Supplementary Material for: Household food insecurity and dental caries experience in adolescents from southern Brazil

Objective: To describe the association between household food insecurity and the prevalence of cavitated dental caries lesions in adolescents. Material and methods: This is a cross-sectional study nested within a 13-year cohort study that began in 2010 with a representative sample of preschool children aged 1 to 5 years from Santa Maria, southern Brazil. Participants were followed up in several phases of the cohort study, and this analysis used data from the most recent reevaluation, when individuals were aged between 14 and 18 years. Dental caries was assessed using the Worl Health Organization (WHO) criteria (cavitated caries lesions). Household food insecurity was measured using the Brazilian Food Insecurity Scale (EBIA), considering households with individuals under 18 years of age. The association between the presence of different levels of household food insecurity and caries experience was analyzed using adjusted Poisson regression models. Results are presented as Mean Ratios (MR) with 95% Confidence Intervals (95% CI). Results: Of the 406 adolescents assessed, 300 parents or guardians (73.9%) completed the food and nutrition insecurity questionnaire. Approximately 56.0% (95%CI 50.2%-61.7%) of households experienced some degree of food and nutrition insecurity. The prevalence of cavitated dental caries lesions was 38.0% (95%CI 32.5%-43.8%). Adolescents living in households with mild or moderate food insecurity had on average 62% higher mean surfaces with cavitated dental caries (MR 1.62;95%CI 1.28–2.06) than their counterparts without food insecurity. The presence of severe food insecurity was also associated with about twice the mean surface with cavitated dental caries (MR 1.92; 95%CI 1.35–2.73). Conclusion: In addition to the nutritional consequences, food insecurity compromises oral health and should be a priority to reduce social inequalities in oral diseases.