越多，其龋病发病率越低。社会经济地位较低、近6个月未定期接受牙科诊疗、既往有龋病病史，且父母认为其口腔健康状况一般/较差的儿童，其未治疗龋病的牙面发病率更高。综上，居住于牙医数量较少社区的儿童，其恒牙列未治疗龋病的发病率更高。