Low oral health literacy, dental caries, and school features are associated with reasons for seeking dental services among adolescents

Abstract

Objective: The present study aimed to investigate associations between reasons for seeking dental services, considering the last dental appointment of adolescents, and their educational features, socioeconomic and oral health status, and oral health literacy. Methods: A cross-sectional study was conducted with 746 adolescents aged 15–19 years in Campina Grande (Paraíba), Brazil. Parents/guardians answered a socioeconomic questionnaire. Adolescents answered a questionnaire on oral health and the Brazilian Rapid Estimate of Adult Literacy in Dentistry. Features of the school environment were investigated through cluster analysis, using type of school and school grade retention. Adolescents were clinically examined for dental caries diagnosis by two dentists (κ>0.80), using the Nyvad criteria, in school facilities. Data were submitted to robust multilevel logistic regression for complex samples (α=5%). Results: At the individual level, low maternal schooling (odds ratio [OR] 1.06; 95%CI 1.01–1.10), low oral health literacy (OR 0.99; 95%CI 0.98–0.99), and dental caries (OR 1.09; 95%CI 1.01-1.18) remained associated with the reasons for the last dental appointment. The school environment was also associated with the outcome (OR 1.07; 95%CI 1.00–1.15). Conclusion: Maternal schooling of less than eight years of study, low oral health literacy, cavitated caries, and unfavorable school environment were associated with seeking dental treatment.