Planning oral health care using the sociodental approach and the index of family living conditions: a cross-sectional study in Brazilian adolescents.
BACKGROUND
Oral health care needs assessment is frequently restricted to clinical measures. Combining normative assessment, behavioural propensity, oral health-related quality of life and information of family living conditions may provide a better comprehensive approach of adolescent's oral health needs assessment. The aim of this study was to compare normative methods of dental caries need with the sociodental approach in 12-year-old adolescents according to family's living conditions in a deprived community in Brazil. In addition, dental caries need assessment using the normative method and the sociodental approach was compared between adolescents living in different living conditions.


METHODS
A cross-sectional survey was conducted in the Manguinhos community in the city of Rio de Janeiro, Brazil. A weighted sample of 159 participants was randomly selected to represent the population of 2004 12-year-old adolescents. Socioeconomic characteristics and living conditions of the family were assessed using the Family Development Index (FDI). Oral health-related quality of life (OHRQoL) was assessed using the generic and CS-Child-OIDP, and adolescent's propensity to adopt oral health promoting behaviours was verified through interviews. Dental caries and treatment need were assessed normatively by clinical oral examinations (DMFT Index) and adolescents were classified into two groups (non severe or severe caries). The sociodental approach included clinical measures of caries, propensity to adopt oral health promoting behaviors and OHRQoL. Families were classified based on the FDI as 'not severe', 'severe' and 'very severe'. Measures of caries, OHRQoL and propensity outcomes were compared between FDI groups using Chi-square and Kruskal-Wallis tests. In addition, dental treatment needs using normative method and sociodental approach were compared for the whole sample and according to FDI groups.


RESULTS
Dental caries, OHRQoL and lower propensity needs were positively associated with FDI severity. The percentages of adolescents with normative dental needs from families with 'very severe', 'severe' and 'not severe' FDI were 59.3, 48.4 and 17.2 % (P < 0.05). Using the sociodental approach, the treatment needs for the three FDI groups decreased to 8.8, 13.6 and 8.6 %, respectively (P < 0.05).


CONCLUSIONS
Using a combination of sociodental approach and the index of family living conditions was useful for defining dental care priorities in adolescents living in deprived communities and can optimise the use of resources in dental services.
National School of Public Health, Oswaldo Cruz Foundation (ENSP⁄FIOCRUZ), Rua Leopoldo Bulhões 1480, Manguinhos, Rio de Janeiro, RJ, CEP: 21041-210, Brazil. fernandanms@gmail.com.
Fernanda Nunes Marques
FN
Alves
National School of Public Health, Oswaldo Cruz Foundation (ENSP⁄FIOCRUZ), Rua Leopoldo Bulhões 1480, Manguinhos, Rio de Janeiro, RJ, CEP: 21041-210, Brazil. carlamv@ensp.fiocruz.br.
Carla Lourenço Tavares
CL
de Andrade
Unit of Dental Public Health, The School of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield, S10 2TA, UK. m.vettore@sheffield.ac.uk.
Mario Vianna
MV
Vettore
D000293:Adolescent; D003430:Cross-Sectional Studies; D003710:Demography; D003731:Dental Caries / Q000453:epidemiology; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D009909:Oral Health; D011788:Quality of Life; D012924:Social Conditions