Dental caries experience and associated factors in 12-year-old-children: a population based-study

Relevant public policies in oral health have been implemented in Brazil since 2004. Changes in the epidemiological status of dental caries are expected, mainly in the child population. This study aimed to assess the dental caries experience and associated factors among 12-year-old children in the state of Sao Paulo, Brazil. A cross-sectional population-based study was conducted with data obtained from 415 cities, including a total of 26,325 schoolchildren who were included by the double-stage cluster technique, by lot and by systematic sampling. The statistical model included data from the Sao Paulo Oral Health Survey (SBSP 2015), the Human Development Index (HDI) and the Social Vulnerability Index (SVI). A theoretical-conceptual model categorized the variables into three blocks, namely, contextual (HDI, SVI, region of residence and fluoridation of water), individual (sex and ethnicity) and periodontal conditions (gingival bleeding, dental calculus and the presence of periodontal pockets), for association with the experience of caries (DMFT). Statistically significant associations were verified by hierarchical multivariate logistic (L) and Poisson (P) regression analyses (p < 0.05). The results showed that 57.7% of 12-year-old children had caries experience. Factors that determined a greater prevalence of dental caries in both models were non white ethnicity (ORL = 1.113, ORP = 1.154) and the presence of gingival bleeding (ORL = 1.204, ORP = 1.255). Male children (ORL= 0.920 ORP = 0.859) and higher HDI (ORL = 0.022), (ORP = 0.040) were associated with a lower prevalence of dental caries experience. Water fluoridation was associated with a lower DMFT index (ORP = 0.766). Dental caries experience is still associated with social inequalities at different levels. Policymakers should direct interventions towards reducing inequalities and the prevalence of dental caries among 12-year-old children.