The influence of family income trajectories from birth to adulthood on adult oral health: findings from the 1982 Pelotas birth cohort.
ABSTRACT We assessed whether 3 models of life course socioeconomic status (critical period, accumulation of risk, and social mobility) predicted unsound teeth in adulthood among a Brazilian cohort.
Life course data were collected on the 5914 live-born infants in the 1982 Pelotas Birth Cohort study. Participants' oral health was assessed at 15 (n = 888) and 24 (n = 720) years of age. We assessed family income trajectories and number of episodes of poverty in the life course through Poisson regressions, yielding unadjusted and adjusted prevalence ratios for number of unsound teeth at age 24 years.
The adjusted prevalence ratio for participants born into poverty was 30% higher than for those who were not. Participants who were always poor had the highest prevalence of unsound teeth; those who were downwardly or upwardly mobile also had more unsound teeth than did other participants, after adjustment for confounders. More episodes of poverty were associated with greater prevalence of unsound teeth in adulthood.
Poverty at birth and during the life course was correlated with the number of unsound teeth at 24 years of age.
Dataset: Factors associated with prevalence of oral lesions and oral self-examination in young adults from a birth cohort in Southern Brazil.[show abstract] [hide abstract]
ABSTRACT: 155 Factors associated with prevalence of oral lesions and oral self-examination in young adults from a birth cohort in Southern Brazil Fatores associados à prevalência de lesões bucais e à realização do autoexame bucal em adultos jovens de uma coorte de nascidos vivos do Sul do Brasil Factores asociados a la prevalencia de lesiones bucales y a la realización del autoexamen bucal en adultos jóvenes de una cohorte de nacidos vivos del sur de Brasil Abstract The objective of this study was to assess the prev-alence and characteristics of oral lesions and oral self-examination and the association between these variables and life course determinants in a young population. A representative sample (n = 720) of all births occurring in Pelotas, Rio Grande do Sul State, Brazil, in 1982, was investigated and the outcomes were assessed in 2006. Data regard-ing exploratory variables was collected from other cohort waves. The prevalence of oral lesions was 23.3% (95%CI: 20.3-26.6). A total of 31% of indi-viduals (95%CI: 27.6-34.4) reported never having performed oral self-examination. Multivariable analysis showed that low socio-economic status at birth, lack of oral hygiene instruction from a dentist up to the age of 15 years and smoking habits at the age of 22 year were associated with the presence of oral lesions. Performing oral self-examination was associated with high levels of maternal schooling at birth and having received oral hygiene orientation from a dentist up to the age of 15 years. Socioeconomic and behavioral factors are associated with both presence of oral mucosal lesions and the habit of performing self-examination.
[show abstract] [hide abstract]
ABSTRACT: OBJECTIVE: To assess the relation between race and tooth loss, as well as the influence of socioeconomic factors, health behaviours, routine dental care and self-reported discrimination on this association. METHODS: This is a cross-sectional study with data collected from the baseline of the Pró-Saúde Study (Rio de Janeiro/Brazil), among 3253 civil servants in 1999-2001. Race was measured as self-reported skin colour (Black/Brown/White). The outcome was self-reported tooth loss, measured in four ordered categories (none/one or few/many/all or almost all). Three mediating pathways were explored between race and tooth loss. The first included self-reported discrimination assessed with a five-item scale. The second pathway included behavioural factors: routine dental care, marital status, smoking and alcohol consumption. The third considered socioeconomic factors: income, education, maternal education and early life poverty. Confounding factors were age and sex. Statistical analyses were carried out with ordinal logistic regression. RESULTS: Absence of all or almost all teeth was reported by 8% of respondents. White individuals comprised 53% of the population, followed by Browns (26%) and Blacks (22%). After adjustment, Blacks had an odds ratio of being in a higher category of missing teeth equal to 1.39 (95% CI 1.12-1.72), and Browns, 1.33 (95% CI 1.10-1.60), when compared to Whites. Age, sex and socioeconomic variables explained most of racial inequalities in tooth loss, while behavioural and discrimination variables contributed very little. Behavioural and socioeconomic variables were associated with tooth loss, while discrimination was not. No statistically significant interactions were found. CONCLUSIONS: There is an association between race and tooth loss that is mainly explained by current and early life socioeconomic variables, but not by behavioural factors and self-reported discrimination.Community Dentistry And Oral Epidemiology 05/2013; · 1.89 Impact Factor
Article: Challenges in comparing the methods and findings of cohort studies of oral health: the Dunedin (New Zealand) and Pelotas (Brazil) studies.[show abstract] [hide abstract]
ABSTRACT: to systematically compare methods and some findings from two prospective cohort studies of oral health. This paper describes and compares two such population-based birth cohort studies of younger adults: the Dunedin Multidisciplinary Health and Development Study (conducted in New Zealand); and the 1982 Pelotas Birth Cohort Study (conducted in Brazil). The two cohorts showed socio-demographic similarities and differences, with their gender mixes being similar, but their ethnic compositions differing markedly. There were some important similarities and differences in methods. Overall dental caries experience was higher among the Dunedin cohort. Each of the studies has examined the association between childhood-adulthood changes in socio-economic status and oral health in the mid-20s. Both studies observed the greatest disease experience among those who were of low SES in both childhood and adulthood, and the least among those who were of high SES in both childhood and adulthood. In each cohort, disease experience in the upwardly mobile and downwardly mobile groups lay between those two extremes. There are important similarities and differences in both methods and findings. While the need for a degree of methodological convergence in future is noted, the two studies are able to use each other as replicate samples for research into chronic oral conditions.Australian and New Zealand Journal of Public Health 12/2011; 35(6):549-56. · 1.20 Impact Factor