Self-reported oral health among Brazilian adults: results from the National Health Surveys 2013 and 2019

Corassa, Rafael Bello; Silva, Carlos José de Paula; Paula, Janice Simpson de; Aquino, Érika Carvalho de; Sardinha, Luciana Monteiro Vasconcelos; Alves, Paula Aryane Brito

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Brasil

Epidemiologia e Serviços de Saúde

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Brasil

Español English

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Sumário

Original Article • Epidemiol. Serv. Saúde 31 (spe1) • 2022 • https://doi.org/10.1590/SS2237-9622202200014.especial copy

Self-reported oral health among Brazilian adults: results from the National Health Surveys 2013 and 2019

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To evaluate indicators of oral health conditions and behaviours among Brazilian adults in the 2019 National Health Survey (PNS) and analyse the evolution of those indicators compared to the 2013 PNS.

Methods:

Cross-sectional study. Prevalence ratios of oral health conditions and behaviours, in 2019, were estimated by demographic characteristics. Risk ratios were computed using Poisson regression, and absolute differences (Dif.) between indicators in 2013 and 2019 were calculated.

Results:

Prevalence of brushing teeth twice a day, using toothbrush/toothpaste/floss and edentulism were, respectively, 93.6% (95%CI 93.3;93.9), 63.0% (95%CI 62.3;63.6) and 10.3% (95%CI 9.93;10.7). There was increase in prevalence of brushing teeth ≥ 2 a day (Dif. = 4.5; 95%CI 3.9;5.1), using toothbrush/toothpaste/floss (Dif. = 10.0; 95%CI 8.6;11.3) and a decrease in prevalence of edentulism (Dif. = -0.7; 95%CI -1.3;-0.1).

Conclusion:

Respondents who were younger, more educated, with higher income and lived in urban areas had better oral health indicators. Most indicators demonstrated positive improvement.

Keywords:
Oral Health; Health Surveys; Public Health Surveillance; Health Status Disparities; Cross-Sectional Studies

Variables	2019		2013		Difference^a		p-value^d
Variables	%	95%CI^c	%	95%CI^c	Dif.	95%CI^c
Brushing teeth at least twice a day	93.6	93.3;93.9	89.1	88.6;89.6	4.5	3.9;5.1	< 0.001
Using a toothbrush, toothpaste and dental floss for teeth cleaning	63.0	62.2;63.7	53.0	52.0;54.0	10,0	8.6;11.3	< 0.001
Self-assessment of oral health as good or very good	69.7	69.1;70.3	67.4	66.7;68.2	2.2	1.2;3.3	< 0.001
Total tooth loss	10.3	9.9;10.7	11.0	10.5;11.5	-0.7	-1.3;-0.1	0.021
Use of some type of dental prosthesis^b	45.9	45.2;46.6	46.5	45.6;47.4	-0.6	-1.8;0.6	0.339
Intense or very intense difficulty in eating due to teeth or prosthesis problems	1.8	1.7;2.0	1.5	1.4;1.7	0.3	0.1;0.6	0.017

