title: Inequality in dental caries distribution at noncavitated and cavitated thresholds in preschool children.
abstract: OBJECTIVE
  To evaluate the inequality in dental caries distribution according to different thresholds assessed using the International Caries Detection and Assessment System (ICDAS) and to investigate the associations of socioeconomic factors with caries lesions at both noncavitated and cavitated thresholds.
  
  
  METHODS
  Study subjects were recruited in Santa Maria, Brazil, during the National Day of Children's Vaccination, and 639 children aged 12-59 months were included. Fifteen calibrated examiners performed the examinations using ICDAS criteria. Inequality in dental caries distribution was measured using the Gini coefficient, and the Significant Caries Index was calculated for several thresholds of ICDAS. Poisson regression analysis was used to assess the associations of socioeconomic factors with the highest caries scores.
  
  
  RESULTS
  The inequality in the distribution of dental caries was lower when precavitated caries were included; the Gini coefficient decreased from 0.77 to 0.60 when noncavitated caries lesions were included in the analyses. Moreover, the inequalities were higher in the younger than in the older children for all thresholds. Socioeconomic factors were significantly (P < 0.001) associated with caries when an ICDAS score of 3 was considered as the cut-off point. Children whose mothers did not complete primary education (P < 0.001) and those with low household income (P < 0.001) were more likely to have increased dental caries.
  
  
  CONCLUSIONS
  Caries lesions were more equally distributed when noncavitated lesions were included in the dental survey. Socioeconomic factors are found to be associated with the inequalities in caries distribution in this age group.
authors.affiliation: Centro Universitário Franciscano, Santa Maria, Rio Grande do Sul, Brazil.
authors.forename: Chaiana
authors.initials: C
authors.lastname: Piovesan
authors.forename: Fernanda
authors.initials: F
authors.lastname: Tomazoni
authors.forename: Joana
authors.initials: J
authors.lastname: Del Fabro
authors.forename: Bruna Cássia Schmidt
authors.initials: BC
authors.lastname: Buzzati
authors.forename: Fausto Medeiros
authors.initials: FM
authors.lastname: Mendes
authors.forename: José Leopoldo Ferreira
authors.initials: JL
authors.lastname: Antunes
authors.forename: Thiago Machado
authors.initials: TM
authors.lastname: Ardenghi
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D012923:Social Class; D012935:Social Justice
keywords: ICDAS; dental caries; epidemiological surveys; inequality