Tooth loss and associated factors in adolescents: a Brazilian population-based oral health survey

OBJECTIVE: To estimate tooth loss among adolescents and its factors associated. METHODS: Data from 16,833 participants of the Brazilian Oral Health Survey 2002-2003 were analyzed. The outcome studied was tooth loss of at least one tooth. Independent variables included geographical localization, gender, skin color, per capita income, education gap, dental service utilization and fluoridated water supply at the local level. Crude and adjusted prevalence ratios were estimated using Poisson regression for each Brazilian macroregion and nationwide. RESULTS: The prevalence of at least one tooth loss was 38.9% (95% CI 38.2%; 39.7%). Adolescents living in localities with non-fluoridated water supply were 40% more likely to have tooth loss compared with those living in areas with fl uoridated water supply. There was seen a strong association (p<0.01) between non-fl uoridated water supply and tooth loss prevalence in the Northeast. In other Brazilian regions this association was confounded for distal variables, mainly socioeconomic variables, reinforcing regional inequalities. CONCLUSIONS: High prevalence of tooth loss among Brazilian adolescents shows a need for targeted dental actions including prevention at earlier ages, treatment of affected teeth and universal access to fl uoridated water.