title: Association between dental pain and caries: a multilevel analysis to evaluate the influence of contextual and individual factors in 34 843 adults.
abstract: OBJECTIVE
  To evaluate the influence of the social context and individual factors on the relationship between oral pain and caries METHODS: Data from the 2007 National Public Health Survey in Colombia were collected. A multiple-stage stratified sampling was used. The influence of different factors in oral pain was investigated with logistic and multilevel regression analyses.
  
  
  RESULTS
  A total of 34 843 individuals (individual level) in 32 states and one Capital District (contextual level) were studied. Dental pain was associated with caries in the logistic (odds ratios = 56.2, confidence interval 49.5-63.9) and multilevel (3.342 ± 0.073; P < 0.0001) models. After adjusting for covariables, dental pain variance was still significant at individual and contextual levels; interestingly the variation in individual level was smaller (28%) than the variation among states (72%). In addition, individual-level variables explained 80% of the individual-level variance in dental pain, and contextual-level variables explained 35% of the community-level variance. All individual variables, including caries, had a significant association with dental pain. Low gross domestic product (GDP) and human development index (HDI) at contextual level were associated with dental pain.
  
  
  CONCLUSIONS
  Dental pain associated strongly with caries and other individual factors were also significant, however, contextual factors, specifically low GDP and HDI affect dental pain significantly.
authors.affiliation: Biomedical Stomatology Research Group, Universidad de Antioquia U de A, Medellín, Colombia. martin.ardila@udea.edu.co.
authors.forename: Carlos Martín
authors.initials: CM
authors.lastname: Ardila
authors.affiliation: Research Center, School of Dentistry Universidad de Antioquia U de A, Medellín, Colombia.
authors.forename: Andrés A
authors.initials: AA
authors.lastname: Agudelo-Suárez
mesh_terms: D000328:Adult; D000367:Age Factors; D003105:Colombia; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000150:complications* / Q000453:epidemiology; D003753:Dental Health Surveys; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D016017:Odds Ratio; D012737:Sex Factors; D012923:Social Class; D012931:Social Environment; D011795:Surveys and Questionnaires; D014098:Toothache / Q000453:epidemiology / Q000209:etiology*
keywords: dental caries; multilevel analyses; self-report; socioeconomic factors; toothache