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Income inequality and traumatic dental injuries in 12‐year‐old children: A multilevel analysis
Author(s) -
Vettore Mario Vianna,
Efhima Salma,
Machuca Carolina,
Lamarca Gabriela de Almeida
Publication year - 2017
Publication title -
dental traumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 81
eISSN - 1600-9657
pISSN - 1600-4469
DOI - 10.1111/edt.12350
Subject(s) - overjet , gini coefficient , medicine , demography , economic inequality , socioeconomic status , odds ratio , logistic regression , inequality , population , dentistry , malocclusion , environmental health , sociology , mathematical analysis , mathematics , pathology
Abstract Background/Aim Contextual socio‐economic factors have been associated with traumatic dental injuries ( TDI s). However, evidence concerning the role of income inequality on TDI s in children is scarce. The aim of this study was to investigate the association between contextual income inequality over a 10‐year period and TDI s in Brazilian children. Subjects and Methods The study population comprised a representative sample of 5027 children aged 12 years who participated in the Brazilian oral health survey in 2010. City‐level Gini Index was used to measure contextual income inequality in the years 2000 and 2010, as well as the variation in income inequality between 2000 and 2010. Covariates were gender, ethnicity, family income, number of people per room and incisal overjet. Clinical examinations were used to assess TDI s. Multivariable multilevel ordered multinomial logistic regression was used to estimate cumulative Odds Ratio ( OR ) and 95% confidence intervals between income inequality and TDI s. Results The prevalence of children who had one tooth with TDI and two or more teeth with TDI s was 15.2% and 6.4%, respectively. The maxillary central and left lateral incisors were the teeth most affected by TDI s. Gini coefficient reduction between the years 2000 and 2010 decreased the odds of TDI s even after adjustment for demographic and socio‐economic characteristics, and incisal overjet. The likelihood of more TDI s decreased 21% for each 0.05 unit decrease in the Gini coefficient between the years 2000 and 2010. Boys, brown skin colour, overcrowding and incisal overjet greater than 5 mm remained statistically associated with TDI s in the final model. Conclusions The decrease in income inequality over a 10‐year period was inversely associated with TDI s among Brazilian children aged 12 years.