	Brushing teeth at least twice a day						Use of toothbrush, toothpaste and dental floss for teeth cleaning
	n^a	%	95%CI^c	PR^d	95%CI^c	p-value^e	n^a	%	95%CI^c	PR^d	95%CI^c	p-value^e
Sex
Male	37,402	91.7	91.2;92.2	1.00		< 0.001	21,715	57.6	56.7;58.6	1.00		< 0.001
Female	44,279	95.3	95.0;95.6	1.04	1.03;1.05		29,134	67.7	66.9;68.4	1.17	1.15;1.20
Age group (years)
18 to 29	14,836	96,0	95.4;96.7	1.00		< 0.001	10,211	69.8	68.5;71.1	1.00		< 0.001
30 to 39	17,493	96.7	96.3;97.2	1.01	1.00;1.02		12,772	74.8	73.7;75.9	1.07	1.05;1.10
40 to 59	30,238	94.6	94.2;95.0	0.99	0.98;0.99		19,529	65.8	64.8;66.8	0.94	0.92;0.96
≥ 60	19,114	86.5	85.8;87.2	0.90	0.89;0.91		8,337	39.8	38.6;41.0	0.57	0.55;0.59
Education
No schooling and incomplete elementary education	30,377	87.5	86.9;88.0	1.00		< 0.001	11,903	38.5	37.5;39.4	1.00		< 0.001
Complete elementary education and incomplete high school	11,318	94.4	93.6;95.2	1.08	1.07;1.09		6,857	61,0	59.5;62.6	1.59	1.53;1.65
Complete high school and incomplete higher education	26,594	97.3	97.0;97.7	1.11	1.10;1.12		20,181	76.5	75.6;77.4	1.99	1.94;2.04
Complete higher education	13,392	98.2	97.9;98.6	1.12	1.11;1.13		11,908	88.6	87.6;89.5	2.30	2.24;2.37
Race/skin color^b
White	30,273	94.5	94.1;94.9	1.00		< 0.001	20,753	68.1	67.1;69.2	1.00		< 0.001
Black	9,239	92.7	91.8;93.5	0.98	0.97;0.99		5,519	59.1	57.4;60.7	0.87	0.84;0.89
Brown	40,927	93,0	92.6;93.4	0.98	0.98;0.99		23,767	58.7	57.8;59.6	0.86	0.84;0.88
*Household income per capita* (minimum wage)**
Up to 1	43,555	91.4	90.9;91.8	1.00		< 0.001	22,963	53.4	52.5;54.3	1.00		< 0.001
More than 1 to 3	27,874	95.5	95.1;95.8	1.04	1.04;1.05		19,206	69.6	68.6;70.6	1.30	1.28;1.33
More than 3	10,230	97.5	96.9;97.9	1.07	1.06;1.07		8,660	83.8	82.5;85.0	1.57	1.53;1.66
Place of residence
Urban	64,237	94.6	94.3;94.9	1.08	1.07;1.09	< 0.001	43,203	66.2	65.5;67.0	1.55	1.51;1.60	< 0.001
Rural	17,444	87.7	86.8;88.6	1.00			7,646	42.6	41.3;43.9	1.00

	Self-rated oral health as good or very good						Loss of all teeth
	n^a	%	95%CI^c	PR^d	95%CI^c	p-value^e	n^a	%	95%CI^c	PR^d	95%CI^c	p-value^e
Sex
Male	27,462	68.3	67.4;69.1	1.00		< 0.001	3,984	7.7	7.3;8.2	1.00		< 0.001
Female	32,423	70.9	70.1;71.7	1.04	1.02;1.06		6,714	12.5	12.0;13.0	1.62	1.51;1.73
Age group (years)
18 to 29	11,224	74.9	73.7;76.1	1.00		< 0.001	26	0.2	0.1;0.3	1.00		< 0.001
30 to 39	12,923	72.5	71.4;73.7	0.97	0.95;0.99		80	0.4	0.3;0.5	2.10	1.10;4.01
40 to 59	21,015	66.7	65.6;67.7	0.89	0.87;0.91		2,234	6.3	5.8;6.8	36.04	20.71;62.73
≥ 60	14,723	66.5	65.4;67.6	0.89	0.87;0.91		8,358	36.8	35.7;37.9	211.69	122.34;366.29
Education
No schooling and incomplete elementary education	21,188	60.4	59.4;61.3	1.00		< 0.001	8,606	23.5	22.7;24.4	1.00		< 0.001
Complete elementary education and incomplete high school	7,777	65.8	64.2;67.3	1.09	1.06;1.12		856	5.9	5.3;6.7	0.25	0.22;0.28
Complete high school and incomplete higher education	19,669	74.3	73.4;75.1	1.23	1.21;1.25		922	2.7	2.4;3.0	0.11	0.10;0.13
Complete higher education	11,251	83.6	82.5;84.7	1.39	1.36;1.41		314	2.0	1.6;2.4	0.08	0.07;0.10
Race/skin color^b
White	23,588	74.8	73.9;75.7	1.00		< 0.001	4,144	10.9	10.3;11.5	1.00		< 0.001
Black	6,325	63.2	61.6;64.8	0.84	0.82;0.87		1,153	9.5	8.6;10.4	0.87	0.78;0.97
Brown	29,104	66.3	65.5;67.2	0.89	0.87;0.90		5,249	9.9	9.5;10.4	0.91	0.85;0.98
*Household income per capita* (minimum wage)**
Up to 1	29,778	62.9	62.1;63.7	1.00		< 0.001	6,206	11.2	10.8;11.7	1.00		< 0.001
More than 1 to 3	21,433	74.6	73.6;75.5	1.18	1.16;1.21		3,856	10.7	10.1;11.3	0.95	0.89;1.02
More than 3	8,655	83.9	82.6;85.1	1.33	1.31;1.36		636	4.9	4.3;5.5	0.44	0.38;0.50
Place of residence
Urban	47,363	70.9	70.2;71.5	1.14	1.11;1.16	< 0.001	7,443	9.6	9.3;10.0	0.67	0.63;0.72	< 0.001
Rural	12,522	62.3	61.1;63.5	1.00			3,255	14.3	13.5;15.1	1.00

