title: Social Conditions and High Levels of Dental Caries in Five-year-old Children in Brazil.
abstract: OBJECTIVE
  To identify factors associated with dental caries experience in at least four primary teeth in five-year-old Brazilian children.
  
  
  METHODS
  This was a case-control study, part of a prior investigation of the prevalence of dental caries in the primary dentition of five-year-old children conducted in 2006 in public health services in Recife, Brazil. Study patients had a decayed, missing, and filled teeth [dmft] score ≥ 4 and controls had a dmft score ≤ 3. The cutoff point was based on the dmft scores mean value of the study population. Categories of independent variables were sociodemographic, family structure, oral health behavior, and use of oral health services. Crude odds ratios and 95% CI were calculated. Variables associated with dmft greater than or equal to four at a significance level of P≤.20 in univariate analyses were included in multivariate logistic regression models using a backward stepwise variable selection method and permanence criterion in the final model of P≤.10.
  
  
  RESULTS
  The study included 479 children (171 study patients and 308 controls). After controlling for confounding variables, factors associated with a dmft score ≥ 4 were children living in households with at least six people, residence in a poor area, caregiver's low educational level, consumption of sweets between meals, and the reason for and location of oral health care seeking.
  
  
  CONCLUSIONS
  Most factors associated with high levels of dental caries in five-year-old children were related to the social conditions in which they lived.
authors.affiliation: Department of Clinical and Preventive Dentistry, School of Dentistry, Federal University of Pernambuco (UFPE); in Recife, Pernambuco, Brazil. marciamdcm@hotmail.com.
authors.forename: Márcia M
authors.initials: MM
authors.lastname: Dantas Cabral de Melo
authors.affiliation: Aggeu Magalhães/Fiocruz Research Center; in Recife, Pernambuco, Brazil.
authors.forename: Wayner Vieira
authors.initials: WV
authors.lastname: de Souza
authors.affiliation: District VI Oral Health Program; in Recife, Pernambuco, Brazil.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Tavares
authors.affiliation: Aggeu Magalhães/Fiocruz Research Center , School of Medicine, Federal University of Pernambuco (UFPE); in Recife, Pernambuco, Brazil; assistant professor, Department of Social Medicine, School of Medicine, Federal University of Pernambuco (UFPE); in Recife, Pernambuco, Brazil.
authors.forename: Maria Luiza Carvalho
authors.initials: ML
authors.lastname: de Lima
authors.affiliation: Researcher, Department of Child and Adolescent Health, School of Medicine, and an associate professor, Department of Clinical and Preventive Dentistry, School of Dentistry, at the Federal University of Pernambuco (UFPE); in Recife, Pernambuco, Brazil.
authors.forename: Silvia
authors.initials: S
authors.lastname: Jamelli
authors.affiliation: Visiting professor, Department of Clinical and Preventive Dentistry, School of Dentistry, at the Federal University of Pernambuco (UFPE); in Recife, Pernambuco, Brazil.
authors.forename: Geraldo Bosco Lindoso
authors.initials: GB
authors.lastname: Couto
mesh_terms: D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002675:Child, Preschool; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology*; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D012924:Social Conditions; D014094:Tooth, Deciduous