Caries research · 2026
Social Intersectional Differences in Pulpal Clinical Consequences of Untreated Dental Caries among Brazilian Adolescents: Analysis of the SB Brasil 2023 Survey.
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de Souza Gabriela Scortegagna, Braccini Fagundes Maria Laura, Hugo Fernando Neves, Hilgert Juliana Balbinot, Giordani Jessye Melgarejo do Amaral, do Amaral Júnior Orlando Luiz
Аннотация
INTRODUCTION: The aim of the study was to examine differences in the occurrence of consequences of untreated dental caries (pulpal involvement, ulceration, fistula, and abscess-PUFA) across intersectional social positions defined by sex, skin color, and household income among adolescents.
METHODS: This study analyzed data from the Brazilian National Oral Health Survey (SB Brasil 2023), using a multistage stratified probability sampling design to represent adolescents aged 15-19 years. Social variables were combined into 8 intersectional groups based on sex, skin color, and family income. Outcomes included PUFA prevalence ≥1 and counts of its components. Survey-adjusted Poisson regression with robust variance and a three-way interaction term was applied.
RESULTS: The sample comprised 4,892 adolescents. Compared to high-income White males, prevalence was higher among low-income Black males (PR = 5.93; 95% CI: 2.60-13.51) and low-income Black females (PR = 4.06; 95% CI: 1.85-8.90). The predicted prevalence of PUFA ≥1 ranged from 4.0% (95% CI: 2.0-7.0) among high-income White males to 21.0% (95% CI: 11.0-32.0) among low-income Black males. Among females, prevalence estimates were 15.0% (95% CI: 9.0-20.0) in high-income Black, 16.0% (95% CI: 5.0-28.0) in low-income White, and 18.0% (95% CI: 12.0-24.0) in low-income Black individuals.
CONCLUSION: Marked differences in PUFA occurrence were observed across intersectional social positions, with the highest burden observed among low-income Black adolescents, particularly males for prevalence ratios, although females also presented high absolute prevalence. These findings reinforce the need for policies addressing structural social inequalities in oral health.
METHODS: This study analyzed data from the Brazilian National Oral Health Survey (SB Brasil 2023), using a multistage stratified probability sampling design to represent adolescents aged 15-19 years. Social variables were combined into 8 intersectional groups based on sex, skin color, and family income. Outcomes included PUFA prevalence ≥1 and counts of its components. Survey-adjusted Poisson regression with robust variance and a three-way interaction term was applied.
RESULTS: The sample comprised 4,892 adolescents. Compared to high-income White males, prevalence was higher among low-income Black males (PR = 5.93; 95% CI: 2.60-13.51) and low-income Black females (PR = 4.06; 95% CI: 1.85-8.90). The predicted prevalence of PUFA ≥1 ranged from 4.0% (95% CI: 2.0-7.0) among high-income White males to 21.0% (95% CI: 11.0-32.0) among low-income Black males. Among females, prevalence estimates were 15.0% (95% CI: 9.0-20.0) in high-income Black, 16.0% (95% CI: 5.0-28.0) in low-income White, and 18.0% (95% CI: 12.0-24.0) in low-income Black individuals.
CONCLUSION: Marked differences in PUFA occurrence were observed across intersectional social positions, with the highest burden observed among low-income Black adolescents, particularly males for prevalence ratios, although females also presented high absolute prevalence. These findings reinforce the need for policies addressing structural social inequalities in oral health.