Structural determinants explain caries differences among preschool children in Chile’s Metropolitan Region

María José Monsalves*, Iris Espinoza, Patricia Moya, Josefina Aubert, Doris Durán, Oscar Arteaga, Jay S. Kaufman, Shrikant I. Bangdiwala

*Autor correspondiente de este trabajo

Producción científica: Contribución a una revistaArtículorevisión exhaustiva

1 Cita (Scopus)


Objective: To estimate the association between Social Determinants of Health (structural and intermediate) and caries indicators in Chile's Metropolitan Region preschool children. Methods: A multilevel cross-sectional study of Social Determinants of Health (SDH) and caries in children aged 1 to 6 years in Chile's Metropolitan Region was conducted in 2014–2015, with three levels: district, school and child. Caries were assessed by the dmft-index and the prevalence of untreated caries. The structural determinants analyzed were Community Human Development Index (CHDI), urban/rural location, school type, caregiver's education and family income. Poisson multilevel regression models were fit. Results: The sample size was 2,275 children from 40 schools in 13 districts. While the highest CHDI district had an untreated caries prevalence of 17.1% (12.3–22.7%), in the most disadvantaged district it was 53.9% (95% CI 46.0–61.6%). As family income increased, the probability of untreated caries prevalence decreased (PR = 0.9 95% CI 0.8–1.0). Rural districts had an average dmft-index of 7.3 (95% CI 7.2–7.4), while in urban districts, it was 4.4 (95% CI 4.3–4.5). Higher probabilities of untreated caries prevalence (PR = 3.0 95% CI 2.3–3.9) were observed in rural children. Greater probabilities of untreated caries prevalence (PR = 1.3 95% CI 1.1–1.6) and prevalence of caries experience (PR = 1.3 95% CI 1.1–1.5) were observed in children whose caregivers had a secondary educational level. Conclusions: A strong association was observed between the social determinants of health, specifically the structural ones, and the caries indicators studied in children of the Metropolitan Region of Chile. There were notable differences in caries between districts according to social advantage. Rurality and caregiver's education were the most consistent predictors.

Idioma originalInglés
Número de artículo136
PublicaciónBMC Oral Health
EstadoPublicada - 2023

Nota bibliográfica

Funding Information:
These results were developed within the FONIS SA13I20130 project, funded by the National Scientific and Technological Commission (CONICYT) of Chile, awarded to the School of Public Health, Universidad de Chile, in collaboration with the Faculty of Dentistry, Universidad Finis Terrae. Also, the support of CONICYT through the scholarships for postgraduate students who are part of this team is appreciated (CONICYT-PCHA/National Master/2016-22161352; CONICYT-PCHA/National Doctorate/2013-21130855 and ANID-PCHA/National Doctorate/2121-1603). Additionally, this article was support from the Vice-Rectory for Research and Doctoral Studies of the Universidad San Sebastián - project VRID_APC23/02

Publisher Copyright:
© 2023, The Author(s).

Áreas temáticas de ASJC Scopus

  • Odontología General


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