Spatial distribuition of tooth loss in a population of adults

ABSTRACT Introduction: Although there has been an improvement in the oral health status of the population, tooth loss still aggravates the oral health of adults and is a matter of great relevance to dentistry. Aim: To determine the spatial distribution of tooth loss in adults and correlate this with the Social Exclusion Index and proximity to public dental services. Material and Method: This ecological study was based on epidemiological data of adults from Piracicaba municipality and from the Piracicaba Research and Planning Institute (IPPLAP). Data on dental evaluations were extracted from the Piracicaba epidemiological survey, which was a cross-sectional study with probabilistic sampling of 248 adults aged 20-64 years, representative of adults living in Piracicaba, Brazil. Oral examinations of the DMFT index were in accordance with the World Health Organization codes and criteria and were performed by a single examiner calibrated for this purpose. Data on social exclusion and the municipal health units that have dental services were extracted from IPPLAP. Georeferencing was performed of census tracts selected by draw, and the city health facilities that have dental services. For Spearman correlation analysis (p 1000m the census tract. Result: There was a correlation between tooth loss and higher IEX, and r=−0.51 (p=0.01), but no correlation with proximity to public dental services (p=0.42). Conclusion: Tooth loss in adults was distributed according to social exclusion, however, it was unrelated to proximity to the public dental services.摘要 引言：尽管人群口腔健康状况已有所改善，但牙齿缺失仍会加重成年人的口腔健康负担，且是口腔医学领域极具研究价值的重要议题。 研究目的：明确成年人牙齿缺失的空间分布特征，并探讨其与社会排斥指数（Social Exclusion Index）以及距公立口腔医疗服务机构的距离之间的相关性。 材料与方法：本项生态学研究基于巴西皮拉西卡巴市及皮拉西卡巴研究与规划研究所（Piracicaba Research and Planning Institute, IPPLAP）的成年人口腔流行病学数据。牙齿评估相关数据提取自皮拉西卡巴市流行病学调查：该研究为横断面研究，采用概率抽样方法纳入248名年龄20~64岁的成年人，样本可代表巴西皮拉西卡巴市全体成年居民。口腔检查采用符合世界卫生组织（World Health Organization, WHO）规范的DMFT指数（DMFT index）诊断标准与编码规则，由经过本研究校准的1名检查者完成。社会排斥指数及设有口腔诊疗服务的市政卫生单元相关数据均提取自IPPLAP。本研究对抽签选取的普查区以及设有口腔诊疗服务的城市卫生机构进行了地理编码。针对普查区开展斯皮尔曼相关性分析（Spearman correlation analysis），以1000米为距离阈值。 研究结果：牙齿缺失程度与更高的社会排斥指数呈显著负相关，相关系数r=-0.51（p=0.01），但与距公立口腔医疗服务机构的距离无显著相关性（p=0.42）。 研究结论：成年人牙齿缺失的空间分布与社会排斥水平相关，但与距公立口腔医疗服务机构的距离无关。