Association between socioeconomic contextual factor, dental care service availability, and prevalence of periodontitis in Brazil : a multilevel analysis

Abstract

This study aimed to examine the effect of dental care services on periodonti tis cases in Brazilian municipalities. The sample comprised 3,426 individuals aged 35-44 years. Moderate to severe periodontitis with clinical attachment loss and probing depth was the dependent variable, both > 3mm. Its explor atory variables were grouped into four categories: (1) individual characteris tics; (2) contextual development indicators; (3) health service and structural factors; and (4) dental care use. Data were collected using the SBBrasil 2010 Project, the Brazilian Institute of Geography and Statistics, the Brazilian In formation System of Primary and Secondary Care, and the Program to Im prove Access and Quality of Dental Specialization Centers (PMAQ-CEO). Multilevel logistic regression was used to assess associations of periodontitis with individual and context variables. Municipalities with > 1 CEO or > 1 of any centers were associated with periodontitis, with OR = 0.97 (95%CI: 0.55- 1.71) and OR = 0.41 (95%CI: 0.17-0.97), respectively. Prevalence of periodon titis was more likely in older people, lower education levels, and individuals that sought dental visits for pain/extraction and periodontal treatment. Other dental care services availability were not associated with the prevalence of periodontitis.