IADR Abstract Archives
Early Childhood Caries and Armed Conflict in Colombia: a Multilevel Analysis
Objectives: To assess the relationship between early childhood dental caries and internal armed conflict in Colombia using a multilevel analysis.
Methods: We used data from Colombian children 1-, 3- and 5-year-olds, who participated in the Fourth National Oral Health Survey in 2014 (ENSAB-IV), which were linked with information on two internal armed conflict indicators (presence and intensity) at municipality level using the latest report by the Resource Centre for Conflicts Analysis. Early childhood caries was determined through oral clinical examinations by calibrated dentists and the caries outcomes were the numbers of decayed teeth (dt), decayed, missing and filled teeth (dmft), untreated caries (dt>0), and caries experience (dmft>0). To test the association between caries outcomes and presence and intensity of conflict, two-level regression models were fitted, with children nested within municipalities, which were adjusted by well-known confounder variables.
Results: Overall, about 5,200 children were included in our analysis, who living in municipalities of 23 Departments plus the capital city of Colombia. Under 15% of municipalities included in the analysis experienced permanent conflict, and around 20% experienced high intensity conflict. Prevalence of caries experience was around 37%, while untreated caries was around 33.0%. After adjustment for all confounders, some caries outcomes remained associated with internal armed conflict indicators, suggesting that children living in municipalities with more presence and intensity of armed conflict had lower levels of untreated disease and caries experience.
Conclusions: There is an association between early childhood caries and internal armed conflict in Colombia. These findings highlight the role of social/political context on oral health. Thus, greater efforts are needed to control dental caries, especially in children.
Methods: We used data from Colombian children 1-, 3- and 5-year-olds, who participated in the Fourth National Oral Health Survey in 2014 (ENSAB-IV), which were linked with information on two internal armed conflict indicators (presence and intensity) at municipality level using the latest report by the Resource Centre for Conflicts Analysis. Early childhood caries was determined through oral clinical examinations by calibrated dentists and the caries outcomes were the numbers of decayed teeth (dt), decayed, missing and filled teeth (dmft), untreated caries (dt>0), and caries experience (dmft>0). To test the association between caries outcomes and presence and intensity of conflict, two-level regression models were fitted, with children nested within municipalities, which were adjusted by well-known confounder variables.
Results: Overall, about 5,200 children were included in our analysis, who living in municipalities of 23 Departments plus the capital city of Colombia. Under 15% of municipalities included in the analysis experienced permanent conflict, and around 20% experienced high intensity conflict. Prevalence of caries experience was around 37%, while untreated caries was around 33.0%. After adjustment for all confounders, some caries outcomes remained associated with internal armed conflict indicators, suggesting that children living in municipalities with more presence and intensity of armed conflict had lower levels of untreated disease and caries experience.
Conclusions: There is an association between early childhood caries and internal armed conflict in Colombia. These findings highlight the role of social/political context on oral health. Thus, greater efforts are needed to control dental caries, especially in children.