Caries-related social determinants in the early childhood in Anapoima, Cundinamarca

Objectives:
Within the Alliance-for-a-Cavity-Free-Future Colombian chapter, Universidad El Bosque is developing a project in Anapoima, Cundinamarca to achieve caries free new generations by 2026. Understanding caries as a complex disease, with biological and social components, this study aimed at identifying and analyzing the association between caries and social determinants in the early childhood population (0 to 6-yr. olds)
Methods: With Ethical-Board approval and parents/institutions signed informed-consent forms, two characterization instruments were designed and applied in the children care institutions and families. The institutions and families’ instruments assessed social-economic conditions and general/oral hygiene practices. Caries examinations were performed with ICCMS^TM criteria by trained students, including equivalence with WHO criteria.
The collected information was analyzed using the health social-determinant model, defining institutions categories into: infrastructure and sanitation characteristics for health-practices, and families’ categories into: infrastructure, general-living characteristics and hygiene practices (surrounding). The findings were grouped in two with/without any caries lesion. Statistical analysis of association between social determinants and child caries condition (individual) was explored with c² tests.
Results: Six institutions (5 urban/1 rural) and 120 families were characterized. Institutions: Accomplishment of regulatory norms for hygiene practices and mandatory spaces were observed. However, some failed in permanent availability of hygiene elements and in the frequency of the practices due to logistical and time problems.
Caries experience (dmf-t) was 33.3% (WHO) and 46.7% (ICCMS^TM).
Families: Nuclear families (61.7%); parental care (81.7%); infrastructure and hygiene elements (100%); tap water (92.5%); toothbrush holders (50.8%).
Associations were found between caries and: oral problems, caretakers, appointment reason, public services and toothbrush’ placement (p<0.05)
Conclusions: The individual caries situation was associated with some social determinants. The surrounding component, the familiar composition and housing/environmental characteristics contribute to the best care and better individual conditions against national caries correspondent figures.