Socio-economic factors associated with periodontal conditions among Brazilian elderly people - Multilevel analysis of the SBSP-15 study

The objective of the present study was to analyze individual, contextual and social support factors associated with periodontal condition among 2332 dentate elderly Brazilian participants from the São Paulo State Oral Health Survey 2015 (SBSP-15). Methods: This study used the database compiled by the SBSP-15, conducted from January to December in 2015. The associations were made by relative risk (RR), with Multilevel Poisson Regressions, among individual, contextual and social support variables, and had periodontal diseases as outcomes. Results: The mean age of elders was 70.13 years (SD 5.67). The risk factors for all outcomes of periodontal diseases were male gender and self-perceived color of non-white skin. Regarding social support, feeling unhappy was a risk factor for the presence of shallow periodontal pockets (3–5mm) RR 1.43(CI 95% 1.10–1.86). The coverage of the Family Health Strategy (FHS) was a protective factor for gingival bleeding RR = 0.7(CI 95% 0.44–0.99) and calculus RR = 0.75(CI 95% 0.60–0.95), and a risk factor for the number of lost sextants (sextants with only one tooth or without any teeth) RR = 1.12(CI 95% 1.00–1.28). Living in municipalities with more than 90% fluoridation coverage was a protective factor for the number of lost sextants RR = 0.89(CI 95% 0.78–0.99). Conclusions: The study showed evidence that individual (gender and self-perceived skin color), contextual (coverage of the family health strategy and water fluoridation) and social support factors (feeling unhappy) are associated with the clinical outcomes of periodontal diseases in Brazilian elders. This reinforces the need for transdisciplinary actions in the FHS, stimulating work together and intersectoral collaboration between FHS and NASF (Family Health Support Center).