# Association of Individual and Contextual Factors for Protection from Dental Caries

## TL;DR

This study finds that individual socioeconomic factors are more important than local factors in protecting young children from tooth decay, highlighting the need for equity-focused public health policies.

## Contribution

The study applies a salutogenic framework to identify individual-level socioeconomic factors linked to protection from dental caries in early childhood.

## Key findings

- 50.5% of five-year-old children in the sample were caries-free.
- Socioeconomic factors like income and material goods were strongly associated with being caries-free.
- Salutogenic approaches may improve oral health strategies beyond traditional risk models.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Early childhood dental caries remains a common and socially patterned public health problem.This study analyses protection from caries using a salutogenic, health-promotion framework.

Early childhood dental caries remains a common and socially patterned public health problem.

This study analyses protection from caries using a salutogenic, health-promotion framework.

Public health significance—Why is this work of significance to public health?
Individual socioeconomic factors were more strongly associated with caries-free status than contextual municipal factors.The findings reinforce equity as a central principle in childhood oral health promotion.

Individual socioeconomic factors were more strongly associated with caries-free status than contextual municipal factors.

The findings reinforce equity as a central principle in childhood oral health promotion.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Policies should prioritize reducing individual-level social inequalities to increase the number of caries-free children.Salutogenic approaches may strengthen oral health strategies beyond traditional risk-focused models.

Policies should prioritize reducing individual-level social inequalities to increase the number of caries-free children.

Salutogenic approaches may strengthen oral health strategies beyond traditional risk-focused models.

Background/Objectives: Dental caries remains a global challenge, with high prevalence among five-year-old children and regional inequalities. The aim of this study is to identify factors associated with protection from dental caries in five-year-old children, using Salutogenic Theory as a reference. Methods: Secondary data were analyzed from the Minas Gerais Oral Health Survey. Five-year-old children (n = 1193) were examined. Parents or guardians answered a questionnaire addressing individual variables and the use of dental services. Dependent variables were the absence of caries activity (ACA) and absence of caries experience (ACE), which were extracted from the decayed–missing–filled primary teeth (dmft) index. Logistic regression analysis was used to estimate odds ratios with 95% confidence intervals for each block of variables on the hierarchical levels. The Complex Samples module of the SPSS 19.0 program was used. Results: Five hundred ninety-five children (50.5%) in the overall sample were caries-free. In the final model, white skin color, monthly family income greater than R$1500, having more than six material goods, and not visiting a dentist in the previous year were associated with ACA and ACE. Conclusions: Factors related to socioeconomic conditions were associated with protection from dental caries in early childhood, supporting equity-based public policies to increase the number of children not affected by caries.