title: Contextual and individual determinants of dental pain in preschool children.
abstract: OBJECTIVE
  Despite growing interest on dental pain in children, there are very few studies on its prevalence and determinants among preschool children. The objective of this study was to assess prevalence of dental pain and associated individual and contextual factors in 5 year-old Brazilian children.
  
  
  METHODS
  This cross-sectional study used primary data from the 2010 National Survey of Oral Health, carried out in capital cities and a sample of country towns. Participants were 7280 5-year-olds, who were examined in their homes and whose parents answered a questionnaire. Dependent variable was report of dental pain in the last 6 months. Independent variables were contextual (city level) socioeconomic factors, and individual (child) sociodemographic and oral health-related variables. Data analysis included hierarchized Poisson regression models, using a multilevel approach and prevalence rate (PR) estimates.
  
  
  RESULTS
  The prevalence of dental pain was 22.0% (95% CI 19.1-25.2). It was higher among those living in cities with lower human development index (PR 0.07; 95% CI 0.02-0.22) and with a higher percentage of their population with an incomplete primary education (PR 1.03; 95% CI 1.01-1.06). Indigenous children had prevalence of dental pain 1.97 times higher (95% CI 1.19-3.26) than those of white colour. Families with monthly incomes of U$ 218.00 or less and between U$ 219.00 and U$ 656.00 had, respectively, a prevalence of dental pain 2.67 (95% CI 1.33-5.32) and 2.11 (95% CI 1.03-4.32) times higher than families with highest income level. For each unit increase in the number of dwellers per bedroom, there was a 14% increase in the probability of having pain. Children with caries experience had a 3.45 (95% CI 2.58-4.62) higher prevalence of pain than caries-free individuals.
  
  
  CONCLUSIONS
  Dental pain prevalence in Brazilian preschool children was high and influenced by contextual and individual factors.
authors.affiliation: Dentistry Graduate Program, Universidade Federal de Goias, Goiania, Brazil.
authors.forename: Osmar Martins
authors.initials: OM
authors.lastname: Ferreira-Júnior
authors.affiliation: Faculdade de Odontologia, Universidade Federal de Goias, Goiania, Brazil.
authors.forename: Maria do Carmo Matias
authors.initials: Mdo C
authors.lastname: Freire
authors.affiliation: Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil.
authors.forename: Rafael da Silveira
authors.initials: Rda S
authors.lastname: Moreira
authors.affiliation: Faculdade de Odontologia, Universidade Federal de Goias, Goiania, Brazil.
authors.forename: Luciane Rezende
authors.initials: LR
authors.lastname: Costa
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000150:complications / Q000453:epidemiology; D003753:Dental Health Surveys; D004522:Educational Status; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014098:Toothache / Q000453:epidemiology / Q000209:etiology*
keywords: dental caries; epidemiology; multilevel analysis; oral health; socioeconomic factors; toothache