title: Social capital and dental pain in Brazilian northeast: a multilevel cross-sectional study.
abstract: BACKGROUND
  There is limited evidence on possible associations between social determinants and dental pain. This study investigated the relationship of neighborhood and individual social capital with dental pain in adolescents, adults and the elderly.
  
  
  METHODS
  A population-based multilevel study was conducted involving 624 subjects from 3 age groups: 15-19, 35-44 and 65-74 years. They were randomly selected from 30 census tracts in three cities in the State of Paraíba, Brazil. A two-stage cluster sampling was used considering census tracts and households as sampling units. The outcome of study was the presence of dental pain in the last 6 months. Information on dental pain, demographic, socio-economic, health-related behaviors, use of dental services, self-perceived oral health and social capital measures was collected through interviews. Participants underwent a clinical examination for assessment of dental caries. Neighborhood social capital was evaluated using aggregated measures of social trust, social control, empowerment, political efficacy and neighborhood safety. Individual social capital assessment included bonding and bridging social capital. Multilevel logistic regression was used to test the relationship of neighborhood and individual social capital with dental pain after sequential adjustment for covariates.
  
  
  RESULTS
  Individuals living in neighborhoods with high social capital were 52% less likely to report dental pain than those living in neighborhoods with low social capital (OR = 0.48, 95% CI = 0.27-0.85). Bonding social capital (positive interaction) was independently associated with dental pain (OR = 0.88, 95% CI = 0.80-0.91). Last dental visit, self-perceived oral health and number of decayed teeth were also significantly associated with dental pain.
  
  
  CONCLUSIONS
  Our findings suggest that contextual and individual social capital are independently associated with dental pain.
authors.affiliation: Department of Clinic and Social Dentistry, Federal University of Paraíba, Manaíra, João Pessoa, PB, Brazil. bianca.santiago@yahoo.com.br
authors.forename: Bianca Marques
authors.initials: BM
authors.lastname: Santiago
authors.forename: Ana Maria Gondim
authors.initials: AM
authors.lastname: Valença
authors.forename: Mario Vianna
authors.initials: MV
authors.lastname: Vettore
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004245:DMF Index; D003729:Dental Care / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D012111:Residence Characteristics; D012923:Social Class; D014098:Toothache / Q000453:epidemiology*; D055815:Young Adult