	Use of some type of dental prosthesis^a						Intense or very intense difficulty in eating due to teeth or prosthesis problems
	n^b	%	95%CI^d	PR^e	95%CI^d	p-value^f	n^b	%	95%CI^d	PR^e	95%CI^d	p-value^f
Sex
Male	13,066	41.0	39.9;42.0	1.00		0.001	750	1.3	1.2;1.5	1.00		< 0.001
Female	19,335	50.0	49.0;50.9	1.22	1.18;1.26		1,173	2.3	2.0;2.6	1.75	1.46;2.10
Age group (years)
18 to 29	429	6.3	5.3;7.5	1.00		< 0.001	104	0.6	0.4;0.8	1.00		< 0.001
30 to 39	2,096	17.5	16.3;18.7	2.77	2.29;3.34		186	0.8	0.7;1.0	1.49	0.99;2.23
40 to 59	13,834	49.5	48.4;50.6	7.85	6.58;9.37		762	2.2	1.8;2.6	3.87	2.63;5.71
≥ 60	16,042	75.0	74.1;76.0	11.90	9.98;14.20		871	3.6	3.2;4.1	6.43	4.47;9.25
Education
No schooling and incomplete elementary education	18,010	56.4	55.5;57.4	1.00		< 0.001	1,380	3.8	3.4;4.2	1.00		< 0.001
Complete elementary education and incomplete high school	3,796	40.6	38.7;42.5	0.72	0.69;0.75		222	1.5	1.2;1.8	0.39	0.31;0.49
Complete high school and incomplete higher education	6,774	34.5	33.2;35.7	0.61	0.59;0.64		254	0.7	0.6;0.9	0.18	0.15;0.23
Complete higher education	3,821	42.9	41.2;44.7	0.76	0.73;0.80		67	0.5	0.3;0.7	0.12	0.08;0.20
Race/skin color^c
White	13,077	50.7	49.6;51.9	1.00		< 0.001	579	1.5	1.2;1.9	1.00		< 0.001
Black	3,271	40.7	38.8;42.7	0.80	0.76;0.85		293	3.2	2.6;4.0	2.14	1.58;2.90
Brown	15,544	42.5	41.5;43.5	0.84	0.81;0.87		1,024	1.9	1.7;2.1	1.23	0.98;1.54
*Household income per capita* (minimum wage)**
Up to 1	15,959	40.2	39.3;41.0	1.00		< 0.001	1,365	2.6	2.3;2.9	1.00		< 0.001
More than 1 to 3	12,238	51.7	50.5;52.9	1.29	1.25;1.33		475	1.3	1.1;1.5	0.51	0.41;0.62
More than 3	4,199	54.2	52.0;56.3	1.35	1.29;1.41		83	0.6	0.4;0.8	0.22	0.15;0.33
Place of residence
Urban	24,847	46.4	45.6;47.2	1.07	1.03;1.11	< 0.001	1,352	1.7	1.6;2.0	0.69	0.58;0.81	< 0.001
Rural	7,554	43.4	42.0;44.7	1.00			571	2.5	2.2;2.9	1.00

