Factors associated with toothache in 12-year-old adolescents in a southeastern state of Brazil.

This cross-sectional study evaluated factors associated with toothache in 12-year-old adolescents from the state of Minas Gerais in Brazil. Secondary data were collected from the SB Minas Gerais 2012 epidemiological survey. The dependent variable was toothache in the past 6 months. The independent variables were grouped into two levels: individual (sex, ethnic group, family income, periodontal condition, dental caries, dental treatment needs, and type of service used) and contextual (allocation factor, Human Development Index, Gini coefficient, gross domestic product, unemployment, illiteracy, basic sanitation, garbage collection, family income, half or a quarter of a minimum wage, primary healthcare coverage, primary oral healthcare team coverage, oral health technician, access to individual dental care, and supervised tooth brushing). A multilevel analysis was performed using the Hierarchical Linear and Nonlinear Modeling Software Program to assess the association of individual and contextual variables with toothache in the last 6 months. The prevalence of toothache in the last six months among the adolescents of this study was 19.1%. An association was found with family income (p <0.001), dental caries (p <0.001), primary oral healthcare team coverage (p = 0.015) and oral health technician (p = 0.008). Socioeconomic conditions and the most prevalent oral diseases, such as dental caries, as well as the use of public services, were related to toothache in adolescents aged 12 years. These findings reinforce the need to develop and implement public policies to address the oral health problems of this population.

Factors associated with toothache in 12-year-old adolescents in a southeastern state of Brazil

Abstract: This cross-sectional study evaluated factors associated with toothache in 12-year-old adolescents from the state of Minas Gerais in Brazil. Secondary data were collected from the SB Minas Gerais 2012 epidemiological survey. The dependent variable was toothache in the past 6 months. The independent variables were grouped into two levels: individual (sex, ethnic group, family income, periodontal condition, dental caries, dental treatment needs, and type of service used) and contextual (allocation factor, Human Development Index, Gini coefficient, gross domestic product, unemployment, illiteracy, basic sanitation, garbage collection, family income, half or a quarter of a minimum wage, primary healthcare coverage, primary oral healthcare team coverage, oral health technician, access to individual dental care, and supervised tooth brushing). A multilevel analysis was performed using the Hierarchical Linear and Nonlinear Modeling Software Program to assess the association of individual and contextual variables with toothache in the last 6 months. The prevalence of toothache in the last six months among the adolescents of this study was 19.1%. An association was found with family income (p <0.001), dental caries (p <0.001), primary oral healthcare team coverage (p = 0.015) and oral health technician (p = 0.008). Socioeconomic conditions and the most prevalent oral diseases, such as dental caries, as well as the use of public services, were related to toothache in adolescents aged 12 years. These findings reinforce the need to develop and implement public policies to address the oral health problems of this population.

Fatores associados à dor dentaria em adolescentes de 12 anos no estado de Minas Gerais e educação em saúde como ferramenta de enfrentamento aos problemas de saúde bucal / Factors associated with dental pain in 12-year-old adolescents in the state of Minas Gerais and health education as a tool to address oral health problems

