Trajetórias de vida e a cárie dentária em jovens no nordeste brasileiro: um estudo de coorte / Trajectories of life and tooth decay in young people in northeastern Brazil: a cohort study

RESUMO

A trajetória de vida percorrida pelo indivíduo determina sua forma de adoecer e manter-se saudável; além disso, os determinantes sociais da saúde influenciam a saúde da população ao longo do seu curso de vida. O objetivo deste trabalho foi investigar a saúde bucal e seus fatores determinantes ao longo do curso de vida dos jovens no município de Sobral, Ceará. Tratou-se de um estudo de coorte, com três ondas 2000, 2006 e 2012. Foram examinados e entrevistados 482 indivíduos nas três ondas, atualmente, na faixa etária de 17 a 21 anos. Investigaram-se a cárie dentária, má oclusão, doença periodontal, edentulismo e traumatismo dentário. As variáveis independentes coletadas na última onda foram as características sociodemográficas, utilização de serviços e ações de saúde bucal, autopercepção de saúde bucal e hábitos e comportamentos de saúde bucal. Foi analisada a incidência de cárie de 2006 para 2012, a trajetória da cárie dentária, a trajetória da assistência odontológica e a trajetória da condição socioeconômica familiar. Os dados foram analisados no programa SPSS versão 20, no qual foram utilizados os testes t de student, ANOVA e regressão de Poisson. A incidência média de cárie de 2006 para 2012 foi de 2,95 dentes.

ABSTRACT

The life pathway determines the way of getting sick and staying healthy and the social determinants of health influence population health throughout their life course. The aim of this study was to investigate the oral health and its determinants throughout the life course of young people in Sobral, Ceará. This was a cohort study with three waves 2000, 2006 and 2012. 482 individuals aged 17-21 years were examined and interviewed in the three waves. Were investigated tooth decay, malocclusion, periodontal disease, tooth loss and dental trauma. The independent variables collected in the last wave were sociodemographics factors, use of dental services and actions, self-perceived oral health and habits and oral health behaviors. Caries incidence from 2006 to 2012, the trend of dental caries, the trajectory of dental care and the trajectory of family socioeconomic status was analyzed. Data were analyzed using SPSS version 20, where the student t test, ANOVA and Poisson regression were used. The average incidence of caries from 2006 to 2012 was 2.95 teeth. Socioeconomic conditions presented themselves as risk factors for all outcomes investigated in different waves. The social capital is presented as a protective factor for oral health, while the use of oral health services implied an increase of recurrent caries and mutilation. Explanatory theories of life course (critical period, socioeconomic mobility and accumulation of risk) were proven in this study. Those who were never poor had better oral health conditions, while downwardly mobile entails a worsening in the context of oral health. However, the risk was higher for those who have always remained poor and have had most experienced poverty throughout life. There was the presence of inequalities in oral health and at the utilization of dental services. (AU)