Contextual and Individual Social Determinants of OHRQoL in Middle-Aged Adults

Objectives: To estimate the prevalence of oral health-related quality of life (OHRQoL) in middle-aged Brazilian adults and to assess the association between contextual and individual social determinants with OHRQoL.
Methods: Data on Brazilian adults aged 35–44 years from the 2010 Brazilian Oral Health Survey (SBBrasil, 2010) were analysed. OHRQoL was assessed using the Oral Impacts on Daily Performance (OIDP). The contextual socioeconomic characteristics assessed were social development as measured by the Human Development Index (HDI), income inequality measured by the Gini index and water fluoridation. Individual socioeconomic data included family income, years of schooling and number of goods. Co-variates considered in the analysis were age, sex, ethnicity/skin colour and clinical oral measures (DMFT index, number of decayed teeth, number of missing teeth and periodontal disease). Multilevel Poisson regression analysis was carried out for 4,594 adults with completed data sets to estimate prevalence ratios and 95% confidence intervals (95%CI).
Results: The total prevalence of at least one impact on OHRQoL (OIDP≥1) was 46.9%. Eating and cleaning teeth were the most reported daily activities influenced by oral conditions. In the non-adjusted bivariate analysis, having a low HDI in 1991 was a contextual variable associated with OIDP≥1. Low family income, low schooling and a low number of goods were also associated with OIDP≥1. Demographic variables including sex and brown and black skin colour were significantly associated with OIDP≥1. All clinical oral variables were also associated with OIDP≥1. The worst the oral clinical condition, the higher the higher the prevalence of OIDP≥1. In the adjusted multivariable analysis, contextual (a lower HDI in 1991) and individual social characteristics (lower family income and lower schooling) remained associated with OIDP≥1. Sex (females) and clinical oral measures also remained associated with OIDP≥1.
Conclusions: Contextual and individual socioeconomic conditions were determinants related to OHRQoL in Brazilian middle-aged adults.