Os determinantes sociais de saúde e a experiência de cárie da primeira infância em uma escola municipal de Fortaleza

Abstract

Early childhood caries is characterized by the presence of one or more decayed primary teeth missing or restored as a result of the disease in children up to 71 months. Several factors are related to the worsening of the disease, such as sociodemographic, environmental, psychosocial and individual factors. Social capital defined as the sum of resources that individuals or groups acquire through social relationships networks has been positively associated with general indicators of health and oral health. The objective of this study was to investigate the relationship between social determinants of health, among them social capital, and early childhood caries in a municipal school in Fortaleza. A cross-sectional study was carried out with 100 children from Adroaldo Teixeira Castelo School. Children up to 5 years and 11 months of age were included in the study. For the oral examination in children, the International Caries Detection and Assessment System (ICDAS) was used. Those responsible for the children were interviewed through a structured questionnaire that addressed the social capital, evaluated through the network of support and social support, as well as socioeconomic factors, oral health habits and use of the dental service. The chi-square test was used for bivariate analysis, as well as logistic regression, considering the 95% confidence interval, with a significance level of 5%. The research was approved by the research ethics committee. An association between dental caries and socioeconomic factors was observed, such as number of siblings living in the same household (p = 0.012) (PR = 1.77) and household agglomeration (p = 0.013) (PR = 0.248). It was also observed an association between the occurrence of caries and the visit to the dentist (p = 0.011) (PR = 1.99). The social capital showed an inverse correlation with the number of decayed teeth (p = 0.028) (r = - 0.219). It is suggested that social capital influences the health of individuals through mechanisms such as the diffusion of health-friendly behaviors, psychosocial factors and civic engagement. The role of social capital over oral health conditions is not yet clear, according to the study's finding, the social support of caregivers is associated with greater attention in oral health of children, implying better health status preschool children whose caregivers had better social support.