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Contextual and individual determinants of periodontal disease: Multilevel analysis based on Andersen's model
Author(s) -
Valente Maria I. B.,
Vettore Mario V.
Publication year - 2018
Publication title -
community dentistry and oral epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.061
H-Index - 101
eISSN - 1600-0528
pISSN - 0301-5661
DOI - 10.1111/cdoe.12349
Subject(s) - medicine , poisson regression , periodontal disease , multilevel model , disease , gerontology , association (psychology) , gingival and periodontal pocket , demography , dentistry , population , environmental health , psychology , machine learning , sociology , computer science , psychotherapist
Aim To investigate the relationship of contextual and individual factors with periodontal disease in dentate adults and older people using the Andersen's behavioural model. Methods Secondary individual data from 6011 adults and 2369 older people from the Brazilian Oral Health Survey (2010) were combined with contextual data for 27 cities. Attachment loss ( AL ) categories for each sextant were coded and summed to obtain the periodontal disease measure. The association of predisposing, enabling and need characteristics at city and individual level with periodontal disease was assessed using an adapted version of the Andersen's behavioural model. Multilevel Poisson regression was used to estimate rate ratios ( RR ) and 95% CI s. Results Periodontal disease was associated with contextual predisposing ( RR 0.93; 95% CI = 0.87‐0.99) and enabling factors ( RR 0.99; 95% CI = 0.98‐0.99) in adults. Contextual predisposing was also associated with periodontal disease in older people ( RR 0.82; 95% CI = 0.73‐0.92). Individual predisposing (age, sex and schooling) and need characteristics (perceived treatment need) were common predictors of periodontal disease in adults and older people. Periodontal disease was also associated with behaviours in the latter age group. Conclusion Contextual predisposing factors and individual characteristics influenced periodontal disease experience in adults and older people. Contextual enabling factors were also meaningful determinants of periodontal disease in the former age group.