Lifetime Use of Dental Services and Dental Caries in Adolescents in 2004 Pelotas Birth Cohort.

Abstract

Objective: To examine the association between the lifetime utilisation of dental services and dental caries experience in mixed dentition among adolescents participating in the 2004 Pelotas Birth Cohort, Southern Brazil.

Methods: This longitudinal study analysed a sample of 996 adolescents aged 12-13 years. Dental caries experience and untreated dental caries were the outcomes, assessed by the mean of decayed, missed and filled in deciduous (dmfs index) and in permanent (DMFS index) teeth, based on World Health Organization criteria. The main exposure was lifetime use of dental services, defined as: always have gone to the dentist for preventive reason; have gone to the dentist at times for preventive reason, at times for problem-oriented reason; always have gone to the dentist for problem-oriented reason (reference category). Family income mobility during the first 4 years of the child's life, maternal schooling, adolescent sex and skin colour were the confounders. Crude and adjusted analyses were conducted using negative binomial regression, estimating mean ratios (MR), and 95% confidence intervals (95% CI).

Results: In the adjusted analysis, adolescents who consistently utilised dental services for preventive reasons exhibited a mean 49% lower dental caries indexes (MR = 0.51; 95% CI 0.35-0.76) and 56% lower mean of untreated dental caries (MR = 0.44; 95% CI 0.26-0.74) compared to their counterparts who consistently sought dental care for problem-oriented reasons. The utilisation of dental services occasionally for preventive reasons and occasionally for problem-oriented reasons was also associated with lower caries indexes.

Conclusion: The lifetime utilisation of dental services, whether always or occasionally for preventive reasons, was found to be a protective factor for dental caries in adolescence. These findings reinforce the importance of raising awareness among the public regarding the preventive use of dental services. Additionally, there is a need to organise dental services to facilitate the provision of preventive dental care since early childhood.