	Brushing teeth at least twice a day		Use of toothbrush, toothpaste, and dental floss for teeth cleaning		Self-rated oral health as good or very good		Loss of all teeth		Use of some kind of dental prosthesis^a		Intense or very intense difficulty eating due to problems with teeth or prosthesis
	Dif.^b	95%CI^g	Dif.^b	95%CI^g	Dif.^b	95%CI^g	Dif.^b	95%CI^g	Dif.^b	95%CI^g	Dif.^b	95%CI^g
Sex
Male	3.8^f	3.1;4.5	10.6^f	9.1;12.0	2.0^e	0.7;3.3	-0.8	-1.7;0.0	-1.4	-2.9;0.1	0.6^e	0.2;1.0
Female	5.2^f	4.3;6.2	9.2^f	7.5;11.0	2.5^e	1.1;3.9	-0.6	-1.4;0.2	0.2	-1.5;2.0	-0.1	-0.4;0.2
Age group (years)
18 to 29	1.1^d	0.1;2.0	8.4^f	6.2;10.6	0.9	-0.9;2.7	0.1^e	0.0;0.2	-1.5	-3.2;0.1	0.0	-0.3;0.3
30 to 39	2.1^f	1.4;2.9	9.9^f	7.9;11.9	2.4^e	0.6;4.2	-0.2	-0.4;0.0	-8.0^f	-10.0;-6.0	0.1	-0.2;0.4
40 to 59	5.1^f	4.2;6.0	14.1^f	12.3;15.9	3.2^f	1.5;4.8	-3.6^f	-4.5;-2.6	-6.3^f	-8.1;-4.5	0.3	-0.2;0.8
≥ 60	13.1^f	11.3;14.8	10.7^f	8.4;13.0	4.2^f	2.2;6.3	-4.7^f	-6.8;-2.6	2.9^e	1.0;4.7	0.3	-0.4;1.0
Education
No schooling and incomplete elementary education	7.8^f	6.7;8.9	9.3^f	7.7;10.8	2.9^f	1.4;4.4	0.7	-0.6;2.0	1.8^d	0.1;3.5	0.6	0.0;1.1
Complete elementary education and incomplete high school	2.1^e	0.8;3.5	8.5^f	6.0;11.0	-1.0	-3.3;1.2	-0.6	-1.8;0.7	-1.2	-4.2;1.8	0.7^f	0.3;1.1
Complete high school and incomplete higher education	1.8^f	1.1;2.5	6.8^f	5.2;8.4	1.0	-0.5;2.4	0.1	-0.3;0.6	-0.7	-2.7;1.3	0.3^d	0.0;0.5
Complete higher education	0.5	-0.2;1.2	5.4^f	3.6;7.1	0.2	-1.7;2.0	-0.1	-0.7;0.5	-3.1	-6.5;0.3	0.3^d	0.1;0.5
Race/skin color^c
White	4.2^f	3.4;5.0	8.2^f	6.5;10.0	1.7^d	0.3;3.0	-0.7	-1.6;0.2	-2.1^d	-3.9;-0.3	0.2	-0.2;0.6
Black	4.6^f	2.9;6.4	15.5^f	12.4;18.6	2.0	-0.9;4.9	-1.5	-3.4;0.4	0.0	-3.4;3.4	1.0^d	0.0;2.0
Brown	5.1^f	4.2;5.9	11.6^f	9.9;13.3	3.9^f	2.5;5.3	-0.5	-1.3;0.4	1.4	-0.3;3.0	0.2	-0.1;0.5
*Household income per capita* (minimum wage)**
Up to 1	5.6^e	4.7;6.5	11.9^e	10.4;13.5	3.0^e	1.7;4.3	-1.0^c	-1.8;-0.1	-0.6	-2.1;1.0	0.3	-0.2;0.7
More than 1 to 3	4.2^e	3.4;5.0	10.4^e	8.7;12.1	2.7^e	1.3;4.2	-0.6	-1.6;0.4	-0.6	-2.5;1.3	0.3	0.0;0.6
More than 3	1.4^d	0.5;2.4	3.2^d	1.2;5.2	-0.5	-2.5;1.4	-0.3	-1.3;0.7	-0.9	-4.2;2.5	0.3^c	0.1;0.6
Place of residence
Urban	8.7^f	7.0;10.3	12.2^f	9.9;14.6	5.7^f	3.7;7.8	-0.7	-2.1;0.8	1.9	-0.7;4.4	0.2	-0.4;0.8
Rural	3.8^f	3.2;4.4	9.6^f	8.2;11.0	1.7^e	0.6;2.8	-0.7^d	-1.4;-0.1	-1.1	-2.4;0.3	0.3^d	0.0;0.6

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[1] Correspondence
Rafael Bello Corassa rafael.corassa@saude.gov.br