title: Oral health determinants and caries outcome among non-privileged children.
abstract: The study aimed at identifying oral health determinants that are present in early childhood, are amenable to change and for which there is evidence of their modulation of the rate of caries progression in a sample of non-privileged children. The null hypothesis was that determinants associated with the child's institutional environment as evidenced by nursery policies significantly influenced the child's oral health. The sample was formed by 2,511 Brazilian 1-5-year-olds. Caries severity and activity were recorded. Parents were interviewed and nurseries answered a questionnaire. According to the case status d1efs, the final multilevel model (generalized linear mixed model) identified significant associations with determinants such as bottle-feeding the child during the night on demand, not assisting the child in toothbrushing, ensuring visit to the dentist in case of troubles with teeth only (p < 0.0001) and intake of sugary products 2-4 times daily at nursery (p = 0.026). The likelihood of caries outcomes was associated with determinants related to nursery policies, not promoting preventive oral health care for children of mothers with 4 years of education (OR = 2.14; p < 0.0015) and <4 years of education (OR = 2.6; p = 0.0010), as well as consumption of sugary products 2-4 times daily for children of mothers with 4 years of education (OR = 3.35; p = 0.0010) and <4 years of education (OR = 4.07; p = 0.0063). In conclusion, determinants related to parental negative practices and to nursery policies significantly influenced children's oral health. Of particular interest was the identification of determinants considered amenable to change in connection with nursery policies towards oral health.
authors.affiliation: Faculty of Medicine and Dentistry, Catholic University of Louvain, Brussels, Belgium.
authors.forename: Joana C
authors.initials: JC
authors.lastname: Carvalho
authors.forename: Eduardo F
authors.initials: EF
authors.lastname: Silva
authors.forename: Elcio O
authors.initials: EO
authors.lastname: Vieira
authors.forename: Arnaud
authors.initials: A
authors.lastname: Pollaris
authors.forename: Alain
authors.initials: A
authors.lastname: Guillet
authors.forename: Heliana D
authors.initials: HD
authors.lastname: Mestrinho
mesh_terms: D000293:Adolescent; D000328:Adult; D001903:Bottle Feeding / Q000706:statistics & numerical data; D001938:Brazil / Q000453:epidemiology; D002656:Child Day Care Centers / Q000458:organization & administration; D002675:Child, Preschool; D004245:DMF Index; D003729:Dental Care / Q000706:statistics & numerical data; D003731:Dental Caries / Q000453:epidemiology*; D019422:Dietary Sucrose / Q000008:administration & dosage; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D006291:Health Policy; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007223:Infant; D008297:Male; D008423:Maternal Age; D009035:Mothers / Q000193:education; D009909:Oral Health; D016487:Parenting; D012578:Schools, Nursery / Q000458:organization & administration; D064890:Social Determinants of Health; D014099:Toothbrushing / Q000706:statistics & numerical data; D035862:Vulnerable Populations / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D019422:Dietary Sucrose