Social inequalities and untreated dental caries in 5-year-old children: an intersectional analysis based on SB Brasil 2023.

OBJECTIVE

To identify intersectional vulnerability profiles among 5-year-old children with untreated dental caries and to analyze associated social inequalities in Brazil.

METHODS

This is a population-based, cross-sectional study using data from the National Survey of Oral Health (SB Brasil 2023). Five-year-old children examined in the survey were included. The variables used to identify profiles were: race/skin color, household income, maternal level of education, beneficiaries of social welfare programs, and region of residence. For profile comparison, the variables "last dental appointment" and "presence of piped water at home" were used. Descriptive, bivariate (χ²), Two-Step Cluster, and binary and multinomial logistic regression analyses were performed.

RESULTS

A total of 7,185 children were analyzed, of whom 44.8% presented untreated dental caries. Higher prevalence values were observed among children with low maternal education (51.9%), Black (49.9%) and Indigenous (75.0%), low income (54.1%), living in the North (56.3%) region, and beneficiaries of social welfare programs (53.0%) (p<0.001). Three profiles were identified: Profile A (boys, Black, from the Northeast, low income, and high dependence on social welfare programs) showed lower probability of dental appointment in the past 2 years (OR 0.59; 95%CI 0.48-0.73; p<0.001); Profile B (boys, White, from the Northeast, low income, and beneficiaries of social welfare programs) showed worse conditions regarding the presence of piped water at home (OR 0.38; 95%CI 0.19-0.76; p=0.006); and Profile C (girls, Black, from the North, higher income, and lower dependence on social welfare programs) concentrated the best conditions for dental appointment and piped water (p<0.001).

CONCLUSION

Untreated dental caries among 5-year-old children reflects structural inequities combining racial, socioeconomic, territorial, and income-related inequalities.