Gains in children's dental health differ by socioeconomic position: evidence of widening inequalities in southern Brazil

儿童牙齿健康改善情况因社会经济地位而异:巴西南部不平等现象日益加剧的证据

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Abstract

Oral health inequalities are the measures by which equity in oral health is tracked. Despite widespread improvement in children's dental health globally, substantial socio-economic disparities persist and may be worsening. OBJECTIVES: Quantify 10-year changes in child caries occurrence by socio-economic position in a Southern Brazilian city and compare oral health inequalities over time. METHODS: Representative surveys of dental caries in children (age <6 years) in Canoas, Brazil, were conducted in 2000 and 2010 following standardized methods. For each survey year, we calculated disparities by socio-economic position (maternal education and family income) in age- and sex-standardized caries occurrence (prevalence: dmft > 0; severity: mean dmft) using absolute measures (difference and Slope Index of Inequality) and relative measures (ratio and Relative Index of Inequality). RESULTS: Comparing 2010 to 2000, caries occurrence was lower in all socio-economic strata. However, reductions were more pronounced among socio-economically advantaged groups, yielding no improvement in children's oral health disparities. Some disparity indicators were consistent with increasing inequality. CONCLUSIONS: Overall, dental caries levels among children in Canoas improved, but inequalities in disease distribution endured. Concerted public health efforts targeting socio-economically disadvantaged groups are needed to achieve greater equity in children's oral health.

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