Individual and Contextual Factors Associated with Adolescents' Self-Perceived Need for Treatment.

The present study aimed to investigate associations between the self-perceived dental treatment need and clinical factors, familial characteristics, and school context in adolescents. A cross-sectional study was conducted with a representative sample of 746 students aged 15 to 19 years in a medium-sized city in Brazil. Data collection involved the use of a sociodemographic questionnaire, an oral health questionnaire, and the Family Adaptability and Cohesion Scales (FACES III) instrument. Clinical examinations were performed by two trained and calibrated examiners (Kappa > 0.80) using the Nyvad criteria. A robust logistic regression analysis for complex samples was performed using a multilevel approach (α = 5%). The individual factors associated with the self-perceived treatment need were dental pain (OR = 1.08; 95% CI: 1.01-1.16), the loss of the first molars (OR = 1.09; 95% CI: 1.03-1.15), and disengaged family cohesion (OR = 1.15; 95% CI: 1.01-1.31). In terms of context, attending a public school was associated with the self-perceived treatment need (OR = 1.17; 95% CI: 1.02-1.33). Thus, the individual factors of toothache, tooth loss, and a disengaged family, as well as the school context, exerted an influence on the self-perceived treatment need.

Impact of oral health literacy and psychoactive substances on tooth loss in adolescents.

The aim of the present study was to investigate associations between tooth loss, and oral health literacy, the use of multiple psychoactive substances, and the reason for the last dental appointment in adolescents. A cross-sectional study was conducted with a representative sample of 746 adolescents aged 15-19 years in Campina Grande, Brazil. Parents/guardians answered a sociodemographic questionnaire. The adolescents answered the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), the alcohol, smoking, and substance involvement screening test, and an oral health questionnaire from the National Oral Health Survey. The adolescents were then examined by two examiners who had undergone training and calibration exercises for the diagnosis of tooth loss due to caries (K > 0.80). Associations between variables were investigated using robust logistic regression analysis for complex samples (α = 5%). The prevalence of tooth loss was 17.4%. Oral health literacy (OR = 0.93; 95% CI: 0.89-0.97) was inversely associated with tooth loss, while multiple psychoactive substance use (OR = 2.01; 95% CI: 1.09-3.69) and last dental visit for treatment/symptoms (OR = 3.05; 95% CI: 1.73-5.36) were directly associated with tooth loss. Oral health literacy, multiple psychoactive substance use, and reason for last dental appointment exerted an influence on tooth loss among adolescents.

Structuring of the effects of oral health literacy on dental caries in 12-year-old adolescents.

OBJECTIVES: To explore the pathways by which oral health literacy is associated with dental caries in adolescents, assessing direct and indirect effects of family cohesion and socioeconomic status. METHODS: A population-based, representative cross-sectional study was conducted with 740 12-year-old adolescents in Campina Grande, Brazil. Parents/guardians answered a sociodemographic questionnaire. Adolescents answered validated questionnaires addressing family cohesion and oral health literacy. Dental caries was diagnosed using Nyvad criteria. Two dentists underwent training exercises for the diagnosis and administration of the questionnaires (k > 0.80). Descriptive analysis was followed by the use of structural equation modelling to determine direct and indirect associations between the variables incorporated into the theoretical model of the study (95% CI). RESULTS: Oral health literacy (standardized coefficient: -3.472, p < .01) and mother's schooling (standardized coefficient: -0.405, p < .01) were directly associated with dental caries, whereas family cohesion and socioeconomic status exerted an indirect effect on the occurrence of dental caries in the adolescents. CONCLUSIONS: Sociodemographic factors, family characteristics and oral health literary are associated with dental caries in 12-year-old adolescents.