A dor de dente é frequentemente descrita como o tipo mais frequente de dor orofacial. Tem um impacto significativo na vida das pessoas e da sociedade. Isso pode ser evitado por meio de estratégias eficazes, incluindo prevenção e intervenção. As principais causas da dor de dente são cáries, doenças periodontais e traumas dentários. A adolescência é uma fase de transição caracterizada por intensas mudanças físicas e psicológicas, em que o indivíduo pode se engajar em comportamentos que podem comprometer sua saúde. O adolescente é, portanto, um grupo populacional vulnerável que requer cuidados adequados de acordo com seu contexto individual, familiar e social, o que pode influenciar em sua saúde geral e bucal. A literatura tem demonstrado que a dor de dente está associada a fatores socioeconômicos, familiares, culturais, comportamentais e psicossociais. Existem estudos sobre a prevalência de dor de dente em adolescentes, porém, para Minas Gerais, Brasil, não há estudo com abordagem multinível. O objetivo principal deste estudo transversal foi avaliar quais fatores contextuais e individuais estão associados à dor de dente em adolescentes (12 anos) no estado de Minas Gerais, localizado na região sudeste do Brasil, além de desenvolver um produto técnico voltado para a prevenção da dor de dente. Este estudo utilizou dados secundários do banco de dados epidemiológicos do SB Minas 2012. A variável dependente foi dor dentária reportada nos últimos seis meses. As covariáveis foram agrupadas em dois níveis, individual (sexo, grupo étnico autorrelatado, renda familiar (valores em reais), condição periodontal, cárie dentária, necessidade de tratamento odontológico, tipo de serviço utilizado). As variáveis contextuais foram: fator de Alocação (interior I, interior II, capital), IDH, Coeficiente de Gini, Produto Interno Bruto, desemprego, analfabetismo, renda familiar por pessoa, metade do salário-mínimo, um quarto do salário-mínimo, esgotamento sanitário, coleta de Lixo, cobertura de atenção primária a saúde (APS), cobertura das equipes de saúde bucal na APS, presença de Técnico em Saúde Bucal, cobertura de 1° consulta, escovação supervisionada. Essas covariáveis foram analisadas no nível regional do Estado. Os dados foram analisados no programa IBM SPSS Software versão 22.0. Um modelo de regressão logística (Razão de Chances ­ RC/IC95%) multinível foi usado para inferir associação entre os diferentes níveis, considerando ao final uma significância de 5%. A prevalência de dor dentária foi de 19,1% e esteve associada a renda familiar (p <0,001), cárie dentária (p <0,001), cobertura da Equipe de Saúde Bucal na APS (p = 0,015) e presença de Técnico em Saúde Bucal na ESB (p = 0,008). Condições socioeconômicas e uso de serviço odontológico estiveram associados com dor dentária. Os achados deste estudo reforçam a necessidade de formular mais estratégias públicas efetivas. Em relação ao produto técnico, a ideia foi elaborar um material educativo para ser divulgado em mídias com grande circulação de pessoas. Os principais temas foram o auto-cuidado em saúde bucal e como prevenir condições bucais, tais como cárie dentária, doença periodontal, câncer bucal, trauma dentária e edentulismo. As ilustrações foram realizadas no programa de designs e templates Canva. Este é um produto educacional, fácil de ser replicado, de baixo custo, com grande potencial de alcance e tem potencial para promover mudanças positivas em nível de comportamento individual e coletivo a fim de lidar com os problemas bucais.

Toothache is often described as the most frequent type of orofacial pain. It has a significant impact on people's lives and society. This can be avoided through effective strategies, including prevention and intervention. The main causes of toothache are caries, periodontal diseases and dental trauma. Adolescence is a transitional phase characterized by intense physical and psychological changes, in which individuals can engage in behaviors that can compromise their health. Adolescents are, therefore, a vulnerable population group that requires adequate care according to their individual, family and social context, which can influence their general and oral health. Literature has shown that toothache is associated with socioeconomic, family, cultural, behavioral and psychosocial factors. There are studies on the prevalence of toothache in adolescents, however, for Minas Gerais, Brazil, there is no study with a multilevel approach. The main objective of this cross- sectional study was to assess which contextual and individual factors are associated with toothache in adolescents (12 years old) from the state of Minas Gerais, located in the southeast region of Brazil, in addition to developing a technical product aimed at preventing toothache. This study used secondary data from the epidemiological database of SB Minas 2012. Dependent variable was toothache reported in the last six months. The covariates were grouped in two levels, individual (sex, self-reported ethnic group, family income (values in reais), periodontal condition, dental caries, need for dental treatment, type of service used). The contextual variables were Allocation factor (interior I, interior II, capital), HDI, Gini Coefficient, Gross Domestic Product, Unemployment, Illiteracy, Family income per person, Half the minimum wage, One quarter of the minimum wage, Sanitary Sewage, Garbage Collection, Primary Health Care Coverage (APS), Coverage of Oral Health Teams in APS, Presence of Oral Health Technician, Coverage of 1st appointment, Supervised brushing. These covariates were analyzed at the regional level of the state. Data were analyzed in the IBM SPSS Software version 22.0 program. A multilevel logistic regression statistical model (OR ­ 95%CI) was carried out to assess the association between the different levels, considering 5% significance. The prevalence of dental pain was 19.1% and was associated with family income (p <0.001), dental caries (p <0.001), coverage of the Oral Health Team in PHC (p = 0.015) and presence of a Health Technician Oral in ESB (p = 0.008). Socioeconomic conditions and the use of dental services were associated with toothache. The results of this study reinforce the need to formulate more effective public strategies. Regarding the technical product, the idea was to prepare educational material to be published in media with a large circulation of people. The main themes were oral health care and how to prevent oral problems such as caries, periodontal diseases, oral cancer, dental trauma and edentulism. The illustrations were done in Canva's design and template program. It is an educational product, easy to replicate, low cost, with great social reach and with the potential to promote positive changes in individual and collective behavior in dealing with oral problems.