# Factors associated with the use of dental services by older people in the city of São Paulo, Brazil

## TL;DR

This study explores factors influencing older people's use of dental services in São Paulo, Brazil, over three time periods.

## Contribution

The study identifies changing associations between socioeconomic and demographic factors and dental service use among older adults from 2003 to 2015.

## Key findings

- Higher education remained consistently associated with dental visits across all years.
- Younger older adults (up to 74 years) were more likely to visit a dentist in 2008 and 2015.
- Income and health insurance became significant factors in 2008 and 2015, but not in 2003.

## Abstract

The aim of this study was to investigate the factors associated with the use of dental services by older people living in São Paulo, Brazil.

A cross-sectional study was conducted using secondary data analysis from sub-samples of older people in the Health Surveys in the City of São Paulo, Brazil (ISA-Capital), conducted in 2003, 2008 and 2015. Several variables were tested as factors associated with the outcome “dental visit in the last year”. Adjusted odds ratios were estimated from three binary logistic regression models, one for each year.

Sex was associated with the outcome only in 2008, with an adjusted odds ratio (ORa) of 0.65 (0.48-0.89) for females. Younger individuals (up to 74 years old) were more likely to have seen a dentist in 2008 and 2015. The variable years of study remained associated with the outcome throughout the entire period, revealing an ORa of 8.22 (4.23-15.99) for individuals with 12 or more years of study in 2003. This measure decreased to 1.77 (1.25-2.51) in 2015. Race remained an associated factor only in 2003 [ORa=1.50 (1.04-2.17)] in favor of self-declared white individuals. On the other hand, monthly income and health insurance were factors associated with the outcome only in 2008 and 2015.

The findings of this study point to critical issues that deserve the attention of managers, on the basis of intersectoral measures that contribute to active and healthy aging.

O estudo em questão teve como objetivo investigar os fatores associados ao uso dos serviços odontológicos pelas pessoas idosas residentes no município de São Paulo, Brasil.

Para tanto, foi conduzido um estudo transversal com análise de dados secundários provenientes das subamostras de pessoas idosas dos Inquéritos de Saúde no Município de São Paulo/Brasil (ISA-Capital), realizados em 2003, 2008 e 2015. Diversas variáveis foram testadas como fatores associados ao desfecho “consulta odontológica no último ano”. Razões de Chance ajustadas foram estimadas a partir de três modelos de regressão logística binária, um para cada ano.

O sexo se associou ao desfecho apenas em 2008, com Razão de Chance ajustada (RCa) de 0,65 (0,48-0,89) para os indivíduos do sexo feminino. Os indivíduos mais jovens (até 74 anos) tiveram mais chance de terem se consultado com o dentista em 2008 e 2015. A variável anos de estudo permaneceu associada ao desfecho nos três anos, revelando uma Razão de Chance ajustada de 8,22 (4,23-15,99) para os indivíduos com 12 anos ou mais de estudo em 2003. Essa medida diminuiu para 1,77 (1,25-2,51) em 2015. Cor/raça se manteve como fator associado somente em 2003 [RCa=1,50 (1,04-2,17)], a favor dos indivíduos autodeclarados brancos. Por outro lado, renda mensal e plano de saúde se mostraram fatores associados ao desfecho somente em 2008 e 2015.

Os achados desse estudo apontam nós críticos que merecem atenção por parte dos gestores, a partir de ações intersetoriais que contribuam para um envelhecimento ativo e saudável.